You may not notice any symptoms of alcoholic liver disease until your liver is badly damaged, so it is important to regulate your drinking.
Alcoholic fatty liver disease
Alcoholic fatty liver disease does not usually cause any noticeable symptoms unless the build-up of fatty acids in your liver is severe.
If this is the case, symptoms of alcoholic fatty liver disease include:
- weakness
- loss of appetite
- nausea
- abdominal pain
- a general sense of feeling unwell
Alcoholic hepatitis
Symptoms of alcoholic hepatitis include:
- yellowing of the eyes and skin (jaundice)
- abdominal pain or tenderness
- the appearance of ‘spider-like’ red blood vessels in your skin
- loss of appetite
- nausea
- high temperature, usually around 38°C (101°F)
- fatigue
Cirrhosis
The symptoms of cirrhosis usually come in two stages:
- Early stage symptoms occur when your liver starts to lose some of its function.
- End stage symptoms occur when your liver loses more or all of its function (total loss of liver function is known as liver failure).
Early stage symptoms include:
- tiredness and weakness
- loss of appetite
- weight loss
- feeling sick
- very itchy skin
- blotchy red palms
- problems sleeping (insomnia)
Tenderness or pain around the liver (located in your abdomen) is not common (many forms of advanced liver disease don't have obvious symptoms at first).
Later symptoms include:
- jaundice
- hair loss
- build-up of fluid in the legs, ankles and feet (oedema) or in the abdomen, making you look heavily pregnant (ascites)
- dark urine and black, tarry or very pale stools
- a tendency to bleed and bruise more easily, such as frequent nosebleeds and bleeding gums
- vomiting blood
- muscle cramps
- right shoulder pain
- loss of sexual desire (loss of libido)
- dizziness and fatigue
- breathlessness
- rapid heartbeat
- fever and shivering attacks (because you are more prone to infections)
- memory loss and confusion
- changes in your personality (caused by toxins in the bloodstream affecting your brain)
- staggering when walking
- increased sensitivity to alcohol and drugs (because the liver cannot process them)
- more weight loss from the body and upper arms
When to seek medical advice
Alcoholic liver disease often causes no symptoms until it has reached an advanced level. 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 and ask for a liver function test if you have a history of regular alcohol misuse. Read more about how alcoholic liver disease is diagnosed.
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.
