Alcoholic Liver Disease
December 23, 2008 by rainier
Drinking too much alcohol can lead to three types of liver conditions – fatty liver, hepatitis, and cirrhosis. Any, or all, of these conditions can occur at the same time in the same person.
Fatty liver
Fatty liver is marked by a build-up of fat cells in the liver. Usually there are no symptoms, although the liver may be enlarged and you may experience discomfort in your upper abdomen. Fatty liver occurs in almost all people who drink heavily. The condition will improve after you stop drinking.
Alcoholic hepatitis
Hepatitis means inflammation of the liver. The inflammation can range from mild to severe.
Mild hepatitis may not cause any symptoms. The only indication of inflammation may be an abnormal level of liver enzymes in the blood which can be detected by a blood test. However, in some cases the hepatitis becomes persistent (chronic), which can gradually damage the liver and eventually cause cirrhosis.
A more severe hepatitis tends to cause symptoms such as feeling sick, jaundice (yellowing of the skin caused by a high level of bilirubin – a chemical normally metabolised in the liver), generally feeling unwell, and sometimes pain over the liver.
A very severe bout of alcoholic hepatitis can quickly lead to liver failure. This can cause deep jaundice, blood clotting problems, confusion, coma, bleeding into the guts, and is often fatal.
Alcoholic cirrhosis
Cirrhosis is a condition where normal liver tissue is replaced by scar tissue (fibrosis). The scarring tends to be a gradual process. The scar tissue affects the normal structure and regrowth of liver cells. Liver cells become damaged and die as scar tissue gradually develops. So, the liver gradually loses its ability to function well. The scar tissue can also affect the blood flow through the liver which can cause ‘back pressure’ in the blood vessels which bring blood to the liver.
About 1 in 10 heavy drinkers will eventually develop cirrhosis. It tends to occur after 10 or more years of heavy drinking. Note: cirrhosis can develop in people who have never had alcoholic hepatitis.
Cirrhosis can happen from many causes other than alcohol. For example, persistent viral hepatitis and some hereditary and metabolic diseases. If you have another persistent liver disease, and drink heavily, you are likely to increase your risk of developing cirrhosis.
Cirrhosis can lead to end-stage liver disease (’liver failure’). However, in the early stages of the condition, often there are no symptoms. You can ‘get by’ with a reduced number of working liver cells. But, as more and more liver cells die, and more and more scar tissue builds up, symptoms start to appear. The eventual symptoms and complications are similar to a severe episode of hepatitis (listed above). However, unlike a bout of severe hepatitis, the symptoms and complications tend to develop slowly.
Many heavy drinkers will progress from fatty liver to alcoholic hepatitis and finally to alcoholic cirrhosis, though the progression may vary from patient to patient. The risk of developing cirrhosis is particularly high for people who drink heavily and have another chronic liver disease such as viral hepatitis C.
