The liver performs numerous functions such as detoxifying the blood, aiding in food digestion, regulating levels of blood sugar and cholesterol, and assisting in combating infections and diseases. Remarkably resilient, the liver possesses regenerative capabilities. However, each instance of alcohol filtration results in the death of some liver cells. While it can produce new cells to compensate for this loss, consistent excessive alcohol consumption over a long period can impair this regeneration process. This may lead to severe and irreversible liver damage. In recent years, Alcohol-related Liver Disease (ARLD) has become increasingly prevalent in the country due to rising trends in alcohol abuse.
What is Alcohol-Related Liver Disease (ARLD)?
Excessive consumption of alcohol can lead to Alcohol-Related Liver Disease (ARLD), a condition causing liver damage. The severity of this disease varies and it's associated with different symptoms.
The symptoms
ARLD often remains asymptomatic until there is significant liver damage. Later, one may experience nausea, weight loss, appetite loss, jaundice (yellowing of the skin or whites of the eyes), swelling in the abdomen and ankles, confusion or sleepiness, and blood in vomit or stools. ARLD is often discovered during medical tests for other health issues or when liver damage has advanced considerably. If you have a habit of heavy drinking, it's crucial to inform your general physician so they can assess if your liver has been compromised.
These are the stages of ARLD:
Having large quantities of alcohol, even over a short period, can result in an accumulation of fats in the liver. This condition is known as alcoholic fatty liver disease and marks the initial phase of ARLD. It rarely presents any symptoms but serves as a crucial indicator that alcohol consumption is at a damaging level. Fortunately, this condition is reversible, and abstaining from alcohol for several months or years can restore your liver to its normal state.
Stage 2: Alcoholic Hepatitis
This is a severe condition that may develop due to prolonged misuse of alcohol. Mild alcoholic hepatitis-related liver damage can usually be reversed by permanently quitting drinking. However, severe alcoholic hepatitis is extremely serious and life-threatening.
Stage 3: Cirrhosis
This represents an advanced stage of ARLD wherein significant scarring has occurred in the liver. Symptoms may not necessarily present themselves even at this stage. It's not reversible, but quitting alcohol without any further delay can prevent liver damage and improve the quality of life.
The complications are internal bleeding (variceal), toxin accumulation in the brain (encephalopathy), fluid build-up in the abdomen (ascites) leading to potential kidney failure, liver cancer, and a higher risk of infections.
The diagnosis and treatment
Blood tests, CT scan, MRI, liver biopsy, and liver ultrasounds can confirm the liver damage not necessarily caused by alcohol. The vital piece in diagnosing ARLD is often the patient's history of alcohol consumption. Treatment for ARLD gravitates usually towards immediately discontinuing alcohol. Despite this, specific treatments further depend on how far the disease has progressed and whether it’s causing symptoms or complications such as cirrhosis. A liver transplant is the last option to save the life of the person.
The prevention
To prevent this condition, it is better to avoid drinking alcohol to take utmost care of your liver. If you have been a heavy drinker for years then it is a good idea to quit on an immediate basis by taking the help of an alcohol rehabilitation centre.
Authored by: Dr. Uday Sanglodkar, Senior Consultant Hepatologist and Clinical lead liver and transplant ICU, Global Hospitals Parel, Mumbai
