Stages of Alcoholic Liver Disease - How These are Treated?

Alcohol is an excessively consumed drink in many corners of the world, especially in western countries. However, every year, 3 million people die due to the consumption of alcohol. High amounts of alcohol consumption can severely damage the liver and cause liver disease from alcohol. Liver disease from alcohol is also known as Alcoholic Liver Disease (ALD) or Alcohol-Related Liver Disease (ARLD).   

If not treated earlier, alcoholic liver disease may lead to life-threatening issues. This article will discuss the different stages of alcoholic liver disease and how those stages of alcoholic liver disease can be treated. Keep reading to know more about it. 

What is Alcoholic Liver Disease?

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.

Different Stages of Alcoholic Liver Disease

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)

Fatty Liver Disease

Alcoholic Hepatitis Liver Cirrhosis

Stage number 

First   Second Last (End stage)


Reversible  Reversible  Irreversible
Major symptoms
  1. Liver enlargement 
  2. Fever, often low grade
  3. Fatigue and weakness
  4. Loss of appetite
  5. Nausea and vomiting
  1. Jaundice
  2. Feeling sick.
  3. Weight loss.
  4. Loss of appetite.
  5. Yellowing of skin and eyes (Jaundice)
  6. Swelling in the ankles and tummy.
  7. Confusion or drowsiness.
  8. Blood in vomit or stools
  1. Drowsiness
  2. Fatigue.
  3. Easily bleeding or bruising.
  4. Loss of appetite.
  5. Nausea.
  6. Swollen ankles and legs (oedema) 
  7. Weight loss.
  8. Itchy skin
  9. 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.

Diagnosis of Alcoholic Liver Disease

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 

How is Alcoholic Liver Disease Treated?

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.

Preventive measures for ARLD

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! 

Frequently Asked Questions

What are the three stages of alcoholic liver disease?

The three stages of alcoholic liver disease are as follows: 

  1. Fatty liver disease : in which there's fat accumulation in the liver cells. Thus, it leads to the enlargement of the liver. 
  2. Alcohol hepatitis : in which liver cells die due to inflammation. This stage of alcoholic liver disease is mostly accompanied by jaundice. 
  3. Liver cirrhosis : in which scar tissues replace healthy liver tissues. It is the last stage of alcoholic liver disease and leads to liver failure. 

How is alcohol liver disease treated?

Alcohol liver disease can be treated in the following ways: 

  1. Abstinence: complete stoppage of alcohol for a few years or whole life. 
  2. Malnutrition treatment: taking necessary protein and vitamins for fast recovery from alcoholic liver disease. 
  3. Liver transplant: replacing the damaged liver with a new healthy one. Liver transplants are recommended for patients with liver cirrhosis or complete liver failure.

Which stages of alcoholic liver disease are reversible?

The first two stages of alcoholic liver disease are reversible. These are fatty liver disease and alcoholic hepatitis.

What is the treatment for Stage 1 cirrhosis of the liver?

A few treatments for Stage 1 cirrhosis of the liver are as follows: 

Stopping the consumption of alcohol throughout your life.

Taking the prescribed medications on time.

Undergoing nutritional therapies, if required.

What are the three stages of liver damage in order?

The three stages of liver damage are as follows: 

  1. Fatty liver disease
  2. Alcohol hepatitis
  3. Liver cirrhosis

Is stage 3 cirrhosis a terminal?

Stage 3 cirrhosis is usually irreversible and might lead to death. Still, life expectancy can be increased for a few years with the help of a successful liver transplant.

How fast does alcoholic liver disease progress?

Alcohol liver disease may take up to 10 years to progress from Fatty Liver Disease to Alcohol Hepatitis and eventually to the last stage, i.e. Liver Cirrhosis.

How long can a person live with alcoholic liver cirrhosis?

A person can live up to 6 to 12 years with alcoholic liver cirrhosis if given the right medical care.

Which stage of liver damage is not reversible?

The third stage of alcoholic liver disease, referred to as Liver cirrhosis, is irreversible. At this stage, the liver's healthy tissues get replaced with scarred ones. Subsequently, it is not reversible.

Does cirrhosis of the liver means death?

Liver Cirrhosis can be slowed down with the right medical treatment. A patient with liver cirrhosis can live up to twelve years. In the meanwhile, liver transplants can be performed to increase life expectancy. Thus, cirrhosis of the liver does not always mean death.

How long can you live with Stage 4 cirrhosis?

In stage 4 liver cirrhosis, your liver stops working, and it can't heal. Therefore, most of the patients with stage 4 liver cirrhosis live only for up to one year. However, a liver transplant might increase your life expectancy.

What are the last stages of liver failure?

The last stage of liver failure includes liver cirrhosis. The main symptoms are as follows: 

  1. Vomiting blood
  2. Itchy skin 
  3. Confusion
  4. Swollen stomach and ankles
  5. Blood in stools
  6. Easily bleeding 
  7. Loss of appetite
  8. Weight loss
  9. Excess fatigue

What does end-stage cirrhosis look like?

Symptoms of end-stage liver cirrhosis are

  1. Easy bleeding
  2. Confusion or drowsiness 
  3. Jaundice (yellowing of eyes and skin)
  4. Blood in vomit and urine
  5. Unexplained weight loss and appetite loss

What are the first signs of liver damage from alcohol?

The first signs of liver damage from alcohol are : 

  1. Enlargement of the liver
  2. Fatigue
  3. Jaundice (yellowing of eyes and skin)
  4. Weight loss
  5. Loss of appetite
  6. Scars in the liver
  7. Nausea 
  8. Vomiting

How long does it take for an alcoholic liver to fail?

An alcoholic liver might take 10 to 30 years to fail. However, under six years of excess alcohol consumption, complications might show up. It depends on person to person.

How long can you live with alcohol liver disease?

You can live up to 6 to 12 years with alcohol liver disease if given the right medical treatment. You might also be suggested a liver transplant to increase your life expectancy.

What are the final symptoms of end-stage liver disease?

The final symptoms of end-stage liver disease are as follows: 

  1. Jaundice
  2. Drowsiness, for example: unable to differentiate between day and night
  3. Easy bruising
  4. Weight loss
  5. Blood in vomit and stools
  6. Itchy skin

About the Author

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