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Alcoholic Liver Disease

Contact the UPMC Center for Liver Care

To make an appointment with a UPMC liver disease expert, call 412-647-1170 or fill out our contact form.

What is Alcoholic Liver Disease (ALD)?

ALD is liver damage that occurs due to drinking excessive amounts of alcohol over a long period of time.

This liver damage worsens as you drink more.

Early in the disease, you may not notice any symptoms. As it progresses, your liver may start to scar (cirrhosis).

In advanced stages, this scarring can lead to reduced liver function and you may even need a liver transplant.

Early diagnosis is vital.

You have hope at the UPMC Alcohol-Related Liver Disease Clinic. Our experts provide focused care for people with ALD, starting with treatment of the root cause of the illness.

Types of ALD

There are 3 stages of ALD:

  • Alcoholic fatty liver, or steatosis. Fat cells build up inside the liver during this early stage of ALD. Fatty liver is common in people who drink heavily, but it's often reversible if you seek immediate care and stop drinking.
  • Alcoholic hepatitis. This stage often occurs quickly once liver damage is very advanced. People with ALD will notice more severe symptoms like vomiting and the yellowing of the eyes and skin (jaundice). At this stage, you will need to seek emergency care right sway.
  • Alcoholic cirrhosis. Liver tissue becomes scarred, known as cirrhosis. This advanced liver damage is not reversible.

ALD causes

The direct cause of alcoholic liver disease is consuming large amounts of alcohol. But there are many hard to control factors that may lead a person to drink heavily.

Research shows that these factors all affect alcohol consumption:

  • Genetics. Alcohol use disorders are known to run in families.
  • Mental, social, and emotional factors. Most people with ALD are also getting treatment for PTSD, anxiety, bipolar disorders, depression, or pain disorders.
  • Environmental factors. Acceptance of alcohol use, availability, advertising, and even climate influence heavy consumption.

It's vital to seek care for any of the above factors to help you stop drinking. This, in turn, will slow the progression of your liver disease.

ALD risk factors and complications

You're at increased risk for ALD if you:

  • Often consume more than 2 alcoholic drinks in a day.
  • Have a history of alcohol-use disorder.
  • Have a family history of liver disease of any kind.

Left untreated, ALD can cause complications like:

  • Ascites — fluid that builds up in the belly.
  • Bleeding from varices — enlarged veins in the esophagus.
  • Hepatic encephalopathy — impaired brain function due to built-up toxins.
  • Hepatic hydrothorax — fluid between the chest and lungs.
  • Hepatorenal syndrome — kidney decline or failure.
  • Cirrhosis — scarring of the liver that can cause end-stage liver disease or liver failure.

You're also at an increased risk of liver cancer if you have ALD.

How to prevent ALD

You can prevent ALD by drinking less alcohol or none at all.

It can be challenging to stop drinking on your own. You should speak to your doctor about your drinking and seek care for your mental and emotional health.

Why choose UPMC for alcohol-related liver disease care?

  • Our team includes behavioral health experts to help treat the root causes of your ALD.
  • We work with you to provide the treatment that's right for you, such as lifestyle changes, medicine, and counseling.
  • We partner with experts at the UPMC Liver Cancer Center and the UPMC Liver Transplant Program. This means you get complete and seamless treatment no matter the stage or how severe your illness.

Alcoholic Liver Disease Symptoms and Diagnosis

ALD is a silent disease. That means you will likely not notice any symptoms, sometimes for years, as your liver disease worsens.

Symptoms of advanced ALD

At later stages, you might have symptoms such as:

  • Nausea or stomach pain.
  • Fatigue.
  • Visible blood vessels on your skin.
  • Weight loss.

Advanced liver damage can cause symptoms like:

  • Jaundice, or yellow eyes or skin.
  • Swelling in your legs or belly.
  • Light-colored stools.

Tests to diagnose alcoholic liver disease

If you're a heavy drinker and have ALD symptoms, your doctor:

  • Will do a blood test. These blood tests help confirm that another liver condition isn't causing your liver damage.
  • May also perform a non-invasive scan to screen your liver.
  • May remove a tissue sample from your liver to study it. This test is a liver biopsy.

You may need other testing so doctors can learn more about your liver's health.

Alcoholic Liver Disease Treatment

If you have ALD, it's crucial that you stop drinking. We can help.

At the UPMC Alcohol-Related Liver Disease Clinic, you'll have access to expert hepatologists and a team of nurses and behavioral therapists.

Counseling to treat ALD

Our clinic's behavioral health experts can help treat the underlying causes of your alcohol consumption.

These treatments may include:

  • Motivational counseling.
  • Cognitive therapy.
  • Mindfulness meditation.
  • Training in stress control techniques.

Lifestyle changes for ALD

If you have an alcohol addiction, our experts can connect you with resources or a treatment program to help you stop drinking.

Your doctor might also suggest:

  • Eating a special diet to help with weight gain.
  • Taking supplements to get the nutrients your body needs.

Medicine to treat ALD

Your doctor might prescribe certain drugs to treat the early stages of liver damage from ALD.

These drugs include:

  • Steroids, such as prednisone, to reduce liver inflammation.
  • Water pills to help your body get rid of excess fluids.
  • Vitamin K to help control bleeding (such as bleeding from varices).
  • Medicine that reduces cravings for alcohol.

Surgery to treat ALD

If ALD advances to alcoholic cirrhosis, you may experience liver failure. In these cases, the only treatment is liver transplant.

In liver transplant surgery, doctors replace your liver with a healthy liver from a donor.

Learn more about liver transplant and living-donor liver transplant.