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Alcohol and Liver Disease – Cirrhosis Symptoms and Treatment

If you have a drinking problem and drink long enough, the result from that kind of alcohol intake over time can be liver disease in the form of cirrhosis.  The symptoms of cirrhosis vary by the extent of the damage, and the treatment is based on how far the damage has progressed.  The importance of liver functions can’t be overstated because the liver is one of the largest and most complex organs in the body. It stores vital energy and nutrients, manufactures proteins and enzymes necessary for good health, protects the body from disease, and breaks down and helps remove harmful toxins, like alcohol, from the body.

Because the liver is the main organ responsible for metabolizing alcohol, it is a target for alcohol-related injury and disease. Even as few as three drinks at one time may have toxic effects on the liver if you use them in combination with some over-the-counter medications, for example those containing acetaminophen.

Early Stages to Cirrhosis

Alcoholic liver disease can come in three forms; fatty liver, alcoholic hepatitis, and cirrhosis. Heavy drinking for as little as a few days can lead to a fatty liver or the earliest stage of alcoholic liver disease called steatosis.  Steatosis is an excessive buildup of fat inside liver cells. This condition can be reversed if the drinking stops.

Drinking heavily for longer periods may lead to a more severe, and potentially fatal condition, alcoholic hepatitis, which is the actual inflammation of the liver. The symptoms here include nausea, lack of appetite, vomiting, fever, abdominal pain or tenderness, jaundice, and sometimes confusion. If the drinking continues, the next step for some can be alcoholic cirrhosis, where healthy liver cells are replaced by scar tissue, and enough of this scarring can render your liver unable to perform its vital functions.

It is thought that up to 70 percent of all alcoholic hepatitis drinkers will eventually go on to develop cirrhosis.  Alcoholics who stop drinking  have a good chance for a virtually complete recovery from liver disease.

Liver cirrhosis is in the top twenty for major cause of death in the United States and other countries.  Cirrhosis mortality rates vary logically by age groups.  They are lower among young people but increase considerably in middle age, which makes sense in view of the fact that the middle aged person has been drinking longer. In fact, cirrhosis is roughly the 5th leading cause of death in people ages 45-54.

Women tend to be at higher risk than men for developing cirrhosis.  This higher risk is likely due to the differences in the way alcohol is absorbed and broken down in the body. When a woman drinks, the alcohol in her bloodstream reaches a higher level than a man’s even if both are drinking the same amount. And it is fairly well known that the chemicals involved in breaking down alcohol also differ between men and women. For example, women’s stomachs contain less of an important enzyme here (alcohol dehydrogenase) needed for the initial breakdown of alcohol, resulting in breaking down alcohol at a slower rate than men and resulting in higher blood alcohol concentrations for longer periods of time – a situation toxic to the liver.

Treatment strategies include lifestyle changes – reduce alcohol consumption, cigarette smoking, and obesity; better nutrition; drug therapy; and possibly liver transplantation in cases of advanced cirrhosis.

You can find a list of the symptoms of cirrhosis here:   Cirrhosis Symptoms – List

Lifestyle Changes

Abstinence from alcohol is the obvious answer to preventing more severe liver injury.

Many people who drink alcohol also smoke cigarettes and European studies have found scarring of the liver occurs more rapidly in patients who smoke.  Obesity is another factor associated with liver disease and the development of fatty liver which is a disorder similar to alcoholic hepatitis.

Nutritional Treatment Approaches

Although alcoholic drinks contain calories, these calories contain few if any nutrients.  Many alcoholics suffer from malnutrition, which not only enhances but also can lead to liver damage and impaired liver function. 

To prevent these deficiencies the problem drinker needs to make the change to a balanced diet. Dietary supplements can also help prevent or relieve some of alcohol’s harmful effects.

Brain damage can result from a lack of vitamin B1, which can be reversed to some extent. Because vitamin B1 is so important here, the recommendation is that all alcoholics take 50 milligrams of thiamine per day. Alcoholics also should take supplements of vitamins B2 (riboflavin) and B6 (pyridoxine) in a standard multivitamin dosage. Vitamin A can be toxic when combined with alcohol and should be taken only by those who established a deficiency and who have significantly reduced their drinking.

Emerging Therapies

There are other dietary supplements that may help in the treatment of liver disease. For example, eating certain healthy fats (referred to medium chain triglycerides, or MCTs) may help to reduce the buildup of harmful fats in the liver.  MCTs generally are available only in health food stores as a dietary supplement.

Alcohol also causes free radicals to form in the body, which can lead to a multitude of illnesses, cancer included.  So using antioxidants can help prevent this free radical damage.

SAMe may possibly help the treatment of liver damage.  SAMe was used in a clinical study with cirrhosis patients and the results were the patients who took SAMe were  less likely to die or require a liver transplant within the next 2 years, compared with patients who had received a placebo.  This theory has not been proven 100%.

Drug Therapy

Even though they are not FDA approved, several drugs have been used, including pentoxifylline and corticosteroids.

Corticosteroids have been studies more in the therapy for alcoholic hepatitis and their effectiveness appears to be  short-term.   In severely ill alcoholic hepatitis patients the survival edge did not last for just beyond one year. It is generally thought if corticosteroids are used, they should only be used for patients with the most severe liver disease. Also, steroids have side effects, including increased risk of infection, which complicates an already present condition in patients with alcoholic hepatitis.

Transplantation

Liver transplantation currently is the only definitive treatment for severe liver failure.

Potential liver transplant candidates go through a rigorous screening process which shows any coexisting medical problems, such as heart damage, cancer, pancreatitis and other conditions which might influence the outcome of the transplant. It also includes a psychological evaluation to determine who are most likely to remain abstinent and comply with the strict medical regimen that follows the procedure.  In many cases if you drink when you are on the list for a liver transplant, you will be removed from the program entirely.

If it is determined that you are likely to drink after the transplant, due to shortage of liver organ donations, you would likely not be considered for a transplant.

Hepatitis C and Alcoholic Hepatitis

There are several forms of hepatitis.  Hepatitis is actually the inflammation of the liver.  With excessive drinking over a period of time you can develop alcoholic hepatitis – hepatitis caused by alcohol consumption.

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). People usually become infected after coming in contact with blood from an infected person. It is widely known that sharing needles is the most common way of spreading Hepatitis C.  What is not as well known is this disease also can be spread by sexual contact.

This infection or inflammation regardless of the source is a prelude to cirrhosis of the liver.  Heavy alcohol consumption accelerates the progression from hepatitis to cirrhosis (which is again a condition in which scar tissue replaces healthy liver tissue) and liver cancer. 

Abstaining from alcohol is important during any kind of treatment, as heavy drinking during treatment has been shown to all but nullify the benefit of therapy.  The general recommendation by doctors for treatment to be a success is the alcoholic patient stops drinking alcohol for at least 6 months before beginning what commonly ends up being interferon therapy. Light drinkers are usually allowed to begin treatment right away and are not required to adhere to a period of abstinence before starting therapy.

The liver is one of the most important vital organs in the body. It performs many of functions necessary for maintaining anything that resembles good health.

Alcohol is a toxin that is especially harmful to the liver and alcoholic liver disease, particularly cirrhosis, is one of the leading causes of alcohol-related death.  The best way to alleviate or even reverse liver disease, especially in the early to middle stages is of course to stop drinking before the damage progresses to the next level.


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  • 1 admin // Jul 10, 2014 at 9:39 pm

    Dear Sandile –

    We are sorry for the late reply. Please tell us what your current state is.

    Yours,

    Brad & Sara for Max Fisher

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