Alcoholic Cirrhosis

Alcoholism & Causes of Alcoholic Cirrhosis, Symptoms of Alcoholic Cirrhosis, People at Risks of This Condition, Diagnosis, Test, Treatment


Little is understood about how alcohol causes liver disease and cirrhosis.  The most valuable evidence of the causality between alcohol and liver disease stems from epidemiological observations.  Factors contributing to alcohol-induced fibrosis and alcoholic cirrhosis include:

  • Cytokines:  Play a significant role in the innate immune system
  • Oxidative Stress:  An imbalance between free radicals and antioxidants in your body
  • Toxic Metabolites of Ethanol:  Most of the ethanol in the body is broken down in the liver by an enzyme called alcohol dehydrogenase (ADH), which transforms ethanol into a toxic compound
Alcoholic Cirrhosis
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Patients with alcoholic cirrhosis commonly have complications at diagnosis, and cirrhotic complications should be actively evaluated because they are closely associated with following morbidity and fatality.

Abstinence is strictly needed to prevent disease progression and is crucial for inevitable liver transplantation.  In addition, nutritional therapy remains the aid of managing alcoholic cirrhosis. [1]

Alcoholism & Causes of Alcoholic Cirrhosis

 Alcoholism is a global health problem.  This is because the liver metabolizes most of the ingested alcohol.  Among individuals who drink more than 70 drinks (1 drink = one 12 oz. beer at 4% alcohol or one 1.5 oz glass of wine at 11% alcohol) per week for over 20 years, 19% developed alcoholic liver disease, and 7% developed cirrhosis.

Thresholds of ethanol consumption per week for the development of alcoholic liver disease were 7 to 13 drinks for women and 14 to 27 drinks for men.

When symptoms happen in individuals with alcohol abuse, many of them already have progressed to cirrhosis.  The risk of cirrhosis associates strongly with past and current alcohol drinking. [2]

Alcoholic liver disease transpires after years of heavy drinking.  Over time, scarring and cirrhosis can occur.  Cirrhosis is the final phase of alcoholic liver disease.

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Symptoms of Alcoholic Cirrhosis

The liver is a large organ that sits up under the ribs on the right side of the belly (abdomen).

  • The liver helps filter waste from the body
  • It makes bile to help digest food
  • Stores sugar that the body uses for energy
  • Produces proteins that work in many places in the body, for example, proteins that cause blood to clot

Unfortunately, when you drink alcohol heavily over decades, the body starts to replace the liver’s healthy tissue with scar tissue. Doctors call this condition alcoholic cirrhosis.

Symptoms of Cirrhosis include those of Alcoholic Hepatitis, as well as the following:

  • Accumulation of fluid in the abdomen (ascites)
  • High blood pressure in the liver (portal hypertension)
  • Bleeding from veins in the esophagus (esophageal varices)
  • Behavior changes and confusion
  • Enlarged Spleen

Research has pointed that cirrhosis can be reversed, although this may not happen for all patients.  In addition, cirrhosis caused by alcohol can be a life-threatening disease.

People at Risks of This Condition

Alcohol consumption is the most crucial risk factor for liver damage.  Usually, for eight years, a person has been drinking excessively.  Heavy drinking according to the National Institute for Alcohol and Abuses is having five or more drinks in at least 5 of the last 30 days in a single day.

Alcoholic liver disease can also have some genetic factors.  For instance, some people are born with a deficiency in enzymes that help to eradicate alcohol.  In addition, obesity, a high-fat diet, and hepatitis C can also increase a person’s probability of having alcoholic liver disease.

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Alcoholic Cirrhosis Diagnosis

 Doctors can diagnose alcoholic liver cirrhosis by first taking a medical history and examining a person’s drinking history.  A doctor will also run some tests that can verify a cirrhosis diagnosis. The outcomes of these tests may reveal:

  • Anemia (low blood levels due to too little iron)
  • High Blood Ammonia Level
  • High Blood Sugar Levels
  • Leukocytosis (a tremendous number of white blood cells)
  • Unhealthy liver tissue when a sample is removed from a biopsy and studied in a laboratory
  • Liver Enzyme Blood Tests that show the level of aspartate aminotransferase (AST) is two times that of alanine aminotransferase (ALT)
  • Low Blood Magnesium Levels
  • Notable Low Blood Potassium Levels
  • Low Blood Sodium Levels
  • Portal Hypertension

Doctors will also attempt to rule out other conditions that may affect the liver to verify that cirrhosis has developed.

Alcoholic Liver Cirrhosis Tests

Other tests used to diagnose alcohol-induced liver disease may involve:

  • Blood Tests:  Liver function tests confirm whether the liver is working the way it should.
  • Liver Biopsy:  Removing small tissue samples from the liver with a needle or during surgery.  These samples are examined under a microscope to find out the type of liver disease.
  • Ultrasound:  This test uses high-frequency sound waves to generate a picture of the organs.
  • CT Scan:  Uses X-rays and a computer to create images of the body.  A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more complex than general X-rays.
  • MRI:  MRI uses a magnetic field, radiofrequency pulses, and a computer to visualize internal body structures.  [3]

Above all, your healthcare provider will do a comprehensive health history and physical exam. 

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Alcoholic Cirrhosis Treatment

 Doctors can improve some liver diseases with treatment, but alcoholic liver cirrhosis usually is not reversible.  However, your doctor can advise treatments that may slow the disease’s progress and lessen your symptoms.

The first step in treatment is to support you to stop drinking.  Those with alcoholic liver cirrhosis are usually so dependent on alcohol that they could experience severe health complications if they discontinue without being in the hospital.  However, a doctor can suggest a hospital or treatment facility for you to begin the journey toward sobriety.

Other Treatments a Doctor may use include:

  • Medications:  Other medications doctors may designate include corticosteroids, calcium channel blockers, insulin, antioxidant supplements, and S-adenosyl-L-methionine (SAMe).
  • Nutritional Counseling:  Alcohol abuse can lead to malnutrition.
  • Extra Protein:  Clients often need additional protein in certain forms to help reduce the likelihood of developing brain disease 
  • Liver Transplant:  A person often must be sober for at least six months before being considered a candidate for a liver transplant.

Possible Complications

Alcoholic liver disease is treatable if you can detect the disease before it causes critical damage.  However, if you continue your excessive drinking, it can shorten your lifespan.

Cirrhosis further worsens the condition and can lead to severe complications.  In case of severe damage, the liver cannot recover or return to normal function.

Complications may include:

  • Bleeding Disorders (coagulopathy)
  • Development of fluid in the abdomen (ascites) and infection of the liquid (bacterial peritonitis)
  • Enlarged veins in the esophagus, stomach, or intestines that bleed easily (esophageal varices)
  • Increased pressure in the blood vessels of the liver (portal hypertension)
  • Kidney Failure (hepatorenal syndrome)
  • Liver Cancer (hepatocellular carcinoma)
  • Mental confusion, change in the level of consciousness, or Coma (hepatic encephalopathy)

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The chances of getting alcoholic cirrhosis to go up are depending on the longer you drink and the more alcohol you consume.  You do not have to drink alcohol for the ailment to happen.

Generally, the disease is common in people between 40 and 50 years of age.  Men are more likely to have this problem.  However, women may develop the condition after less exposure to alcohol than men. On the other hand, some people may have an inherited risk for the disease. [4]

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Sources:

[1-2] Pathogenesis and management of alcoholic liver cirrhosis – National Center for Biotechnology Information, U.S. National Library of Medicine
[3] Alcohol-Induced Liver Disease – The Johns Hopkins University
[4] Alcoholic Liver Disease – U.S. National Library of Medicine