Cirrhosis & Liver Damage From Alcohol Use Disorder (AUD)

Most people know that the liver breaks down drugs and other substances to protect the body from toxic compounds. 

But experts have identified over five hundred other vital functions that the liver performs, ranging from blood plasma production and iron storage to filtering bacteria from the bloodstream.

Unfortunately, however, excessive use of alcohol puts this organ at serious risk.

Alcoholic Liver Disease

When you drink any amount of alcohol it is quickly absorbed into the bloodstream and carried to the brain, where it triggers the effects of alcohol intoxication. 

The liver, meanwhile, is busy filtering that same alcohol out of your blood, using specialized enzymes to convert the ethanol into other, safer substances. 

But when it comes to heavy drinking or binge drinking, the volume of alcohol introduced to the body is simply too great, causing ethanol to build up in the liver and damage its tissue. 

This damage is known as alcohol-related liver disease (ALD) and occurs in heavy drinkers who use alcohol on a regular basis over a long period of time. 

Stages Of Alcohol-Related Liver Disease (ALD)

ALD is a progressive disease, meaning that it gets worse the longer liver damage continues unchecked. The different stages of ALD are:

1. Steatosis, or fatty liver: This is the earliest and the most common type of ALD, and can often be reversed if alcohol intake ceases.
2. Alcoholic hepatitis: At this stage the liver becomes inflamed (steatohepatitis) and healthy liver cells begin to die. This damage is often not fully reversible. 
3. Cirrhosis and liver failure

Alcoholic Cirrhosis

Drinking does not cause severe liver damage in the short-term. 

But each time the liver is damaged, whether by the effects of a disease such as viral hepatitis, fat accumulation (known as nonalcoholic fatty liver disease), or excessive alcohol consumption (ALD), that damage has an effect, and the liver has to heal itself. 

And if the damage is too severe or happens too often, this healing process leaves a mark in the form of hepatic scar tissue known as liver fibrosis.

When an individual develops cirrhosis, it means that the damage and scar tissue buildup on the liver has gotten so severe that liver function is compromised. This is cirrhosis, a life-threatening late stage liver disease strongly associated with alcohol dependence. 

Symptoms Of Cirrhosis

Unfortunately, cirrhosis is extremely hard to detect through signs and symptoms until the underlying liver damage is already extensive and dangerous. These late-stage symptoms include:

• chronic fatigue
• tendency to bruise or bleed easily
• loss of appetite
• nausea or vomiting
• edema, swelling in the legs and ankles
• weight loss
• jaundice, a yellowing of skin and eyes that appear yellowish
• ascites, swelling and fluid accumulation in the abdomen
• appearance of spider-like blood vessels on the skin
• reddening palms
• missed periods for women
• lack of sex drive, testicular atrophy, and/or breast enlargement in men
• dark urine color
• pale stool color
• mental disorder, confusion, and slurred speech

Liver cirrhosis is also known to increase the risk of severe complications including:

• malnutrition
• immune system dysfunction
• portal hypertension (high blood pressure leading into the liver)
• liver cancer, including hepatocellular carcinoma
• splenomegaly (enlargement of the spleen)
• bone disease
• hepatic encephalopathy, or buildup of brain toxins
• multiorgan failure

Prevalence Of Cirrhosis

According to the CDC, chronic liver disease and cirrhosis impact 4.5 million Americans or about 1.8% of the adult population today. It was the 11th most common underlying cause of death in the United States between 1999 and 2019.

Cirrhosis incidence is also more or less likely for individuals depending on certain factors, including genetics, malnutrition, obesity, gender, ethnicity, and others. However, the most significant risk factor is chronic and severe alcoholism. 

Treatment For Cirrhosis

The liver damage resulting from cirrhosis cannot be repaired, but it can be limited with total abstinence from alcohol, a healthy diet, healthy weight, and limiting risky activities that might expose you to the hepatitis B or hepatitis C viruses.

If the damage is too severe, however, a liver transplant may be required. But to be eligible for liver transplantation, a candidate needs to be totally abstinent from alcohol for at least six months and must commit to abstinence for the rest of their lives.

Alcohol Use Disorder Treatment

If cirrhosis develops as a result of an alcohol use disorder, integrated treatment will likely offer the best possible outcome to improve a participant’s entire quality of life.

Treatment options for AUD and cirrhosis may include:

• medical detox or tapering to safely manage the uncomfortable and potentially dangerous effects of alcohol withdrawal
• medication-assisted treatment, likely using acamprosate rather than naltrexone, as naltrexone is processed by the liver and could cause further liver injury
• behavioral therapies, often cognitive-behavioral therapy (CBT)
• motivational interviewing
• counseling sessions
• nutritional therapy
• use of steroids to reduce liver swelling
• participation in support groups, including Alcoholics Anonymous or other 12-step programs
• nature therapy, art therapy, meditation, exercise therapy, and other treatments

To learn more about our compassionate, evidence-based care for substance use disorders in a professional healthcare setting, please contact us today.