In many cases, people with alcohol-related liver disease (ARLD) do not have any noticeable symptoms until their liver is badly damaged.
If you do experience early symptoms of ARLD, these are often quite vague, such as:
As your liver becomes more severely damaged, you will usually develop more obvious and serious symptoms, such as:
- yellowing of the skin and whites of the eyes (jaundice)
- swelling in the legs, ankles and feet due to a build-up of fluid (oedema)
- swelling in your abdomen due to a build-up of fluid known as ascites
- a high temperature (fever) and shivering attacks
- very itchy skin
- hair loss
- unusually curved fingertips and nails (clubbed fingers)
- blotchy red palms
- significant weight loss
- weakness and muscle wasting
- confusion and memory problems, problems sleeping (insomnia) and changes in your personality due to a build-up of toxins in the brain
- vomiting blood and black, tarry stools due to internal bleeding
- a tendency to bleed and bruise more easily, such as frequent nosebleeds and bleeding gums
- increased sensitivity to alcohol and drugs (because the liver cannot process them)
When to seek medical advice
ARLD often causes no symptoms until it has reached an advanced stage. If you misuse alcohol, you may have liver damage even though you have none of the symptoms above.
It is recommended that you contact your GP for advice if you have a history of regular alcohol misuse.
A good way to assess your history and pattern of drinking is to use a short test known as the CAGE test, which consists of four 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 you answer yes to one or more of the questions above, you may have an alcohol misuse problem and are advised to see your GP.
You should see your GP as soon as possible if you have symptoms of advanced alcohol-related liver disease.
Read more about how alcohol-related liver disease is diagnosed.