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Alcoholic Liver Disease

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Most people who consume alcohol do not suffer clinically significant damage to the liver. However, chronic excessive consumption of alcohol can cause a variety of liver problems including excess fat in the liver (fatty liver), alcoholic hepatitis (inflammation in the liver) and cirrhosis (permanent scarring of the liver). Alcoholic hepatitis and alcoholic cirrhosis develop in approximately 15-20 percent of chronic alcoholics. This means that roughly one out of five people with heavy alcohol consumption will develop the devastating health problem of liver cirrhosis. These patients may die from liver failure, caused by gastrointestinal hemorrhage, infection, or failure of the kidneys. A liver transplant is only offered to those who abstain from alcohol intake for several months.
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Content Preview
American College of Gastroenterology
Digestive Disease Specialists Committed to Quality in Patient Care
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Common Gastrointestinal Problems
A Consumer Health Guide
Alcoholic Liver Disease
Alcoholism is a common problem with an estimated 17
sensitive to the effects of alcohol, while others are seemingly
to 20 million Americans suffering from alcoholism. Men are
invulnerable to its harmful effects. In general the greater the
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more commonly afflicted than women. Young men with a
amount and the longer the duration of alcohol consumption
family history of alcoholism and difficulties with inter-
the more likely that injury to the liver will occur. Women are
personal relations are at the greatest risk for alcoholism.
more susceptible to the damaging effects of alcohol than
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Specific biologic markers for the risk to develop alcoholism
men.
have not been identified.
Daily consumption of one pint of wine, or three 12
ounce beers or 4 ounces of distilled spirits (vodka, whiskey)
is about 20-40 grams of alcohol and will result in liver
Does alcoholism cause liver disease?
damage over time in most women. A man drinking 80
Most people who consume alcohol do not suffer
grams of alcohol daily will, on average, develop cirrhosis of
clinically significant damage to the liver. However, chronic
the liver in 10 years. A woman drinking 80 grams daily of
excessive consumption of alcohol can cause a variety of liver
alcohol will develop cirrhosis in 5 years.
problems including excess fat in the liver (fatty liver),
alcoholic hepatitis (inflammation in the liver) and cirrhosis
(permanent scarring of the liver).
Why are women more susceptible
Alcoholic hepatitis and alcoholic cirrhosis develop in
to alcohol than men?
approximately 15-20 percent of chronic alcoholics. This
The answer to this question is not known. When the
means that roughly one out of five people with heavy alcohol
amount of alcohol consumed by men and women is adjusted
consumption will develop the devastating health problem of
for differences in body size, women still appear to be at
liver cirrhosis. These patients may die from liver failure,
greater risk of liver damage at lower quantities of alcohol.
caused by gastrointestinal hemorrhage, infection, or failure
Women have lower levels of an enzyme known as alcohol
of the kidneys. A liver transplant is only offered to those who
dehydrogenase, found in the stomach lining. This enzyme
abstain from alcohol intake for several months.
breaks down alcohol before it is absorbed and decreases the
Why some people who drink alcohol get liver disease
concentration of alcohol that reaches the blood stream. This
and others do not is not fully understood, but there is some
may also explain why some women feel the effects of alcohol
research suggesting a possible genetic connection. Some
at a smaller amount of alcohol when compared to men. The
people are genetically more susceptible to the effects of
important message is, ?liver damage occurs in women with
alcohol than others. Unfortunately, there is not yet a
consumption of lesser amounts of alcohol.?
laboratory test to identify who is at highest risk for alcoholic
related liver disease.
In the United States, cirrhosis is among the 7 leading
What kinds of liver disease are
causes of death. The most common cause of cirrhosis is
caused by excess alcohol ingestion?
alcohol abuse. In addition, excess alcohol consumption
Fatty Liver
increases the risk of pancreatitis (inflammation of the
This condition can occur with significant intake of
pancreas), cardiomyopathy (damage to the heart muscle),
alcohol, even in individuals who are not alcoholics. In fatty
trauma (accidents occurring during drunkenness), and the
liver, large fat droplets accumulate in the liver, leading to
development of fetal alcohol syndrome (damage to the
enlargement. A blood test can identify early damage to the
unborn child from excess alcohol during pregnancy).
liver. When alcohol consumption is stopped, the fat in the
liver will disappear and the liver should completely heal.
How much alcohol must I drink to
Alcoholic Hepatitis
This is a serious condition where the liver has been
damage my liver?
severely damaged by the effects of alcohol. The illness is
The amount of alcohol consumed before liver damage
characterized by weakness, fever, loss of appetite, nausea,
occurs is extremely variable. Some people are exquisitely
For More Information about Digestive Health and GI Conditions
Call the American College of Gastroenterology Hotline at 1-800-978-7666
or visit our Website at http://www.acg.gi.org

