Stages of Alcoholic Liver Disease

Too much alcohol consumption can harm your health. Excessive drinking is associated with numerous health problems, including chronic disease with liver, pancreas, cancers, high blood pressure, psychological disorders. In chronic liver disease, excessive alcohol intakes damages liver cells, and finally develop into liver cirrhosis, which leads to the fatal liver failure.

Liver cirrhosis doesn’t happen overnight, it’s a long-term developed disease. Generally, there are 3 stages in sequence in alcohol abusers.

  1. Fatty liver
  2. Alcoholic hepatitis
  3. Cirrhosis

Fatty liver

Fatty liver is often asymptomatic. In one third of patients, the liver is enlarged and smooth, but it is not usually tender. Fatty liver is potentially reversible.

Alcoholic hepatitis

Alcoholic hepatitis ranges from mild and reversible to life threatening. Most patients with moderate disease are undernourished and present with fatigue, fever, jaundice, right upper quadrant pain, tender hepatomegaly, and sometimes a hepatic bruit.


When liver damage is extensive, symptoms can include:

  • Fatigue
  • Easily bleeding or bruising
  • Loss of appetite
  • Nausea
  • Swelling in your legs, feet or ankles (edema)
  • Weight loss
  • Itchy skin
  • Yellow discoloration in the skin and eyes (jaundice)
  • Fluid accumulation in your abdomen (ascites)
  • Spider-like blood vessels on your skin
  • Redness in the palms of the hands
  • For women, absent or loss of periods not related to menopause
  • For men, loss of sex drive, breast enlargement (gynecomastia) or testicular atrophy
  • Confusion, drowsiness and slurred speech (hepatic encephalopathy)

At this stage, complications of end-stage liver disease can occur, such as portal hypertension (often with esophageal varices and upper GI bleeding, splenomegaly, ascites, and portosystemic encephalopathy).

Portal hypertension may lead to intrapulmonary arteriovenous shunting with hypoxemia (hepatopulmonary syndrome), which may cause cyanosis and nail clubbing.

Acute renal failure secondary to progressively decreasing renal blood flow (hepatorenal syndrome) may develop.

Hepatocellular carcinoma develops in 10 to 15% of patients with alcoholic cirrhosis.





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