Alcoholic Cirrhosis

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Alcoholic Cirrhosis

Alcoholic Cirrhosis, Symptoms, Causes, Risk Factors, Complications, Diagnosis, Treatment & Alcoholism

What is Alcoholic Cirrhosis?

The liver is a large organ with an important job in your body. It filters the blood of toxins, breaks down proteins, and creates bile to help the body absorb fats. When a person drinks alcohol heavily over the course of decades, the body starts to replace the liver’s healthy tissue with scar tissue. Doctors call this condition alcoholic cirrhosis.

As alcoholic cirrhosis progresses, and more of your healthy liver tissue is replaced with scar tissue, your liver will stop functioning properly According to the American Liver Foundation, between 10 and 20 percent of heavy drinkers will develop alcoholic cirrhosis. Alcoholic cirrhosis is the most advanced form of liver disease that’s related to drinking alcohol. The disease is part of a progression. It may start with fatty liver disease, then progress to alcoholic hepatitis, and then to alcoholic cirrhosis. However, it’s possible a person can develop alcoholic cirrhosis without ever having alcoholic hepatitis.

Alcoholic Hepatitis vs. Alcoholic Cirrhosis

Hepatitis and cirrhosis are both diseases that affect the liver. Since hepatitis and alcoholic cirrhosis are in many ways on a continuum of disease, the symptoms may be very similar.

However, there are many important differences between the two. In general, hepatitis may or may not be reversible (curable), whereas cirrhosis refers to permanent scarring of the liver, often as the result of chronic hepatitis. While some forms of hepatitis may come on very rapidly, cirrhosis also tends to develop more gradually.

Alcoholic Cirrhosis
Alcoholic cirrhosis is the most advanced form of liver disease that’s related to drinking alcohol.

Alcoholic Cirrhosis Symptoms

Symptoms of alcoholic cirrhosis typically develop when a person is between the ages of 30 and 40. Your body will be able to compensate for your liver’s limited function in the early stages of the disease. As the disease progresses, symptoms will become more noticeable.

The symptoms of alcoholic cirrhosis are similar to other alcohol-related liver disorders. Symptoms include:

  • Jaundice
  • Portal hypertension, which increases blood pressure in the vein that travels through the liver
  • Skin itching (pruritus)

What Causes Alcoholic Liver Cirrhosis?

Damage from repeated and excessive alcohol abuse leads to alcoholic cirrhosis. When the liver tissue starts to scar, the liver doesn’t work as well as it did before. As a result, the body can’t produce enough proteins or filter toxins out of the blood as it should. Cirrhosis of the liver can occur due to a variety of causes. However, alcoholic cirrhosis is directly related to alcohol intake.

Alcoholism is a global health problem. The liver metabolizes most of the ingested alcohol. Among individuals who consume more than 70 drinks (1 drink = one 12 oz. beer at 4% alcohol or one 1.5 oz glass of wine at 11% alcohol) per week for over 20 years, 19% developed alcoholic liver disease, and 7% developed alcoholic cirrhosis.

Thresholds of ethanol consumption per week for the development of alcoholic liver disease were 7 to 13 drinks for women and 14 to 27 drinks for men. Alcoholic liver disease can be divided on histology into steatosis, hepatitis, hepatitis superimposed on early cirrhosis, and cirrhosis. When symptoms occur in individuals with alcohol abuse disorder, many of them already have progressed to cirrhosis. The risk of cirrhosis correlates strongly with past and current alcohol drinking,  and many patients with alcoholic cirrhosis have complications at diagnosis. 

 Alcoholic Cirrhosis
Damage from repeated and excessive alcohol abuse leads to alcoholic cirrhosis.

Alcohol Cirrhosis Risk Factors

The most significant risk factor for alcoholic liver disease is alcohol abuse. Typically, a person has drunk heavily for at least eight years. The National Institute on Alcohol Abuse and Alcoholism defines heavy drinking as drinking five or more drinks in one day on at least five of the past 30 days.

Women are also more at-risk for alcoholic liver disease. Women don’t have as many enzymes in their stomachs to break down alcohol particles. Because of this, more alcohol can reach the liver and make scar tissue.

Alcoholic cirrhosis can also have some genetic factors. For example, some people are born with a deficiency in enzymes that help to eliminate alcohol. Obesity, a high-fat diet, and having hepatitis C can also increase a person’s likelihood they will have alcoholic liver disease.

What Complications Can Alcoholic Cirrhosis Cause?

Doctors can diagnose alcoholic liver cirrhosis by first taking a medical history and discussing a person’s history of drinking. A doctor will also run some tests that can confirm a cirrhosis diagnosis. The results of these tests may show:

  • Liver enzyme blood tests that show the level of aspartate aminotransferase (AST) is two times that of alanine aminotransferase (ALT)
  • Low blood magnesium levels
  • Low blood potassium levels
  • Low blood sodium levels
  • Portal hypertension
  • Anemia (low blood levels due to too little iron)
  • High blood ammonia level
  • High blood sugar levels
  • Leukocytosis (large amount of white blood cells)
  • Unhealthy liver tissue when a sample is removed from a biopsy and studied in a laboratory

Doctors will also try to rule out other conditions that may affect the liver to confirm that cirrhosis has developed.

Possible Complications

Alcoholic liver disease is treatable if it is caught before it causes severe damage. However, continued excessive drinking can shorten your lifespan. Cirrhosis further worsens the condition and can lead to serious complications. In case of severe damage, the liver cannot heal or return to normal function.

