Alcoholic liver disease (ALD)
Alcoholic liver disease (ALD) refers to a range of conditions and associated symptoms that develop when the liver is damaged by the overuse of alcohol.
Men who regularly drink more than 8 units of alcohol a day (50 units a week) and women who regularly drink more than 6 units of alcohol a day (over 35 units a week) are at the highest risk of significant liver damage.
Causes of alcoholic liver disease
When alcohol is filtered through the liver, it causes some liver cells to die. While the liver is very hardy and able to regenerate itself, you can seriously damage your liver in two ways:
- Binge drinking - when a large amount of alcohol is consumed in a short time
- Long term drinking - when more than the recommended limits of alcohol are consumed over a long period of time
Symptoms of alcoholic liver disease
Symptoms of alcoholic liver disease don’t usually appear until significant damage has been done to the liver. They include:
Diagnosis of alcoholic liver disease
Your GP may diagnose ALD by arranging liver function blood tests - to check liver enzyme levels and levels of serum albumin.
Treatment for alcoholic liver disease
If you are diagnosed with ALD, treatment will involve abstaining from drinking and making other lifestyle changes. Your GP may suggest you should:
- Stop drinking for at least 2 weeks
- Get support from a self help group such as Alcoholics Anonymous
- Take abstinence medication such as Disulfiram which triggers unpleasant affects such as nausea and vomiting if you drink
- Take withdrawal medicine such as Acamprosate
- Make diet changes or start nutritional therapy (many alcoholics have a poor diet and malnourishment heightens the damaging effects of alcohol)
Risk factors for alcoholic liver disease
Most people who abuse alcohol will develop ALD.
- 1 in 4 people who develop ALD will go on to develop hepatitis.
- 1 in 5 people who develop ALD will go on to develop cirrhosis.
Other alcohol related problems include liver cancer, heart disease and stroke.
A person's risk of alcoholic liver disease may be increased by:
- Eating a high fat diet
- Being female (women are less able to metabolise alcohol than men)
- Having a pre-existing liver condition (such as hepatitis)
- Having a family history of alcohol abuse (hereditary factors may influence how much you drink or affect liver enzymes that break down alcohol)
When to get help for alcoholic liver disease
If you are concerned you may be at risk from ALD, a short test - called the CAGE test - may help you assess your risk.
Ask yourself 4 questions:
- Have you ever thought you should cut down on your drinking?
- Have people annoyed you by criticising your drinking?
- Have you ever felt guilty about your drinking?
- Have you ever drunk an ‘ eye-opener’, which means, have you ever drunk alcohol first thing in the morning to get over a hangover and steady your nerves?
If the answer to one or more of these questions is yes, seek medical advice as you may have an alcohol problem.