Alcoholic Liver Disease

Alcoholic liver disease is liver injury that is due to alcohol abuse. Approximately 75 percent of Americans drink alcohol, though most of them do not develop serious consequences. However, those who consume more than the daily "threshold" level of alcohol will have some evidence of liver injury.

Alcoholic Liver Disease Symptoms

Symptoms of alcoholic liver disease vary. Some patients do not experience any symptoms at all, or symptoms may be nonspecific. Often, by the time a patient consults a physician, severe liver decompensation, or liver failure, has already developed.

If you consume alcohol on a regular basis and experience any of the following symptoms, make an appointment with a liver specialist:

  • Fatigue

  • Jaundice (yellowing of the skin and whites of the eyes)

  • Dry retching ("dry heaves")

  • Abdominal pain

  • Diarrhea

  • Confusion or decreased concentration

  • Swelling of your leg (edema)

Signs and symptoms of alcohol-related liver disease

Although "cirrhosis" is the most commonly used term to describe liver damage, there are actually three stages of liver damage:

  • Fatty liver is an abnormal accumulation of fat in the liver. This can cause your liver to become enlarged. It is usually asymptomatic and is completely reversible once you stop drinking alcohol.

  • Alcoholic hepatitis occurs when your liver becomes inflamed, destroying liver cells, commonly patients experienced abdominal pain, jaundice and feeling very sick.

  • Cirrhosis (scar formation) occurs when the normal liver tissue is destroyed and replaced with scar tissue.. Blood flow through your liver becomes difficult and fluid accumulates in the abdominal cavity. This could lead to liver failure and liver cancer.

Alcoholic Liver Disease Diagnosis at Johns Hopkins

A diagnosis of liver disease begins with a comprehensive medical history and physical exam during which you describe your symptoms and your alcoholic intake with your doctor.

If you drink more than two alcoholic drinks per day, no matter what kind of beverage, you are at risk for liver damage. Often, patients underestimate how much they drink. Other diagnostic procedures include:

Diagnostic procedures your doctor may order:

  • Biochemical Tests

  • Ultrasound

  • Computed Tomography (CT) Scan

  • Liver Biopsy

  • Fibroscan

Biochemical Tests

Blood tests are useful in evaluating liver disorders. Certain abnormalities will appear on a blood test if you have alcoholic liver disease. However, blood tests are only one part of a full diagnostic workup, since the severity of the liver damage need additional imaging of your liver and or liver biopsy.


An ultrasound uses sound wave technology to provide your doctor with a detailed image of your liver. Ultrasound is a noninvasive test that is easy to perform. However, because an ultrasound cannot detect subtle changes in your liver, additional tests may be required.

Computed Tomography

A computed tomography (CT) scan is a powerful X-ray. Your doctor may use a CT scan to help diagnose cirrhosis, portal hypertension (resistance to blood flow through the liver) and look for presence of liver tumors.

Liver Biopsy

In rare occasions, when the diagnosis is not easily to be established, you may need a biopsy for a definitive diagnosis. During a liver biopsy:

  • You receive local anesthesia.

  • Through a small needle, your doctor removes a small piece of liver tissue and sends it to a pathology lab.

  • Pathologists analyze the tissue and determine if you have hepatitis or cirrhosis.

Alcoholic Liver Disease Treatment at Johns Hopkins

The first step in treating alcoholic liver disease is immediate abstinence from alcohol. Continuing to drink alcohol will lead to further progression of the disease. Abstinence benefits all liver disease patients, regardless of the stage of the disease. Patients who are hospitalized for acute alcohol hepatitis also need treatment for alcohol withdrawal symptoms. Learn more about alcoholic liver disease treatment at Johns Hopkins.

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