Alcoholic Cirrhosis of the Liver: Symptoms & Treatment

Excessive alcohol consumption can have a wide range of physical and mental health consequences. One of the most severe risks of persistent unhealthy drinking is a condition called alcoholic cirrhosis of the liver, which is unfortunately more common than you may think. Below we highlight the important role that the liver plays in the human body and how this role can be impacted by alcoholic cirrhosis. 

It’s important to note that alcoholic cirrhosis is typically preceded by other liver issues such as fatty liver disease and hepatitis. Alcoholic cirrhosis can be prevented through early intervention during these stages, and can be mitigated with treatment. If you’re worried about your liver health, it’s never too early to meet with a physician and start changing your relationship with alcohol. At Monument, your physician will create a judgment-free environment for you to share openly and honestly, and provide actionable steps based on your medical history and alcohol consumption.

First, What Exactly Does The Liver Do? 

The liver, located on the right side of our abdomen, is one of the largest organs in the human body. It has several key functions. One of the most important jobs of the  liver is filtering out toxins from the bloodstream. The liver also plays an important role in healthy digestion, and makes various proteins that are needed for blood production.

Unfortunately, certain conditions, like alcoholic cirrhosis, can make it difficult for the liver to do its many important jobs. When the liver is injured or damaged, it becomes less effective at cleaning the blood, which can cause a wide variety of symptoms and health challenges. Some of these symptoms can be relatively mild, while others may be life-threatening. 

What Is Alcoholic Cirrhosis of the Liver?

Alcoholic cirrhosis of the liver is a health condition that commonly affects individuals who struggle with alcohol use disorder. Studies suggest that 15 to 20 percent of those with alcohol use disorder will develop cirrhosis, although these statistics likely underestimate the scope and severity of alcoholic cirrhosis. 

It is important to note that you don’t simply wake up one day with alcoholic cirrhosis because you had too much to drink once or twice. Alcoholic cirrhosis is a progressive disease that happens after long-term exposure to excessive amounts of alcohol. Generally, patients move from early-stage liver disease, commonly known as fatty liver disease, to hepatitis, and then if the disease is left untreated or if the patient continues to drink, cirrhosis will develop. 

Oftentimes, alcoholic cirrhosis develops in patients with severe and untreated alcohol use disorder, which is a medical condition in itself. There’s no shame in having alcohol use disorder or alcoholic cirrhosis, and they deserve treatment just like all other medical conditions. Treatment options like medication to stop drinking and alcohol therapy can help you change your drinking habits and improve health outcomes.

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What Causes Alcoholic Cirrhosis?

Quite simply, the heavy use of alcohol over a lifetime is what causes alcoholic cirrhosis. Processing alcohol is toxic to healthy liver tissue. Over time, with continued exposure to alcohol, healthy liver tissue is replaced by atrophied, or thinning scar tissue. When this happens, the liver becomes stiff and swollen, and its normal functioning slows. The exact mechanism through which alcohol leads to liver scarring is still being explored. But, it’s known that alcohol scars the liver, and a scarred liver is much less effective at doing its job.  

Not everyone who has alcohol use disorder develops alcoholic cirrhosis. And, there doesn’t seem to be a magic cut-off number to determine how much alcohol an individual can consume over their lifetime to avoid developing cirrhosis. Discussing your own drinking habits, health history, and risks with a physician is the best way to determine how alcohol is impacting your health and wellness. 

Cirrhosis Risk Factors

The most significant risk factor for developing alcoholic cirrhosis is consuming unhealthy amounts of alcohol. Some studies suggest that the risk of cirrhosis increases significantly once a person regularly consumes five or more drinks per day. 

However, high levels of alcohol consumption aren’t the only risk factor for alcoholic cirrhosis. Women seem much more prone to developing alcoholic cirrhosis, which can be explained at least in part by body chemistry differences. There are also some additional suggestions that other factors may heighten the risk of developing alcoholic cirrhosis, such as body weight and lack of exercise. There’s also an indication that some people are genetically more likely to develop this condition. 

Finally, logic seems to suggest that if you have poor underlying liver health, such as infectious hepatitis, you may be more prone to developing cirrhosis and that you need to take proactive steps to protect your liver and its health. Additional research continues to be conducted into alcoholic cirrhosis risk factors.

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What Are the Symptoms of Alcoholic Liver Disease? 

Symptoms of alcoholic liver disease can vary dramatically from patient to patient. At the early stages of the disease process, many people find the condition to be mild, and it can be easy to overlook these symptoms or think that they are due to something else. As the disease progresses, though, symptoms generally worsen and can disrupt quality of life and even lead to death. This is particularly true if the condition is left undiagnosed and untreated. While the reality of alcoholic cirrhosis can be heavy and disheartening, it’s important to learn about the risks in order to understand the importance of early diagnosis and treatment. 

Though symptoms vary, common symptoms include: 

  • Itching. Itching can often be severe and can lead to dramatic sleep disruptions and sleep deprivation 
  • Jaundice. This can appear as yellowing of the skin or eyes
  • Intestinal bleeding and abdominal fluid retention. This can result in fatigue, bloating, cramping, and bloody stool
  • Kidney failure. This can present itself as swelling and decreased urine output
  • Liver cancer. Preliminary symptoms may include sudden, unintentional weight loss and upper abdominal pain 

How Is Alcoholic Cirrhosis of the Liver Diagnosed? 

Diagnosing alcoholic cirrhosis of the liver can be challenging. This is partly because many patients are reluctant to disclose their alcohol use to their doctors due to fear of judgment. Thus, doctors may not have alcoholic cirrhosis on their radar as a potential diagnosis. 

