Alcohol and Liver Disease - Symptoms

What conditions do you risk developing by drinking too much alcohol?

The functions of your liver include:

  • Storing glycogen, a chemical made from sugars. When required, glycogen is broken down into glucose which is released into the bloodstream.
  • Helping to process fats and proteins from digested food.
  • Making proteins that are essential for blood to clot (clotting factors).
  • Processing many medicines which you may take.
  • Helping to remove or process alcohol, poisons and toxins from the body.
  • Making bile which passes from the liver to the gut and helps to digest fats.

There are three main stages of alcohol-related liver disease: fatty liver, hepatitis and cirrhosis. Any, or all, of these conditions can occur at the same time in the same person.

Fatty liver

A build-up of fat occurs within liver cells in most people who regularly drink heavily. In itself, fatty liver is not usually serious and does not cause symptoms. Fatty liver will usually reverse if you stop drinking heavily. However, in some people the fatty liver progresses and develops into hepatitis.

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 chemicals (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 (nausea).
    • Yellowing of the skin and the whites of the eyes (jaundice), caused by a high level of bilirubin - a chemical normally metabolised in the liver.
    • Generally feeling unwell.
    • 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 and bleeding into the guts. It is often fatal.
  • The main treatment for alcoholic hepatitis is to provide adequate nutrition (this sometimes involves passing liquid feeds through a tube in the stomach) and steroids.

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. 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. 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. See separate leaflet called Cirrhosis for more details.

It is not clear why some people are more prone to damage of their liver cells by alcohol and to developing hepatitis and/or cirrhosis. But, as a rule, the more heavily and the more regularly you drink, the greater your risk of developing hepatitis and/or cirrhosis.

The scarring and damage of cirrhosis is usually permanent and cannot be reversed. However, recent research has led to a greater understanding of cirrhosis. Research suggests that it may be possible to develop medicines in the future which can reverse the scarring process of cirrhosis.

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Author:
Dr Roger Henderson
Peer Reviewer:
Dr Laurence Knott
Document ID:
4395 (v47)
Last Checked:
11 May 2017
Next Review:
10 May 2020

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.