Stages of Alcoholic Liver Disease - How These are Treated?

Alcoholic Liver Disease (ALD) is a medical condition that develops in the liver due to over-exploitation of alcohol. This condition develops after years of excessive drinking of alcohol.

This condition does not develop in all heavy drinkers. The reason could be their genetic influence. 

Men between 40 to 50 years of age are more prone to develop liver disease from alcohol. However, women can also develop the alcoholic liver disease after less alcohol exposure.

There are three different stages of Alcoholic Liver Disease, which are stated below:

1. Alcoholic Fatty liver disease
   Fatty liver disease due to alcohol develops when there is an upsurge of extreme fat in the liver. The fat gets stored in the form of tiny droplets in the liver cells. This accumulation of fat causes hepatomegaly, the expansion of the liver.
   
   Hepatomegaly could be the first sign of alcoholic liver disease in many patients. 20% of heavy drinkers face this stage in their early binge drinking years. This stage of alcoholic liver disease can be reversed if alcohol consumption is stopped. However, if the patient continues to drink, it might lead to inflammation of the liver, i.e. Alcoholic Hepatitis.
   
   Symptoms of Alcoholic Fatty Liver Disease:
   1. Abdominal tenderness.
   2. Fever, often low grade.
   3. Fatigue and weakness.
   4. Loss of appetite
   5. Nausea and vomiting
       
2. Alcoholic Hepatitis 
   
   Alcoholic hepatitis is the middle stage of alcoholic liver disease. It accompanies inflammation of the liver. As a result, the liver cells start to die, i.e. they go through degeneration. 
   
   This stage of alcoholic liver disease occurs when there is heavy consumption of alcohol for a long period. It might also occur due to binge drinking over a shorter period. This stage of alcoholthe ic liver disease lasts for a few years. 
   
   In many patients, alcohol hepatitis might be the first sign of an alcoholic liver disease. One of the major symptoms of this stage of alcoholic liver disease is the yellowing of skin and eyes, commonly referred to as Jaundice. 
   
   Undoubtedly, alcoholic hepatitis is a serious sign of liver damage. But it could be reversed if the usage of alcohol is completely blocked and the patient is given the necessary treatment. But if they continue to drink, it might result in Fibrosis.
   
    Symptoms of Alcoholic Hepatitis:
   1. Feeling sick
   2. Weight loss
   3. Loss of appetite
   4. Yellowing of skin and eyes (Jaundice)
   5. Swelling in the ankles and tummy
   6. Confusion or drowsiness
   7. Blood in vomit or stools
       
3. Fibrosis
   Fibrosis is the build-up of extracellular protein in the liver.
   
   It is reversible if detected earlier. However, fibrosis becomes irreversible in its last stage and might result in a more severe form of alcoholic liver disease known as liver cirrhosis. 
   
   Symptoms of Fibrosis:
   1. Jaundice 
   2. Nausea
   3. Appetite loss
   4. Difficulty in thinking
   5. Weakness
   6. Unexplained weight loss
   7. Fluid buildup in the legs or stomach 
       
4. Liver Cirrhosis
   Liver cirrhosis is the last stage of alcoholic liver disease. This stage of liver disease from alcohol causes scarring in the liver. Consequently, all the healthy tissues in the liver get replaced with scar tissues.
   ​​​​​​
   Further worsening of this stage leads to complete liver failure. Liver cirrhosis can not be cured by stopping alcohol consumption. This stage of liver disease from alcohol is completely irreversible. However, life expectancy might be increased if one stops consuming alcohol. 
   
   Symptoms of Liver Cirrhosis:
   1. Fatigue
   2. Easily bleeding or bruising
   3. Loss of appetite
   4. Nausea
   5. Swollen ankles and legs (oedema) 
   6. Weight loss
   7. Itchy skin
   8. Yellowing of skin and eyes (Jaundice)

Parameters	Fatty Liver Disease	Alcoholic Hepatitis	Liver Cirrhosis
Stage number	First	Second	Last (End stage)
Reversibility	Reversible	Reversible	Irreversible
Major symptoms	Liver enlargement  Fever, often low grade Fatigue and weakness Loss of appetite Nausea and vomiting	Jaundice Feeling sick. Weight loss. Loss of appetite. Yellowing of skin and eyes (Jaundice) Swelling in the ankles and tummy. Confusion or drowsiness. Blood in vomit or stools	Drowsiness Fatigue. Easily bleeding or bruising. Loss of appetite. Nausea. Swollen ankles and legs (oedema)  Weight loss. Itchy skin yellowing of skin and eyes (Jaundice)
Caused by	Accumulated fat in liver cells.	Inflammation of the liver. Resultantly, liver cells start dying.	Replacement of healthy liver tissues with scarred tissues.

There is a variety of diagnostic measures adopted to detect Alcoholic Liver disease. Some of them are given below:

1. Liver Biopsy : With the help of a needle, a sample of liver cells is taken out. These samples detect the stage of the alcoholic disease. 
2. Blood Test : Referred to as a Liver Function Test, a blood test is performed to detect if there is any liver disease. 
3. Endoscopy 
4. CT Scan
5. MRI
6. Ultrasound 

Alcoholic liver disease is treatable in the following ways: 

1. Lifestyle changes
   Some lifestyle changes, if taken in action, can reverse alcoholic liver disease. These are as follows:
   1. The first thing one should consider is to stop consuming alcohol. This will pave the way to reverse alcoholic liver disease. 
   2. After that, pay attention to salt intake. Eat foods low in salt. The lower, the better. 
   3. Consult a doctor if you take any kind of medication. Ask him/her if it might affect your liver. 
   4. There are vaccines available for certain liver diseases. It is advisable to take vaccines against Hepatitis A and hepatitis B, and pneumococcal pneumonia. 
       
2. Abstinence
   Abstinence is the avoidance of alcohol. Stopping alcohol consumption should be the first and foremost treatment to reverse Alcoholic Liver Disease. 
   
   If it’s the first stage of alcoholic liver disease, i.e. fatty liver disease, avoiding alcohol for a few weeks or years can help the affected liver to get back to a healthy one.
   
   In the case of alcoholic hepatitis, stopping alcohol permanently is the only way to help your liver get back to a normal healthy state. 
   
   Leaving alcohol isn’t easy for binge drinkers. But this problem can be minimised under medical guidance. Consulting the doctor and enrolling in quitlines would help in abstinence.
    
3. Nutrition Supplementation
   Many alcoholic liver disease patients are likely to develop protein-calorie malnutrition. Therefore, they are suggested to take nutritional therapies. These therapies might improve their condition. 
    
4. Liver Transplant
   If alcoholic liver disease has reached its third and the end-stage, i.e. liver cirrhosis, a liver transplant may be the only treatment option.

To prevent alcoholic liver disease, one must:

1. Exercise daily 
2. Stop being overweight
3. Not consume alcohol
4. Eat a balanced diet with less salt
5. Avoid junk foods and fried foods
6. Take only prescribed medicines

Alcoholic liver disease (ALD) is a serious liver disease from alcohol. It has three main stages: fatty liver disease, alcoholic hepatitis, and liver cirrhosis. The most critical and irreversible stage is liver cirrhosis. If the patient isn’t given the right treatment for liver cirrhosis, it might lead to death in a few weeks or years. 

Alcohol Liver Disease patients must stop consuming alcohol as it only worsens the condition. If you or anyone you know is going through ALD, you can take expert advice from our team of experienced doctors at HexaHealth. Contact HexaHealth for a FREE consultation call today!