It’s crucial that if you’re experiencing any of the symptoms noted above that you are transparent with your doctor and disclose how much alcohol you regularly consume. Alcohol use disorder is a medical condition, not a moral failing, and transparency leads to receiving the best care possible. Based on this information, your medical provider may order a series of diagnostic laboratory tests to get more information. 

One of the most important tests is a comprehensive metabolic panel. This panel will include liver function levels, including the enzymes AST (aspartate transaminase) and ALT (alanine transaminase). AST metabolizes amino acids, and ALT aids in converting protein into energy. In alcoholic cirrhosis, the AST level is often dramatically elevated and can be one of the leading clues pointing toward alcoholic cirrhosis. Also, elevated bilirubin levels can be highly indicative of alcoholic cirrhosis. 

Bloodwork will also look at other levels, such as your hemoglobin and white blood cell count. You may find that you have low hemoglobin (anemia) and a high white count, and your inflammation markers may also be elevated. These blood test results are an essential first step in the diagnosis process. However, they are somewhat non-specific. 

Therefore, it’s not uncommon for your medical provider to recommend a liver ultrasound to evaluate liver changes. A liver biopsy can be done to establish a definitive diagnosis. Liver biopsies, however, are somewhat unpleasant and invasive and can run the risk of patient bleeding. Because of these risks, other imaging studies, such as MRIs and CT scans, may be done to identify the liver damage and formalize the diagnosis. However, these tests are usually not as informative as a liver biopsy. Make sure to discuss the benefits and drawbacks of each test with your doctor.

man on bridge at sunset

Complications of Cirrhosis 

Alcoholic cirrhosis can dramatically affect someone’s quality of life, and even reduce their lifespan. 

Three of the most significant complications of cirrhosis are highlighted below: 

  1. Internal bleeding in the GI tract: This can happen for multiple reasons, including when the damaged liver is no longer able to produce sufficient proteins that are needed in the clotting process. 
  2. Encephalopathy: This happens when the liver can no longer effectively clean the blood, and circulating toxins negatively affect the brain. This can lead to confusion and other severe mental symptoms. Alert your doctor if you notice this so that immediate interventions can be implemented as soon as possible.
  3. Poor nutrition: The liver plays an important role in the digestion process. A poorly functioning liver will mean a less efficient GI tract, and in severe cases, this may result in malnourishment. This can cause a wide range of other health problems and, in severe cases, can even lead to death. 

Treatment for Alcoholic Cirrhosis 

The most effective way to prevent alcoholic cirrhosis is to stop drinking before the liver becomes permanently damaged. But, if your liver is already damaged, there are various treatment options available for alcoholic cirrhosis. 

Various medications can be used to modify the progression of the disease. It’s important to note that these medications can have their own side effects and complications, and that decisions should be made in close consultation with a provider who has experience in treating alcoholic cirrhosis. 

Pharmaceutical interventions aren’t the only treatment options available. Some patients may benefit dramatically from nutritional interventions, such as added protein. Alcoholic cirrhosis can cause havoc with the digestive system, and nutritional diet changes can help provide relief. 

If someone with alcoholic cirrhosis finds their quality of life is continuing to worsen, then a liver transplant is often the last option available. However, it can be difficult to find a donor organ. Also, most hospitals have rigid requirements in place to ensure that anyone who is getting a transplant has a track record of sobriety and a strong support system. 

When looking at these options, it’s important to remember that most of them aren’t a cure to alcoholic cirrhosis. It’s largely impossible to reverse cirrhosis completely. Instead, the treatment options are focused on stopping disease progression and maintaining your quality of life for as long as possible. Working with a medical team and finding support for sobriety, like online alcohol treatment, can provide you with guidance and support at every step.  

How to Prevent Alcoholic Liver Disease 

Alcoholic liver disease, including end-stage alcoholic cirrhosis, is a consequence of drinking too much alcohol for too long, ultimately taxing the liver beyond the point where it can maintain its healthy functioning. The only way to prevent alcoholic liver disease is to treat alcohol use disorder. The team at Monument is prepared to work with you on designing an online treatment program that will help you meaningfully change your drinking habits and put your health first.. Educating yourself about alcoholic cirrhosis is already an admirable, and potentially life-changing, step. You are not alone. 

Sources:

  1. National Institute on Alcohol Abuse and Alcoholism. “The Epidemiology of Alcoholic Liver Disease, https://pubs.niaaa.nih.gov/publications/arh27-3/209-219.htm.” Accessed May. 3, 2022. 
  2. The American Journal of Gastroenterology. “Alcohol Consumption and Risk of Liver Cirrhosis: A Systematic Review and Meta-Analysis, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776700/.” Accessed May. 3, 2022.
  3. Science Direct. “Evaluation of Laboratory Tests for Cirrhosis and for Alcohol Use, in the Context of Alcoholic Cirrhosis, https://www.sciencedirect.com/science/article/abs/pii/S0741832917307656.” Accessed May. 3, 2022.
  4. Wiley Online Library.”Diagnosis of Non-Alcoholic Fatty Liver Disease/Non-Alcoholic Steatohepatitis: Why Liver Biopsy Is Essential, https://onlinelibrary.wiley.com/doi/full/10.1111/liv.13653.” Accessed May. 3, 2022.
Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.

About the Author

Jessica ThomasJessica Thomas’ career expertise spans health education and communication, aging studies, quality improvement, and program development. She enjoys learning about and educating others on healthy living and helping business owners achieve more while doing less at Imperative Concierge Services.