There are three types of liver disease caused by alcoholism: alcoholic cirrhosis, alcoholic hepatitis, and steatosis (fatty liver). All are very serious. We’ll discuss them each in turn.
Steatosis is the accumulation of fat within the liver cells. A similar condition can be seen in some obese people or diabetics who do not consume alcohol. The condition is reversible if the person stops drinking, but if not, it can lead to inflammation and scarring of the liver and cirrhosis. Alcoholic cirrhosis, as we’ll discuss later, can be deadly.
There are several types of hepatitis, and alcoholic hepatitis is just one of them. It is usually seen in chronic drinkers, although acute hepatitis may be seen in a drinker who has just consumed a large amount of alcohol.
There are a number of symptoms of alcoholic hepatitis. Patients usually have jaundice, characterized by a yellowish tint to the skin and the whites of the eyes. There may be an accumulation of fluid in the abdomen (ascites), neurological dysfunction which causes confusion (hepatic encephalopathy), and abnormal blood clotting. The patient may even be in a coma. Alcoholic hepatitis can lead to alcoholic cirrhosis.
While other things besides alcoholism can cause cirrhosis, chronic drinking is the most common cause. Cirrhosis develops in about 15% of those who drink heavily for more than one decade.
Cirrhosis is basically scarring of the liver, which prevents it from functioning normally. The liver is supposed to filter toxins from the body, and when it does not function properly, these toxins build up and become harmful. They accumulate in both the blood and the brain. The blood carries them to other organs, and they affect the functioning of the brain, causing confusion and neurological dysfunction.
Many of the symptoms of cirrhosis are similar to those of hepatitis. There may also be bleeding from varicose veins in the esophagus or elsewhere in the digestive tract. The immune system may not function properly, so patients are susceptible to infections. The blood supply to the kidneys may be restricted, which can lead to kidney failure. Other organs, such as the spleen and the pancreas, may be compromised. If untreated, alcoholic cirrhosis can be deadly.
The first step in treating any alcoholic liver disease is to stop drinking. Both steatosis and alcoholic hepatitis are reversible if the patient stops drinking and receives treatment; however, cirrhosis is not. At least if the patient stops drinking, however, cirrhosis will not advance any further.
An alcoholic may need to be admitted to a medical unit to detox. Following that, inpatient rehabilitation treatment may be needed, followed by outpatient follow up care. It is imperative to treat the alcoholism, because if the patient does not stop drinking, they will die from cirrhosis.
Medical treatment may also be necessary to treat the various complications of cirrhosis. For instance, for edema and ascites, a low sodium diet or diuretics may be recommended or prescribed. Protein causes toxins to build up in the digestive tract, so a low protein diet may be recommended, as well. Medication can also be given to help prevent the buildup of ammonia and other natural toxins in the digestive tract. Any infection will be treated with antibiotics. Certain medications should be avoided, as they will be difficult for the liver to process. Following all treatment recommendations is critical.
If the condition is severe enough, or if complications do not respond to medical treatment, a liver transplant may be necessary. About 80-90% of patients survive a liver transplant, providing a donor can be found in time. However, many die while waiting for a donor.