Effects of Alcoholism: Liver Cirrhosis

Functions of the Liver

 The liver is a reddish-brown organ which is rubbery to touch. It weighs about 3 pounds and works to digest, absorb and process food.

The organ’s main job is to filter blood from the digestive system, before circulating it back to the body. The liver breaks down the protein from the food we eat and it creates bile to aid the body to absorb fats. It also filters out the toxins from the blood. The liver detoxifies chemicals and metabolizes drugs. Also, it makes proteins, a vital ingredient for blood clotting and for other functions that the body needs.

What is Alcoholic Liver Cirrhosis?

 Long-term exposure from alcohol builds up toxins in the liver. The body will then start to replace the healthy tissue in the liver with scar tissue. Medical practitioners call this event as alcoholic liver cirrhosis.

Liver scarring can block the liver’s ability to:

  • remove toxins from the blood
  • control infections
  • creates proteins for blood clotting
  • process nutrients, hormones, and medication
  • makes bile to help the body absorbs fats


If the condition continued, the disease will progress and scar tissues will replace the healthy tissues. This will eventually lead to liver failure or the liver can no longer function properly. The liver will decrease its ability to manufacture proteins, process hormones, and medications.

 In a study of the American Liver Foundation, 10% to 20% of heavy drinkers will develop alcoholic liver cirrhosis.  The disease is the end stage chronic form of liver disease related to alcohol consumption.  Cirrhosis is the seventh leading cause of death in the United States. Also, the disease is the third most common cause of death for people ages 45 to 65 years old. About 25,000 people died because of alcoholic cirrhosis. Women are twice most likely to get the disease rather than men.

 Liver cirrhosis is a part of the progression. It usually starts with fatty liver disease, and then progress to alcoholic hepatitis which gradually developed to alcohol cirrhosis. Yet, it is possible for a person to develop the disease without having alcohol hepatitis.

 Quick Facts about the disease

  • 30 million Americans suffers liver or gallbladder disease, which is about one in every 10 people
  • liver cirrhosis is the 7the leading cause of death among adults
  • hepatitis C remains as the number one reason for liver transplant in the US

 Important facts about the liver

 the liver is the only human organ that can regenerate

  • the liver can filter over a liter of blood in a minute
  • liver cirrhosis is a chronic, irreversible disease with distinct scarring of tissues
  • alcoholic hepatitis can affect not just heavy drinkers but social moderate drinkers as well
  • liver disease can go undetected for years and without any obvious signs

  Causes of Alcoholic Cirrhosis

 Long-term alcohol consumption can cause alcoholic liver disease. Years of drinking builds up toxins in the liver. Cirrhosis occurred in the final stage of the alcoholic liver disease. The event can result in the scarring of the liver when it scars starts to appear, the organ cannot function properly. As a result, the body cannot produce sufficient proteins. It will also have difficulty in filtering out toxins from the blood.

 Alcoholic liver disease does not only happen in all heavy drinkers. The probability of acquiring the liver disease depends on the person’s history of alcohol consumption. Also, a person does not need to get drunk to develop alcoholic liver cirrhosis.

 Genetics and Gender

Genetics can also serve as a factor for having the disease. Some people are born with enzyme deficiencies, which are vital to eliminate alcohol in the system. Other includes obesity and having Hepatitis C increases the chance to get the disease.  However, there are several other causes for alcoholic cirrhosis.

 Women may not have many enzymes in their system to break down alcohol particles. Because of this factor, they are more likely to develop the disease compare to men. Unprocessed alcohol may reach their liver and in time builds up the scarring of the organ.

 Alcohol Intake

An important factor in the disease is alcohol. Usually, a person who drank heavily for more than eight years can likely develop alcoholic cirrhosis. According to the National Institute on Alcohol Abuse and Alcoholism, a heavy drinker is someone who drinks at least 5 drinks in a day within 5 days for the past 30 days.

 Signs and Symptoms of Alcoholic Liver Cirrhosis

 Signs and symptoms of alcoholic liver cirrhosis usually surface between the ages 30 to 40 years old. The body can still compensate for the liver’s function during the early stages of the illness. As the disease progress, the symptoms will become more apparent.

Alcoholic cirrhosis disease will show signs and symptoms similar to other liver related illnesses.

 The common symptoms of the diseases include:

  • jaundice ( a yellow color stint in the skin)
  • skin itching (pruritus)
  • portal hypertension (a condition that increases blood pressure in the veins that goes through the liver)

 Depending on the liver’s function, some symptoms may slowly surface, some may take time. Similarly, symptoms can turn worse after a time of heavy drinking. It is important to determine the common signs of the disease. This is to try and reserve the effects of the disease or at least hamper its progression.

