Alcohol related liver disease

What is alcohol related liver disease?

Alcohol related liver disease (ARLD) is a condition where the liver has been damaged by someone drinking too much alcohol. It can lead to the liver not working properly, which may result in serious health problems. 

You do not have to be addicted to alcohol to develop ARLD. Regular drinking above recommended limits can put you at risk. 

With ARLD, there are several stages of severity. The most serious stage is cirrhosis, which usually takes many years to develop.

At the London Liver Group, we have a team of world-class hepatology consultants who are experts at diagnosing, monitoring and treating alcohol related liver disease.

An expert multidisciplinary team will also support you from your first consultation, during diagnostic tests and throughout your treatment.  

Causes

Drinking too much alcohol may lead to you developing alcohol related liver disease (ARLD). 

The more alcohol you drink above recommended limits, the greater chance you have of developing ARLD.

As well as drinking too much alcohol, other factors can increase the risk of liver damage. These include:

•    Being overweight or obese
•    Having diabetes (mainly type 2 diabetes)
•    Being female (women tend to be affected more by the harmful effects of alcohol than men) 
•    Already having a liver condition such as hepatitis C or haemochromatosis
•    A family history of alcohol-related diseases or addiction

Symptoms

The early stages of alcohol related liver disease do not usually cause symptoms. Many people are not diagnosed until their disease is at an advanced stage. 

However, early symptoms may include:
•    Pain in your belly
•    Loss of appetite
•    Tiredness that does not go away with rest (fatigue)
•    Feeling sick
•    Diarrhoea
•    Trouble sleeping
•    Feeling generally unwell

As ARLD becomes more advanced, you may develop one or more of the following symptoms:

•    Yellowing of the skin and whites of the eyes (jaundice)
•    Loss of muscle mass
•    Losing a lot of weight for no reason
•    Mild confusion
•    Lack of energy
•    Swelling in the legs, ankles and feet 
•    Pain in the belly over the liver area
•    Swollen belly
•    Bruising and bleeding easily (nosebleeds and bleeding gums)
•    Itching

Diagnosis

Alcohol related liver disease is often first suspected when tests for other medical conditions show a person has a damaged liver. This is because the early stages of ARLD do not usually cause symptoms. If your doctor suspects you have ARLD, you will usually have blood tests to assess how well your liver is working.

If your blood tests or symptoms suggest your ARLD is advanced, you may have more tests to determine how damaged your liver is. These may include:

•    Ultrasound scan
•    CT scan
•    MRI scan 
•    Fibroscan – uses ultrasound waves to measure scarring and fatty change in your liver
•    Liver biopsy
•    Endoscopy – a thin tube with a camera is passed down your throat into your stomach

Your consultant will also ask you questions about how much alcohol you drink. It is important you answer truthfully, as this will help to diagnose your condition correctly and ensure you get the right care.

Treatments

Your world-class consultant at the London Liver Group will work with you to develop an effective treatment plan for you and your condition. 

If your ARLD is at an early or moderate stage, the aim will be to cure it. If your ARLD is more advanced, the aim will usually be to manage your liver disease and stop it from getting worse.

The main element of any treatment plan for alcohol related liver disease is for the patient to start drinking less or no alcohol.

At the London Liver Group, we will make recommendations and refer you to other professionals to help you achieve this goal. 

Other elements of your treatment plan may include:
•    Medication 
•    Cognitive behavioural therapy
•    Psychological therapy
•    Nutrition support
•    Self-help groups
•    Liver transplant – if your liver loses its ability to function properly.

As part of your treatment plan, we will also screen you regularly to monitor your condition and manage complications quickly.