Alcoholic Fatty Liver Disease | Causes, Symptoms, Prevalence, Risk Factors, & Treatment

The liver is the largest solid internal organ in the body and plays a singular role in processing nutrients and filtering out toxins and other harmful substances that have been absorbed into your bloodstream.

These harmful substances include alcohol and its metabolites, which the liver is able to eliminate at a rate of about one standard drink per hour.

However, if the liver is exposed to too much alcohol for too long, it can become injured, leading to serious health problems and alcohol-related liver diseases that begin with hepatic steatosis (otherwise known as fatty liver disease).

Causes Of Alcoholic Fatty Liver Disease

Also known as steatohepatitis, fatty liver disease/hepatic steatosis occurs when fat builds up in the liver to unhealthy levels, resulting in inflammation and liver cell damage.

Chronic alcohol misuse is a common cause of fatty liver disease, so much so that hepatic steatosis is subdivided by healthcare professionals into two categories: alcoholic fatty liver disease and non-alcoholic fatty liver disease (NAFLD).

Effects Of Alcohol On The Liver

Alcoholic fatty liver develops due to the effects of alcohol on the liver tissue, which interfere with the liver’s ability to process lipids, causing them to be stored in the tissues of the liver in higher concentrations than normal. 

This unhealthy buildup of fat can lead to increased liver inflammation and tissue damage over time.

Alcoholic fatty liver disease is considered the first stage of alcohol-related liver disease (ALD), a progressive and potentially fatal series of conditions resulting from the toxic and harmful effects of alcohol addiction.

Symptoms Of Alcohol-Related Liver Disease

In most cases, both alcoholic and nonalcoholic steatohepatitis cause no noticeable external symptoms. Otherwise, persons may feel tired or have discomfort or pain centered in the upper right of the abdomen.

However, if excessive alcohol intake continues and the degree of liver damage grows worse, alcoholic steatohepatitis can develop into more severe forms of ALD, including alcoholic hepatitis or cirrhosis of the liver. This may prompt symptoms such as:

• reduced appetite
• weight loss
• weakness
• fatigue
• nosebleeds
• nausea
• itchy skin
• jaundice, yellowing skin and eyes
• redness in the palms of the hands
• spider angiomas, web-like clusters of blood vessels that form under the skin
• abdominal pain
• ascites, abdominal swelling
• edema, swelling in the legs, feet, or ankles
• missed periods
• loss of sex drive, breast enlargement, and/or testicular atrophy in men
• hepatic encephalopathy, resulting in confusion, drowsiness, and slurred speech

Epidemiology & Prevalence Of Alcoholic & Non-Alcoholic Fatty Liver Disease

NAFLD is widely prevalent in many different worldwide populations and is estimated to affect 30-40% of the United States population, to one degree or another. 

Closely Linked To Alcohol Use Disorder

The prevalence of alcoholic liver disease, however, remains closely linked to rates of alcohol use disorder and is estimated to develop in approximately 2% of Americans with an estimated mortality of at least 5.5 out of 100,000 individuals in 2010.

These rates have increased significantly over time, both in the United States and abroad. 

Researchers attribute this change to increasing alcohol consumption per capita in much of the world, along with an increase in obesity and increasingly sedentary lifestyles in the developed and developing world.

Risk Factors For Alcoholic Fatty Liver Disease

By definition, alcoholic fatty liver disease occurs because of chronic alcohol abuse and its toxic effects on the tissue of the liver. However, other risk factors linked to NAFLD can also increase a person’s risk of developing alcoholic fatty liver disease, including:

• high cholesterol
• elevated blood triglycerides
• metabolic syndromes
• obesity, especially abdominal obesity
• polycystic ovary syndrome
• sleep apnea
• type 2 diabetes
• hypothyroidism
• hypopituitarism
• middle to old age

Treatment Options For Alcohol-Related Chronic Liver Disease

Alcoholic fatty liver is likely the first stage of ALD, not the last. If heavy alcohol use continues, the fatty buildup and inflammation of the liver will increase, resulting in a condition of prolonged liver inflammation known as alcoholic hepatitis.

Alcohol Abstinence  

At this stage, the liver is still capable of remarkable regeneration, and with abstinence from alcohol and other healthy lifestyle changes, most people can resolve their ALD without any other form of treatment. 

However, after this point the damage to the liver will only grow worse, leading to fibrosis, or a buildup of scar tissue in the liver as hepatocytes (liver cells) die off and the organ patches up the damaged tissue. 

This scarring of the liver can then develop into cirrhosis, a dangerous and generally irreversible late-stage form of ALD in which liver function is compromised, eventually resulting in fatal end-stage liver failure. 

Cirrhosis is also treated with abstinence from alcohol and positive lifestyle changes, as well as with liver transplants if the damage is too severe for the body to regenerate.

If you or a loved one are struggling to stop drinking alcohol, or have tried and failed to stop drinking alcohol in the past, please contact us today.