 Early Stage symptoms of Alcohol Cirrhosis include:

  • Poor appetite
  • Significant weight loss
  • fatigue
  • Nausea or
  • Abdominal pain
  • Minor, red spider-like blood vessels under the skin

 As the liver deteriorates, signs and symptoms may include:

  •  Yellow color stint in the skin or eyes
  • Flushing or redness of the palms
  • abnormal bleeding
  • easy bruising in the skin
  • Confusion, difficulty thinking


For men:

  • impotence
  • shrinking of the testicles
  • swelling of the breast


Alcoholic Cirrhosis Diagnosis

 Knowing the person’s medical history and drinking habits, doctors can diagnose the disease. Also, doctors can request for an additional test and can confirm alcoholic cirrhosis. These may include:

  •  high ammonia level in the blood
  • high sugar levels
  • anemia
  • leukocytosis (over production of white blood cells)
  • high sugar levels in the blood
  • a biopsy result showing unhealthy liver tissue
  • liver enzyme blood test showing results that the level of aspartate aminotransferase (AST) is twice the amount of alanine aminotransferase (ALT)
  • portal hypertension
  • low levels of magnesium in the blood
  • low levels of potassium in the blood
  • low levels of sodium in the blood

Other medical examination that doctors may request and look for symptoms such as:

  • Coagulation studies
  • Complete blood count (CBC)
  • Enlarged liver or spleen
  • Excess breast tissue
  • Liver biopsy
  • Liver function tests
  • Reddened palms
  • Red spider-like blood vessels on the skin
  • Small testicles
  • Swollen abdomen, because of too much fluid
  • Widened veins in the abdomen wall
  • Yellow eyes or skin (jaundice)

 Doctors will also do additional exams to rule out other diseases such as:

  •  Abdominal CT scan
  • Blood tests for other causes of liver disease
  • Ultrasound of the abdomen

 Other laboratory tests to detect Alcoholic Cirrhosis

  •  Magnetic resonance elastography (transient elastography)
  • A non-invasive imaging test to detect the hardening or stiffening of the liver avoiding liver biopsy.
  •  Biopsy-A procedure that requires doctors to get a tissue sample from the liver. Often use to identify the severity, and cause of liver damage.
  • Tests for hepatitis B and C
  • Blood clotting
  • Kidney function
    • The blood is checked for creatinine, as kidney function is connected to decompensated cirrhosis
  • Liver function
    • The blood is checked for any excess bilirubin. These occur when red blood cells breaks down and for other enzymes that may imply liver damage


Complications of Alcoholic Cirrhosis

 Alcoholic liver cirrhosis can result to more devastating health complications, referred to as decompensated cirrhosis. These complications include:

  •  mental confusion, encephalopathy
  • buildup fluid in the abdomen, ascites
  • internal bleeding
  • yellow color tint in the eyes and skin, (jaundice)

 People who develop or in the end stage of alcoholic cirrhosis often needs a liver transplant. If the disease progress into a more severe form of cirrhosis, doctors usually recommend a regular diagnostic test. This can monitor or show the progression or complications of the disease.

 Here are some possible complications of alcoholic liver cirrhosis:

  •  Bleeding disorders (coagulopathy)
  • Buildup of fluid in the stomach (ascites)
  • Infection of the fluid (bacterial peritonitis)
  • Inflamed veins in the esophagus, stomach, or intestines that can simply bleed (esophageal varices)
  • Increased pressure in the liver’s blood vessels (portal hypertension)
  • Kidney failure (hepatorenal syndrome)
  • Liver cancer (hepatocellular carcinoma)
  • Mental confusion, or coma (hepatic encephalopathy)
 Seek immediate medical attention if one or more of these symptoms arises:

 Symptoms of alcoholic liver disease become apparent

  • Symptoms appeared after prolonged heavy drinking
  • Worried about the damaging health effects of heavy drinking
  • You are worried that drinking may be harming your health.


Call the emergency hotline or contact a doctor right away if these happens:

  • Chest or abdominal pain
  • Sudden swelling of the abdomen, ascites
  • Fever greater than 101F or 38.3C
  • Diarrhea
  • Rectal bleeding or blood in the urine
  • Blood vomiting
  • Shortness of breath
  • Sudden confusion
 Alcoholic Liver Cirrhosis Treatments

 The doctor can still reverse some of the liver diseases with medical treatment. However, liver cirrhosis most often can no longer reverse. Correspondingly, doctors can slow the progress of the illness and reduce the symptoms.

 The first step to slow or reverse the illness is to stop drinking. Those who develop the disease usually became dependent on alcohol that they experience withdrawal symptoms. A doctor can also recommend going to a detoxification or rehabilitation process to help the person.

 The initial step to reduce Alcoholic Liver Cirrhosis:

  • Avoid alcohol
  • Drink less alcohol
  • Eat a healthy with low salt diet
  • Get vaccinated for diseases such as hepatitis A and hepatitis B, and pneumonia
 Other treatments a may include:
  • Medications
    • Doctors may prescribe medications such as calcium, corticosteroids, channel blockers, antioxidant supplements, insulin,  and S-adenosyl-L-methionine (SAMe).
  • Nutritional Counseling
    • Alcohol abuse often interconnected with malnutrition
  • Additional protein:
    • Protein can help reducing the possibility of brain disease (encephalopathy)
  •  Liver Transplant
    • To qualify for a liver transplant, the person must avoid alcohol consumption for more than six month



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Effects of Alcoholism: Liver Cirrhosis
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Dr. Vikram Tarugu

Gastroenterologist and medical professional focused on addiction.

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