Alcohol-Related Liver Disease

What is Alcohol-Related Liver Disease?

In the human body, one of the most complex organs with the exception of the brain is the liver.

The liver is quite resistant and has the ability to regenerate itself, however, a certain amount of hepatocytes (liver cells) die every time the liver filters alcohol.

Therefore over the years, the excessive use of alcohol can decrease the liver’s capacity to regenerate causing it to undergo permanent damage.

Alcohol-related Liver Disease (ARLD) is a common, but avoidable, disease.

What are the Affected Populations of Fatty Liver Disease?

Even though as the name suggests, ARLD is more prevalent in the population who drink heavily or binge drink, there are certain factors which make an individual more prone to ARLD,

Gender: It can affect both men and women who have the habit of increased alcohol misuse. However, the dependence and abuse of alcohol are higher in white males than in women, even if women have the likelihood of developing ALD based on the same consumption more promptly than men.
Genetics: Populations more likely to be affected are the ones having a family history of ARLD because genetics play a major role in impelling how the body processes alcohol.
Obesity: Another contributing factor to fatty liver disease is obesity and the cumulative effect of obesity and alcohol is worse. Similarly, even though black men do not have the highest incidence rates of alcoholism, but they are more likely to have a higher rate of cirrhosis.
Malnutrition: The deficiency of nutrients greatly contributes to ALRD as most of the people who misuse alcohol are malnourished, owing to lack of appetite, nausea or the reduced ability of the body from disintegrating and absorbing nutrients by increased alcohol consumption.
Race and Ethnicity: A person’s racial and ethnic heritage greatly determine the risk of liver disease, such as African-American and Hispanic males are more likely to develop alcoholic cirrhosis than Caucasian males.
Disease: particularly Hepatitis C: The cumulative effect of alcohol and chronic viral hepatitis C on the liver causes a more severe form of the disease than either of them individually.

How does Alcohol-Related Liver Disease Affect the Body?

The most commonly anatomic structure being affected is the liver itself, from years of alcohol abuse, which causes the liver to undergo inflammation, swelling and ultimately cirrhosis.

Causes of Alcohol-Related Liver Disease

As the name suggests, ARLD is caused by drinking excessive alcohol. However, two ways by which ARLD is caused are,

Consuming a large amount of alcohol (binge drinking) in a short span of time which results either in fatty liver disease or, alcoholic hepatitis less frequently.
Consuming alcohol more than the suggested limits over many years which results in the severe types of ARLD owing to hepatitis and cirrhosis of the liver.

Signs & Symptoms of Alcohol-Related Liver Disease

Even though the signs and symptoms of ARLD are not that evident until the disease progresses to a certain extent, however few of the common symptoms include:

Abdominal swelling
Tiredness
Loss of desire to eat
Weight loss

Advanced progression of the disease causes the following symptoms,

Yellow appearance of skin and conjunctiva (jaundice)
Accumulation of fluid in the lower extremities (edema)
High fever
Accumulation of fluid in the abdomen (ascites)
Pruritus caused by the accumulation of bile
Hair loss
Clubbing of fingers
Weight loss
Red blotchy palms
Fatigue
Issues in memory, insomnia and moodiness owing to the accumulation of contaminants in the brain.
Internal bleeding causing the passing of black, tarry stool and blood vomiting
Increased likelihood of bleeding and bruising, causing frequent nosebleeds and gums bleeding.
Resistance to alcohol and drugs owing to the lack of the liver’s ability to process them

Types & Stages of Alcohol-Related Liver Disease

The various types of ARLD are dependent on the stage of the disease, which are:

Alcoholic fatty liver disease: This is the initial and most common stage of ARLD which is also called steatosis because this is the stage when the fat starts to store around the liver cells making it more difficult for the liver to work. It is not characterized by any specific symptoms; however, it can cause hepatomegaly causing upper abdominal pain on the right side. This stage of ARLD can be cured decreasing the alcohol consumption.
Acute alcoholic hepatitis: In the second stage, the liver undergoes inflammation (swelling) and destruction of cells owing to alcohol abuse. Alcoholic hepatitis can be mild or severe, with the mild form lasting for years and ultimately causing progressive liver damage. The cessation of drinking can cause damage to be reversed over time. The severe form of alcoholic hepatitis can rapidly result in life-threatening complications, such as liver failure.
Alcoholic cirrhosis: This is the gravest type of alcohol-related liver disease. Alcohol abuse leads to the normal liver tissue being replaced with nonliving scar tissue, and the damage is irreversible. Even though the first stage of liver scarring is, Fibrosis, the cirrhosis of the liver takes place when the scar tissue accumulates and occupies most of the liver. Even though cirrhosis can be treated, but it is not the case for all patients.

How is ARLD diagnosed?

ARLD is mostly diagnosed by,

History: Diagnosis can be made on inquiring about alcohol consumption, and it is essential to be completely honest so as to escape further avoidable tests.
Blood tests: Liver function tests are conducted which even if appearing normal at different stages of the liver disease can detect low levels of serum albumin, suggesting liver impairment. Moreover, a blood test can also indicate signs of abnormal blood clotting.
Further testing is required if symptoms or blood tests suggest an advanced form of ARLD,
Imaging tests that include an ultrasound, CT scan and MRI for detailed images of the liver.
Liver biopsy: conducted by specialist doctors to determine the extent of liver scarring and the cause of damage.
Endoscopy: An endoscopy is done to determine swollen veins (varices), which are indicative of cirrhosis of the liver.