Alcoholic liver disease is the leading cause of alcohol-related death worldwide. It contributes up to 50 percent of the total burden of liver disease and is a factor in up to 15 percent of liver transplants. Once alcoholic liver disease is established in the body, abstinence from alcohol use is essential to improve health outcomes. There is no other accepted treatment of alcoholic liver disease.
Alcohol is known to be toxic to liver cells, known as hepatocytes, and it causes inflammation of the liver. The effect of alcohol on hepatocytes is immediate. However, in most healthy non-alcoholic people, the body repairs itself. Repeated high levels of exposure to alcohol causes chronic and continuing inflammation of the liver, which causes the development of scarring to the liver. This scarring is the beginning of alcoholic liver disease.
Alcoholic liver disease is preventable, but is also a complex disease. Regular and excessive drinking is the known cause of the disease and it is characterized by secondary conditions including steatosis, alcoholic hepatitis, liver fibrosis and cirrhosis. The symptoms of alcoholic liver disease vary, but often include painful stomach cramps, jaundice, chest pain, nausea, vomiting, significant weight loss and asceites. Alcoholic liver disease can cause the body to lose the ability to clot blood. This can be incredibly dangerous as minor cuts will bleed excessively, bruising is often significant and accidents that may otherwise be mild can be life-threatening.
Some studies suggest that there is a genetic risk factor associated with alcoholic liver disease. It is believed that, when alcohol is in present in the body, certain genes trigger an immune reaction that causes damage to the liver. For those with the gene present, their body will begin to attack itself and cause serious and potentially life-threatening damage to the liver including cirrhosis.
Fatty liver disease is a per-cursor to alcoholic liver disease. With abstinence from alcohol, fatty liver will not develop into other more serious conditions. Fatty liver occurs due to a process known as steatosis. This is the abnormal retention of lipids in the liver cells which causes the body to accumulate fat instead of healthy liver tissue. Steatosis is characterized by an enlarged and inflamed liver. Those who suffer from fatty liver disease may experience feelings of fatigue, nausea and vomiting, confusion, discomfort in the abdomen, weight loss or jaundice. Fatty liver can be temporary and resolved if significant changes are made to reverse the damage, which includes reducing the amount of alcohol consumed and abstaining from drinking. It is estimated that up to 90 percent of heavy drinkers will develop the condition at some stage of their alcoholism.
Left unresolved, fatty liver disease will develop into alcoholic hepatitis. This condition is the inflammation of the liver, which can lead to serious tissue damage, including cirrhosis. Hepatitis is known to cause many liver-function problems which include cholesterol and protein metabolizing, processing of fats and sugars, hormone regulating and immune functions. There are a number of possible causes for alcoholic hepatitis. The alcohol itself is a toxic substance that can damage liver cells and cause inflammation. Another contributing factor is that most alcoholics will have poor nutrition. This lack of proper nutrients in the body can also lead to damage of the liver cells. If the liver is severely damaged by alcoholic hepatitis, these functions can be interfered with to the point that the organ is unable to function. It is at this stage that the disease has progressed to cirrhosis.
When a person develops cirrhosis, their liver is no longer able to repair itself. This is a very serious condition that contributes to the development of liver cancer and will cause a person to die. Cirrhosis refers to scaring of the liver that most often occurs because of alcohol abuse. Cirrhosis develops because of previous episodes of inflammation which leaves behind scar tissue. This scarring prevents the blood from flowing through the organ properly which leads to an increase in blood pressure throughout the body. The organ is so severely damaged that it is unable to repair itself and replace damaged liver cells with healthy cells. It is not possible to reverse the damage of cirrhosis, but it can be managed so long as the individual remains abstinent. The damage that has been caused to the liver through excessive drinking cannot be reversed. The only known treatment for cirrhosis is an organ replacement.
The symptoms of alcoholic liver disease vary based on the severity of the disease. In some cases, individuals may experience a worsening of the symptoms after heavy episodes of drinking. Commonly reported symptoms include:
* Nausea and vomiting
* Abdominal pain
* Weight loss or weight gain
* Bloody or dark bowel movements
* Mood changes including agitation and confusion
* Nosebleeds or bleeding gums
* Reddening of the hands and feet
* Headaches and light-headedness
Alcoholism is a recognized disease that is chronic and progressive. The disease is caused by altered brain structure, environmental and genetic factors and can be treated through a range of medical and psychological interventions. Alcoholism is known to cause many serious secondary health problems including brain damage, alcoholic liver disease, psychiatric conditions and organ damage. Chronic alcoholism that causes major liver damage can cause a person to develop cancer of the liver and cirrhosis which can only be treated with an organ transplant.
It is understood that alcoholism is not something that is controllable or avoidable for some individuals. As with other diseases like diabetes or heart disease, there are known treatments and known risk factors. A person who is an alcoholic or at risk of developing alcoholism needs to take steps to avoid triggers, avoid alcohol and make healthy life choices. If a person is committed to their health and willing to make significant changes in the future, they deserve the chance to have a transplant, no matter what their disease. Alcoholic liver disease is 100 percent preventable through healthy lifestyle choices.