Liver disease due to alcohol; Cirrhosis or hepatitis - alcoholic; Laennec's cirrhosis

Symptoms vary based on how bad the disease is. You may not have symptoms in the early stages. Symptoms tend to be worse after a period of heavy drinking.

Digestive symptoms include:

• Pain and swelling in the abdomen
• Decreased appetite and weight loss
• Nausea and vomiting
• Fatigue
• Dry mouth and increased thirst
• Bleeding from enlarged veins in the walls of the lower part of the esophagus (tube that connects your throat to your stomach)

Skin problems such as:

• Yellow color in the skin, mucus membranes, or eyes (jaundice)
• Small, red spider-like veins on the skin
• Very dark or pale skin
• Reness on the feet or hands
• Itching

Brain and nervous system symptoms include:

• Problems with thinking, memory, and mood
• Fainting and lightheadedness
• Numbness in legs and feet

• Complete blood count (CBC)
• Liver biopsy
• Liver function tests

Tests to rule out other diseases include:

• Abdominal CT scan
• Blood tests for other causes of liver disease
• Ultrasound of the abdomen

The most important part of treatment is to stop using alcohol completely. If liver cirrhosis has not yet occurred, the liver can heal if you stop drinking alcohol.

An alcohol rehabilitation program or counseling may be necessary to break the alcohol addiction. Vitamins, especially B-complex and folic acid, can help reverse malnutrition.

If cirrhosis develops, you may need to manage the complications of cirrhosis. You may need a liver transplant if there has been a lot of liver damage.

Many people benefit from joining support groups for alcoholism or liver disease.

Continued excessive drinking can shorten your lifespan. Your risk for complications such as bleeding, brain changes, and severe liver damage go up. The outcome will likely be poor if you keep drinking.

Call your health care provider if:

• You develop symptoms of alcoholic liver disease.
• You develop symptoms after a long period of heavy drinking.
• You are worried that drinking may be harming your health.

Talk to your doctor about your alcohol intake. The doctor can counsel you about how much alcohol is safe for you. 

Carithers RL, McClain C. Alcoholic liver disease. In: Feldman M, Friedman LS, Brandt LJ. Feldman: Sleisinger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 84.

Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371:838-851.

Garcia-Tsao G, Lim JK; Members of Veterans Affairs Hepatitis C Resource Center Program. Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. Am J Gastroenterol. 2009;104:1802-1829.

Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 156.