Alcohol-Related Liver Disease

People throughout Michigan turn to Henry Ford Health for our expertise in all stages of alcohol-related liver disease (ARLD), from fatty liver to end-stage cirrhosis. A multispecialty team works together to reverse liver damage, preserve liver function and prevent long-term complications. Experienced liver specialists (hepatologists) and experts in psychiatry, social services, nutrition and addiction medicine help you heal.

What is alcoholic liver disease?

Alcohol-related liver disease results from drinking too much alcohol, which is a toxin. Your liver cells produce an enzyme that breaks down alcohol and removes it from your body. But excessive drinking damages liver cells and prevents the liver from doing its job.

What are the stages of alcohol-related liver disease?

There are three stages of alcohol-related liver disease:

• Alcohol fatty liver disease: Fat cells build up in the liver, which can prevent the liver from doing its job. Fatty liver is the first stage of ARLD. It’s usually reversible if you stop drinking alcohol.
• Alcohol hepatitis: The second stage of ARLD is liver inflammation and liver cell death. Alcohol hepatitis gets progressively worse with long-term heavy drinking.
• Alcohol cirrhosis: Cirrhosis is the most severe stage of ARLD. Scar tissue (fibrosis) replaces normal liver tissue, causing permanent liver damage. Between 10% and 20% of heavy drinkers develop cirrhosis.

Signs and symptoms of alcohol-related liver disease

The first stage of alcoholic liver disease doesn’t usually cause symptoms, though some people have abdominal pain.

Once the disease leads to complications, symptoms may include:

• Fatigue
• Fever
• Yellow skin and eyes (jaundice)
• Loss of appetite
• Nausea and vomiting
• Weight loss

Alcohol cirrhosis can lead to:

• Fluid buildup in the abdomen (ascites)
• Changes in behavior or confusion
• Enlarged spleen
• Intestinal bleeding
• Malnutrition
• High blood pressure in the liver (portal hypertension)

Ultimately, cirrhosis can lead to liver cancer, liver failure or death.

How is alcoholic liver disease diagnosed?

Your liver specialist evaluates a variety of factors to diagnose alcohol-related liver disease. We do a physical exam, review your symptoms and discuss your drinking habits.

Diagnostic tests may include:

• Lab tests: Blood tests check your liver function and rule out other possible causes of liver disease, such as viral hepatitis.
• Imaging exams: We check the size and shape of your liver. A CT scan, ultrasound or MRI can also help us detect fat in your liver and rule out liver cancer. At Henry Ford, we offer FibroScan®, a highly specialized ultrasound that can measure hardening and scarring in the liver.
• Liver biopsy: We use a needle to get a sample of liver tissue and look at it under a microscope. You may need a biopsy if the results of other tests are unclear or to help understand the cause of your liver disease.

Learn more about how we diagnose liver disease at Henry Ford.

Alcohol-related liver disease treatment at Henry Ford

Abstaining from alcohol is the most important part of liver disease treatment. You must stop drinking alcohol completely. We understand this can be very challenging – even dangerous – so we connect you to the counselors, support services and medical expertise you need to quit drinking and manage withdrawal safely.

Other treatments for alcohol-related liver disease may include:

• Nutrition therapy: Vitamin and mineral deficiencies are common in people with ARLD. We may recommend a special diet and nutritional supplements to help you get the nutrition you need and maintain a healthy weight.
• Medication: Certain medications, such as steroids, can temporarily reduce liver inflammation. You may also need medication to treat alcohol withdrawal symptoms. However, no medication can reverse liver damage.
• Liver transplantation: The only treatment for advanced cirrhosis is liver transplantation, which replaces your damaged liver with a healthy liver from a donor. At Henry Ford, our liver transplant specialists perform the highest volume of transplants in Michigan, including living-donor transplants.

Take the next step

To connect with a liver disease specialist, call (313) 916-8865 or request an appointment.