Alcohol Related Liver Disease Arld

Overview

Alcohol-related liver disease (ARLD) is damage to the liver caused by drinking too much alcohol over a long time. The liver is a large organ that filters your blood, fights infection, and helps store energy. When you drink heavily, alcohol can harm liver cells and cause scarring, which stops the liver from working properly.

ARLD is a common condition in the UK and around the world. It is one of the leading causes of liver disease and liver failure.

It mainly affects people who have drunk large amounts of alcohol for many years, often starting between the ages of 30 and 50. Men and women can both develop it, but women may be more sensitive to the harmful effects of alcohol on the liver. It can also affect younger people if they drink heavily for a long time.

Symptoms

Common symptoms

• Tiredness and weakness
• Loss of appetite and weight loss
• Feeling or being sick
• Yellowing of the skin or whites of the eyes (jaundice)
• Swelling in the tummy, legs, or ankles
• Feeling confused or very sleepy

Symptoms in children

• ARLD is rare in children, but teenagers who drink heavily can develop it. Symptoms are similar to those in adults, such as tiredness, nausea, and jaundice.

Symptoms in older adults

• Older adults may have vague symptoms like confusion, poor balance, or worsening of other health conditions. They may also be more sensitive to alcohol, so liver damage can happen with lower amounts of alcohol.

Causes

Main causes

• Drinking too much alcohol regularly over many years is the main cause. The liver breaks down alcohol, but heavy drinking damages liver cells and leads to fat build-up, inflammation, and scar tissue (cirrhosis).

Risk factors

• Being a woman (women are more sensitive to alcohol's effects on the liver)
• Having obesity or being overweight
• Having hepatitis B or C
• Having diabetes
• Binge drinking or drinking alcohol every day
• Having a family history of liver disease

When to see a doctor

See a doctor urgently if:

• If you have yellowing of your skin or eyes, a swollen tummy, confusion, or vomiting blood, see a doctor urgently or go to an emergency department.

Book a routine appointment if:

• If you drink heavily and feel tired, lose weight, or have belly discomfort, make an appointment with your doctor. It is also a good idea to talk to your doctor if you are worried about how much alcohol you drink.

Diagnosis

Your doctor will ask about your drinking history and do a physical exam. They may order blood tests, scans, or other tests to check how well your liver is working.

Tests that may be done

• Blood tests (liver function tests)
• Ultrasound scan of your liver
• A special ultrasound called a FibroScan to measure liver stiffness
• Sometimes a small tissue sample (biopsy) is needed

What to expect at your appointment

Your doctor will ask you questions about your alcohol use. It is important to be honest so they can give you the right help. Most tests are painless and you can go home the same day.

Treatment

The most important treatment for ARLD is to stop drinking alcohol completely. If the liver has not become too scarred, it can sometimes repair itself. Your healthcare team will also treat any complications and help you manage symptoms.

Self-care at home

• Stop drinking alcohol now. Get help from your doctor or a support service if you find this hard.
• Eat a healthy, balanced diet to help your liver recover.
• Avoid medicines that can harm the liver. Ask your pharmacist before taking any new medicine, herbal product, or supplement.
• Go to all your follow-up appointments and keep track of any new symptoms.

Medical treatments

Your doctor may prescribe medicines to control symptoms such as fluid retention, itching, or pressure in the liver. In some cases, procedures can be done to reduce bleeding or remove fluid. If you have a serious infection, you may need treatment in hospital. No specific medicines are mentioned here because your doctor will choose what is safe for you.

When is surgery considered?

A liver transplant may be considered if your liver fails and other treatments are not working. To be eligible, you must be able to stay alcohol-free and be well enough for the surgery.

Living with this condition

Living with ARLD means making alcohol-free choices a top priority. You will need to avoid alcohol completely, take any prescribed medicines as directed, and keep regular appointments with your healthcare team.

Lifestyle tips

• Stay alcohol-free every day.
• Get enough rest and sleep to support your recovery.
• Stay physically active if you can, starting slowly and checking with your doctor first.
• Ask for help from family, friends, or a support group.

Diet and exercise

Eat small, regular meals with plenty of fruits, vegetables, and whole grains. Avoid very fatty, salty, or sugary foods. Ask to see a dietitian if you are losing weight or have trouble eating. Gentle exercise like walking can help you feel stronger, but get your doctor's advice before starting.

Mental health and emotional wellbeing

Living with a long-term health condition can bring feelings of stress, sadness, or anxiety. Many people feel guilty or angry about the past. It is common and nothing to be ashamed of. Talking to a counsellor, joining a support group, or calling a helpline can make a big difference.

Prevention

Yes, for most people the best way to prevent ARLD is to drink within recommended limits and have several alcohol-free days each week. The safest approach is to avoid alcohol altogether if you are at higher risk.

Vaccines

You can get vaccinations against hepatitis A and B to protect your liver from further infection. Ask your doctor or nurse about these.

Screening programmes

If you are a heavy drinker, your doctor may offer a short questionnaire or blood test to check your liver health. This is often part of a general health check.

Complications

If left untreated

• Cirrhosis (advanced scarring of the liver)
• Liver failure (the liver stops working)
• Bleeding from swollen veins in the food pipe
• Fluid build-up in the belly (ascites)
• Liver cancer

Long-term outlook

The outlook depends on how much liver damage has already happened. If you stop drinking early, your liver can often repair itself. Even with more advanced disease, staying alcohol-free and following your treatment plan can slow down further damage and help you live well. Your healthcare team will work with you to plan the best care.

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