????????????
What Everyone Should Know About
nearly half will have gallstones. Those with cirrhosis are
more likely to suffer from diabetes, kidney problems, ulcers,
ALCOHOLIC LIVER DISEASE and severe bacterial infections.
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vomiting and pain over the liver. The liver is often inflamed
Will alcoholic liver disease affect
causing many individual liver cells to die. Unlike fatty liver,
me when taking medicine?
alcoholic hepatitis often heals with permanent scarring called
Since one of the functions of the liver is to process drugs
fibrosis. The right sided stomach pain is often hard to ? and other chemicals in your body, if your have liver disease
distinguish from other conditions such as a gallbladder ???????????????????????????????????????????????????????????????????? you may process medications differently from other people.
attack. Your doctor may need to order special blood tests and
Always consult with your doctor about the dosage of both
x-rays to diagnose the condition. Alcoholic hepatitis can be
over-the-counter and prescription medicines. Similarly,
life-threatening and require hospitalization. Recovery from
alcohol alone, even without liver disease known to be
alcoholic hepatitis is common, but the fibrosis or scarring of
present, may affect the processing of certain medications.
the liver is irreversible.
For example, even moderate amounts of alcohol may cause
Alcohol-Induced Cirrhosis
adverse effects with some pain medications. If you use
This is the final stage of damage to the liver from alcohol.
alcohol, check the labeling of over-the-counter medications
Cirrhosis is a permanent irreversible form of liver damage.
to alert yourself to any limitations on their usage. You
The fibrosis or scarring of the liver seen in cirrhosis leads to
should check with your physician about precautions in
obstruction of blood flow through the liver. This prevents the
taking your prescription medications if you have been
liver from performing its critical functions of purifying the
drinking any alcohol. You should never use an alcoholic
blood and nutrients absorbed from the intestines. The end
beverage to take medication.
result is liver failure. Some signs of liver failure include
accumulation of fluid in the abdomen (ascites), malnutrition,
How is alcohol-related liver
confusion (encephalopathy) and bleeding from the intestines.
Some of these conditions can be managed by diet, medicines
disease treated?
and special procedures, but the spontaneous recovery of the
Of all treatments for alcoholic liver disease, the most
liver to normal and return of good health is rare.
important is to stop drinking completely. Sometimes the
Cirrhosis is the seventh leading cause of death in the
liver can recover from the injury of alcohol enough to allow
United States. Although alcohol is the cause of over half of the
a normal life, unfortunately the scarring of the liver is
cases of cirrhosis in the United States, not all cases of cirrhosis
permanent and the liver remains vulnerable to any alcohol or
are due to alcoholism. Some are caused by genetic disorders,
infections.
such as hemochromatosis or viral infections, such as
When alcoholic cirrhosis advances to an end-stage
hepatitis.
complicated by life-threatening intestinal bleeding, confusion,
ascites, failure of the kidneys, and infection, the only
How can you diagnose whether a
treatment is liver transplantation. For liver transplantation
person has a fatty liver, alcoholic
to be successful, a patient must be very compliant with
medicines and follow instructions reliably. Only persons
hepatitis, or cirrhosis?
completing a successful alcohol detoxification and
Blood tests and scans are usually very helpful in the
rehabilitation program are considered as candidates for liver
evaluation of the liver, but a biopsy of the liver is often required
transplantation.
to make the diagnosis of cirrhosis and determine the cause. A
American College of Gastroenterology
liver biopsy is performed in the hospital or in a same day
4900 B South 31st Street
surgery clinic. Often the liver biopsy is performed with mild
Arlington, VA 22206
local anesthesia such as lidocaine or with mild sedatives given
through the vein. The discomfort from the liver biopsy is
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usually mild and lasts only for a short time. Most patients can
return to work the following day with only a restriction on
heavy lifting and exercise.
Are there complications associated
with alcoholic liver disease?
Yes, roughly a third of patients with alcoholic liver disease
suffer from a liver infection caused by the hepatitis C virus and

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