Alcohol-Related Liver Disease (ARLD)

What is alcohol related liver disease (ARLD)?

Alcohol-related liver disease or also called alcoholic liver disease is usually caused by overconsumption of alcohol. If left untreated, alcoholic liver disease can lead to building up fats, liver inflammation, and scarring and progress into an irreversible stage which can be fatal. It is estimated that almost 68% of Americans regularly consume alcohol and almost 8% of the population drink alcohol excessively*.

The liver is one of the most hard-working and complex organs in our body carrying out over 500 functions. Other organs depend on the liver — it processes everything that enters our body, filters out toxins, transports nutrients, and regulates blood sugar. Liver damage can affect the whole body. A liver failure leads to multiple organ failure. Once liver damage begins, it can take a long time to become noticeable, as the liver is generally highly effective at regenerating and repairing itself. Often, by the time the damage is found, liver condition has reached an irreversible stage.

Causes of Alcohol-Related Liver Disease

Everything we eat, drink, inhale, or even apply to our skin is processed by the liver. However, the more toxins we expose ourselves to, the more pressure we put on our liver to detoxify all these harmful substances. Since alcohol is one of the most toxic and harmful (yet legal) substances, the liver throws all its capacity to process and detoxify alcohol leaving behind all other “less important” toxins that entered our body. This leads to toxins and the rest of unprocessed alcohol circulating in the bloodstream until the liver can process it. Though the liver is a very resilient organ capable of regenerating itself, it can never win this war against alcohol in the long run. Every time the liver processes alcohol, some of its healthy cells die.

Yes, the liver can develop new cells, but years of excessive drinking can weaken the liver function to the extent that it will no longer be able to regenerate itself.

Risk Factors of Alcohol-Related Liver Disease

Lifetime alcohol consumption, mixing different alcoholic beverages, alcohol consumption on an empty stomach, excessive drinking — all this puts you at most risk of developing alcoholic liver disease.

Stages of Alcohol-Related Liver Disease

There are three stages of the alcohol-related liver disease:

• Alcoholic fatty liver disease. The condition starts with the build-up of fats in the liver. With abstinence, this condition can still be reversed.
• Alcoholic hepatitis. On top of build-up of fats, a serious liver damage and inflammation starts. More healthy liver cells die compromising healthy liver function.
• Cirrhosis. This is when permanent scarring and liver damage takes over. This condition is not reversible.

Symptoms of Alcohol-Related Liver Disease

The symptoms of alcoholic liver disease become easier to recognize as the disease progresses. Some of the symptoms may include:

• Jaundice (yellowing of the eyes)
• Fever
• Itchy skin
• Pain in the right upper abdomen
• Losing weight
• General weakness
• Blood vomiting
• Easy bleeding and bruising
• Diarrhea

Diagnosis of Alcohol-Related Liver Disease

As many other types of liver disease, alcoholic fatty liver often reveals itself when the disease has done a significant damage to the liver. At the beginning there may be only minor symptoms making the condition not obvious in the early stages. If your doctor suspects alcoholic liver disease, they will arrange a blood test to check how your liver is functioning as well as ask you questions about your alcohol consumption. Further tests may be needed in case of a more advanced stage of ARLD:

• Imaging tests (MRI scan, ultrasound, CT scan)
• Liver biopsy
• Endoscopy

Treatment of Alcohol-Related Liver Disease

Full alcohol abstinence is vital to treat alcoholic liver disease. Patients are often unable to abstain from alcohol without assistance especially since many people with ARLD have an alcohol dependency problem. Without alcohol abstinence, however, no medical treatment can prevent further damage to the liver which can result in liver failure and the need of liver transplant.

Prevention of Alcohol-Related Liver Disease

You can prevent alcoholic fatty liver disease by:

• Limiting or better stopping alcohol intake
• Leading a healthy lifestyle
• Maintaining a healthy weight

Why is nutrition so important for liver health?

97% of physicians agree — nutrition is the most important factor for liver health, even ahead of medication and exercise, according to the survey conducted at the Liver Meeting of American Association for the Study of Liver Diseases in Boston, 2019. Indeed, a healthy diet is crucial for people with liver conditions. It can significantly improve the quality of their life and in some cases prevent certain health complications.

Over the course of liver disease, many liver patients develop malnutrition, certain vitamin and mineral deficiencies as well as alterations in their liver´s metabolic and storage capacity. All this should be a foundation of one´s liver-healthy diet. If not otherwise directed by your physician, a liver-healthy diet should be low in sodium, sugar, gluten, simple carbs, and alcohol and include the proper amounts of vitamins, minerals, probiotic soluble fiber, BCAAs (branched-chain amino acids), and protein.

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Are you leading a liver-healthy lifestyle?

Use our free, online tool — the Liver Health Score — to find out how liver-healthy your current lifestyle and diet are for your liver and what improvements you can make. We recommend taking the Liver Health Score on a regular basis to track your progress and understand how your lifestyle impacts your liver health. Click here to find out your Liver Health Score.

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