Alcohol-related liver disease (ARLD) refers to liver damage caused by excess alcohol intake. There are several stages of severity and a range of associated symptoms.
ARLD doesn't usually cause any symptoms until the liver has been severely damaged. When this happens, symptoms can include:
This means that ARLD is frequently diagnosed during tests for other conditions, or at a stage of advanced liver damage.
If you regularly drink alcohol to excess, tell your GP so they can check if your liver is damaged.
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Alcohol and the liver
With the exception of the brain, the liver is the most complex organ in the body. It's functions include:
- filtering toxins from the blood
- aiding digestion of food
- regulating blood sugar and cholesterol levels
- helping to fight infection and disease
The liver is very resilient and is capable of regenerating itself. Each time your liver filters alcohol, some of the liver cells die.
The liver can develop new cells, but prolonged alcohol misuse (drinking too much) over many years can reduce your liver’s ability to regenerate. This can result in serious and permanent damage to your liver.
ARLD is very common in the UK, and the number of people with the condition has been increasing over the last few decades because of increasing levels of alcohol misuse.
Read more about the causes of ARLD.
Stages of ARLD
There are three main stages of ARLD, although there's often an overlap between each stage. These stages are explained below.
Alcoholic fatty liver disease
Drinking a large amount of alcohol, even for just a few days, can lead to a build-up of fats in the liver. This is called alcoholic fatty liver disease, and is the first stage of ARLD.
Fatty liver disease rarely causes any symptoms, but it's an important warning sign that you're drinking at a harmful level.
Fatty liver disease is reversible. If you stop drinking alcohol for two weeks, your liver should return to normal.
Alcoholic hepatitis (unrelated to infectious hepatitis) is a potentially serious condition that can be caused by alcohol misuse over a longer period. When this develops, it may be the first time a person is aware they're damaging their liver through alcohol.
Less commonly, alcoholic hepatitis can occur if you drink a large amount of alcohol in a short period of time (binge drinking).
The liver damage associated with mild alcoholic hepatitis is usually reversible if you stop drinking permanently.
Severe alcoholic hepatitis, however, is a serious and life-threatening illness. Many people die from the condition each year in the UK and some people only find out they have liver damage when their condition reaches this stage.
Cirrhosis is a stage of ARLD where the liver has become significantly scarred. It's generally not reversible, but stopping drinking alcohol immediately can prevent further damage and significantly increase your life expectancy.
Even at this stage, there may not be any obvious symptoms.
A person who has alcohol-related cirrhosis and doesn't stop drinking has less than a 50% chance of living for at least five more years.
How ARLD is treated
There's currently no specific medical treatment for ARLD. The main treatment is to stop drinking, preferably for the rest of your life. This reduces the risk of further damage to your liver and gives your liver the best chance of recovering.
If a person is dependent on alcohol, stopping drinking can be very difficult. However, support, advice and medical treatment may be available through local alcohol support services.
In severe cases, where the liver has stopped functioning and doesn't improve when you stop drinking alcohol, a liver transplant may be required.
You'll only be considered for a liver transplant if you've developed complications of cirrhosis, despite having stopped drinking. All Liver Transplant Units require a person to not drink alcohol while awaiting the transplant and for the rest of their life.
Read more about treating ARLD.
Death rates linked to ARLD have risen considerably over the last few decades and alcohol is now one of the most common causes of death in the UK, along with smoking and high blood pressure.
Life-threatening complications of ARLD can develop. These include:
- internal (variceal) bleeding
- build-up of toxins in the brain (encephalopathy)
- fluid accumulation in the abdomen (ascites) with associated kidney failure
- liver cancer
Read more about the complications of ARLD.
The most effective way to prevent ARLD is to stop drinking alcohol, or stick to the recommended daily limits and have at least two alcohol-free days a week.
The recommended limits of alcohol consumption are:
- men shouldn't regularly drink more than 3-4 units of alcohol a day
- women shouldn't regularly drink more than 2-3 units a day
A unit of alcohol is equal to about half a pint of normal strength lager or a pub measure (25ml) of spirits. You can use the drinking self-assessment tool to work out whether you're drinking too much.
Even if you've been a heavy drinker for many years, reducing or stopping your alcohol intake will have important short- and long-term benefits for your liver and your overall health.
See our drinking and alcohol pages for more information and advice.
Page last reviewed: 24/09/2015
Next review due: 24/09/2017