Alcoholic Liver Disease
~ by Jo Jordan
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In the United States, alcoholic liver disease is the major cause of cirrhosis of the liver – a potentially life-threatening disease. Cirrhosis leads to liver cancer in approximately ten percent of all cases. In 2000, cirrhosis was one of the leading causes of death in the United States.
Also referred to as Laennec's cirrhosis, portal cirrhosis, cirrhosis or hepatitis-alcoholic, or liver disease from alcohol, alcoholic liver disease usually develops after years of excessive alcohol intake. The longer the period during which alcohol is excessively consumed and the greater the amount ingested, the higher the likelihood of developing alcoholic liver disease.
Symptoms of Alcoholic Liver Disease
Symptoms are usually worse after an episode of heavy drinking, and tend to vary with the severity and progression of the disease. Sometimes symptoms do not present themselves until the disease is relatively advanced.
- Abdominal pain and tenderness
- Ascites (excess fluid between the membranes lining the abdomen and abdominal organs)
- Confusion
- Dry mouth / excessive thirst
- Fatigue
- Fever
- Jaundice
- Loss of appetite
- Nausea
- Weight gain due to ascites
Additional symptoms associated with the disease:
- Abnormally dark or light skin
- Agitation
- Altered level of consciousness
- Bloody or dark, black, or tar-like bowel movements
- Breast development in males
- Difficulty concentrating
- Fluctuating mood
- Hallucinations
- Impaired judgment
- Impaired short- or long-term memory
- Light-headedness or fainting
- Paleness
- Rapid heart rate when rising to a standing position
- Redness on feet or hands
- Slow, sluggish, lethargic movement
- Vomiting blood or a sludge-like material
Alcoholic Liver Disease is Progressive
Fatty Change
A progressive illness, alcoholic liver disease first appears as a fatty change in the liver. Also known as steatosis or fatty liver disease, this accumulation of fat in liver cells can be seen through a microscope as large, fatty globules. In addition to alcoholism, these large globules can also be caused by diabetes, obesity, and starvation.
Alcoholic Hepatitis
Some people are more prone to alcoholic hepatitis, or acute hepatitis, than others. Also known as alcoholic steatonecrosis, alcoholic hepatitis is an inflammatory reaction to the fatty change in liver cells. Health experts speculate that this inflammatory condition lays the groundwork for the development of fibrosis.
Liver Fibrosis
While not normally accompanied by symptoms, liver fibrosis can develop into cirrhosis as it progresses. The fibrosis – also known as scar tissue – alters the very fabric of the liver to such an extent that liver functioning is seriously impaired.
Cirrhosis
Often referred to as end-stage liver disease, cirrhosis (pronounced suh-RO-suss) is characterized by replacement of liver tissue with fibrotic scar tissue and regenerative nodules, and permanent, non-reversible damage to the liver.
Cirrhosis is a condition whereby the liver is so extensively damaged that it may no longer function, which can result in death. In its advanced stages, the only option for cirrhosis is liver transplantation.
Symptoms of cirrhosis include, but are not limited to, changes to the nails and palms; strong, sweet-smelling breath; dark urine; jaundice (yellowing of the skin, eye, and mucus membranes); an increase in male breast tissue; impotence, infertility, or loss of sexual drive due reduced hormone secretion from the testes or ovaries; ascites; change in liver size; weight loss; weakness and fatigue; and anorexia.
Prognosis
While fatty change and alcoholic hepatitis are considered reversible, the later stages of fibrosis and cirrhosis tend to be irreversible, but can sometimes be managed for long periods of time.
Malnutrition contributes to liver disease and is therefore a serious concern. It can develop as a result of empty calorie intake from alcohol, reduced appetite, and inadequate absorption of nutrients. Other serious complications associated with the advanced stages of the disease are alcoholic encephalopathy (brain tissue damage) and portal hypertension (high blood pressure within the liver).
Life expectancy is reduced if alcohol consumption is continued.
Treatment
Discontinuing alcohol consumption is vital, as is the implementation of a high-carbohydrate, high-calorie diet to stop the breakdown of proteins.
Improvement has been shown through the incorporation of a multi-vitamin containing both Thiamine (B1) and folic acid. Studies evaluating milk thistle for alcoholic liver disease found significant improvements in liver function.1 Those with the mildest form of the disease appeared to improve the most. Milk thistle was less effective for those with severe liver disease such as cirrhosis.
Counseling and an alcohol rehabilitation program to combat addiction may also be necessary, as well as a health regimen to manage the complications that arise from chronic liver disease.
For more information on the liver, please review the liver cleansing overview article, or search for related articles by using the search box.
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Notes:
1. University of Maryland Medical Center, "Milk thistle,"
http://www.umm.edu/altmed/articles/milk-thistle-000266.htm
(accessed October 30, 2007).
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