Alcohol-Related Liver Disease (ALD)

About - What is Alcohol-Related Liver Disease (ALD)?

Alcohol-Related Liver Disease (ALD) refers to a spectrum of liver conditions that result from excessive and prolonged consumption of alcohol. It includes three main stages: fatty liver (steatosis), alcoholic hepatitis (inflammation), and alcoholic cirrhosis (advanced scarring of the liver). While early stages of ALD may be reversible with lifestyle changes, continued alcohol use can lead to irreversible damage, serious complications, and even liver failure. At Royal Care Hospital, our expert team provides integrated and compassionate care to help patients recover liver function and improve overall health.

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Signs and Symptoms - What are the symptoms of ALD?

The symptoms of ALD vary depending on the stage and severity of liver damage. In the initial phase, many patients may not exhibit symptoms. As the disease progresses, the following signs may become apparent:

Fatigue and weakness

Due to reduced liver efficiency, patients often feel tired and lack energy even with adequate rest.

Loss of appetite and weight loss

Alcohol affects nutrient absorption and digestion, leading to diminished appetite and unexplained weight reduction.

Jaundice

Yellowing of the skin and eyes occurs when the liver fails to break down bilirubin properly. This is a hallmark of more advanced liver injury.

Abdominal pain and swelling

Inflammation or fluid buildup in the liver or abdominal cavity can cause discomfort and visible swelling.

Nausea and vomiting

These are common in patients experiencing alcoholic hepatitis due to liver inflammation.

Confusion or drowsiness (hepatic encephalopathy)

As toxins accumulate in the bloodstream from a poorly functioning liver, they can affect brain function, leading to confusion, forgetfulness, or in severe cases, coma.

Easy bruising or bleeding

A damaged liver produces fewer clotting factors, increasing the risk of unexplained bruises and prolonged bleeding.

Diagnosis / Investigations

Liver Function Tests (LFTs)

Blood tests that evaluate enzyme levels, bilirubin, albumin, and clotting function to assess liver health.

Ultrasound and Fibroscan

Imaging tools that detect fatty changes, fibrosis, or cirrhosis by measuring liver stiffness.

CT or MRI Scanning

Provides detailed visualization of liver architecture, useful in detecting masses or complications like fluid accumulation.

Liver Biopsy

In select cases, a tissue sample is taken to confirm the diagnosis and stage of liver disease.

Alcohol Use Assessment

A detailed evaluation of the patient’s alcohol consumption history to understand the severity of alcohol dependence.

Psychological Screening

Assessment for co-occurring mental health or substance use disorders that may need concurrent treatment.

Types of ALD

ALD encompasses three progressive stages:

Alcoholic Fatty Liver Disease: The earliest and reversible stage, where fat builds up in liver cells. Often asymptomatic and discovered incidentally.
Alcoholic Hepatitis: An inflammatory condition where continued alcohol use causes the liver to become swollen and tender. It may cause jaundice and can be life-threatening.
Alcoholic Cirrhosis: The most severe stage, involving irreversible scarring of liver tissue. It impairs liver function and leads to serious complications.

Causes

The primary cause of ALD is chronic and heavy alcohol consumption over a prolonged period. The risk of developing ALD increases with:

Quantity and duration of alcohol intake: Drinking beyond recommended limits regularly can significantly damage the liver.
Genetic factors: Some individuals are genetically predisposed to liver damage due to alcohol.
Poor nutrition: Alcohol impairs nutrient absorption, which can further compromise liver health.
Gender: Women are generally more susceptible to ALD due to differences in alcohol metabolism.
Co-existing liver conditions: Having viral hepatitis or fatty liver disease can accelerate alcohol-related liver damage.

Treatments & Procedures

Alcohol cessation programs Nutritional therapy Liver-protective medications Management of complications Psychological support and addiction counseling

Alcohol cessation programs

Quitting alcohol is the single most important step.

Nutritional therapy

Tailored diet plans to correct deficiencies, improve liver health, and support overall recovery.

Liver-protective medications

Specific drugs to reduce inflammation and improve liver function are prescribed based on disease severity.

Management of complications

Treatment of ascites, bleeding, encephalopathy, and infections with medications or procedures.

Psychological support and addiction counseling

Dedicated counselors and psychiatrists work with patients to address underlying dependency and ensure long-term sobriety.

Prevention and Awareness

Medical Gastroenterology team

Frequently Asked Questions

1. Is ALD reversible?

Yes, early-stage ALD, such as fatty liver or mild hepatitis, is reversible with complete abstinence and supportive care.

2. What happens if I continue to drink with ALD?

Continued alcohol use will worsen liver damage, increase complications, and can ultimately lead to liver failure or death.

3. Can I undergo a liver transplant for ALD?

Yes, but only after meeting specific criteria including a documented period of abstinence and comprehensive evaluation.