Complications may include:

  • Bleeding disorders (coagulopathy)
  • Buildup of fluid in the abdomen (ascites) and infection of the fluid (bacterial peritonitis)
  • Enlarged veins in the esophagus, stomach, or intestines that bleed easily (esophageal varices)
  • Increased pressure in the blood vessels of the liver (portal hypertension)
  • Kidney failure (hepatorenal syndrome)
  • Liver cancer (hepatocellular carcinoma)
  • Mental confusion, change in the level of consciousness, or coma (hepatic encephalopathy)

Diagnosing Alcoholic Cirrhosis

Doctors can diagnose alcoholic cirrhosis by first taking a medical history and discussing a person’s history of drinking. A doctor will also run some tests that can confirm a cirrhosis diagnosis. The results of these tests may show:

  • Liver enzyme blood tests that show the level of aspartate aminotransferase (AST) is two times that of alanine aminotransferase (ALT)
  • Low blood magnesium levels
  • Low blood potassium levels
  • Low blood sodium levels
  • Portal hypertension
  • Anemia (low blood levels due to too little iron)
  • High blood ammonia level
  • High blood sugar levels
  • Leukocytosis (large amount of white blood cells)
  • Unhealthy liver tissue when a sample is removed from a biopsy and studied in a laboratory

Doctors will also try to rule out other conditions that may affect the liver to confirm that cirrhosis has developed.

Your healthcare provider will do a complete health history and physical exam. Other tests used to diagnose alcohol-induced liver disease may include:

  • Blood Tests – Including liver function tests, which show whether the liver is working the way it should.
  • Liver Biopsy – This involves removing small tissue samples from the liver with a needle or during surgery. These samples are checked under a microscope to find out the type of liver disease.
  • Ultrasound – This test uses high frequency sound waves to create a picture of the organs.
  • CT Scan – This imaging test uses X-rays and a computer to produce images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • MRI – MRI uses a magnetic field, radio frequency pulses, and a computer to make detailed pictures of internal body structures. Sometimes injecting dye into a vein is used to produce images of body parts. The dye helps show the liver and other organs in the abdomen (belly).

Treatment For Alcoholic Cirrhosis

Doctors can reverse some forms of liver disease with treatment, but alcoholic liver cirrhosis usually can’t be reversed. However, your doctor can recommend treatments that may slow the disease’s progress and reduce your symptoms.

The first step in treatment is to help the person stop drinking. Those with alcoholic liver cirrhosis are often so dependent on alcohol that they could experience severe health complications if they try to quit without being in the hospital. A doctor can recommend a hospital or treatment facility where a person can start the journey toward sobriety.

Other treatments a doctor may use include:

  • Medications: Other medications doctors may prescribe include corticosteroids, calcium channel blockers, insulin, antioxidant supplements, and S-adenosyl-L-methionine (SAMe).
  • Nutritional Counseling: Alcohol abuse can lead to malnutrition.
  • Extra protein: Patients often require extra protein in certain forms to help reduce the likelihood for developing brain disease (encephalopathy).
  • Liver Transplant: A person often must be sober for at least six months before they are considered a candidate for liver transplant.

Causes of Alcoholism

It is common to think this condition arises from a person who simply does not know how to control their alcohol consumption and is trapped in a vicious circle, but according to the scientific piece ‘The many causes of Alcoholism’ Cohen, S. Published on the Drug Abuse & Alcoholism Newsletter,  there are three main causes of alcoholism disease: biological, physiological, and sociocultural.

  • Biological causes may be:
    • Genetic: “inherited susceptibility to alcohol’s acute effects, impaired ability to catabolize ingested alcohol, or difficulty in dealing with anxiety, frustration, and depression”. 
    • Biochemical: sensitivity to insulin, episodes of spontaneous hypoglycemia, or adrenal insufficiency.
    • Or endocrine: persistently low levels of androgenic hormones.
  • Among the psychological causes of Alcoholism are:
    • Need for tension relief and anxiety control
    • Personality disorders
    • Psychodynamic factors 
    • Learning: tension reduction from drinking provides a positive reinforcement to continue drinking
    • Role modeling: peer example or occupational pressures
  • Culture-specific drinking traditions, and those stresses and conflicts experienced by certain subcultures also contribute to overindulgence in alcohol

Symptoms of Alcoholism

As stated by the National Institute on Alcohol Abuse and Alcoholism, these are the signs to be aware of in terms of this condition: 

  • Appearing intoxicated more regularly
  • Appearing tired, unwell or irritable
  • An inability to say no to alcohol
  • Becoming secretive or dishonest
  • Drinking more, or longer than one intended
  • Wanting to cut down or stop drinking, or tried to, but haven’t been able to do so 
  • Spending a lot of time drinking, being sick or getting over the aftereffects
  • Experiencing craving, a strong need, or urge to drink
  • Founding that drinking, or being sick from drinking, often interferes with taking care of your home or family, job troubles or school problems
  • Continuing drinking even though it was causing trouble with family or friends
  • Giving up or cutting back on activities that are important or interesting to you, in order to drink
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)
  • Continuing to drink even though it was making you feel depressed, anxious, or adding to another health problem, or after having had a memory blackout
  • Having to drink much more than you once did to get the effect you want. Or finding that your usual number of drinks have much less effect than before
  • Finding that when the effects of alcohol are wearing off, you have withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating.

Treatment for alcoholism

When it comes to Alcoholism treatment, it is normal to think of 12-step programs or 28-day inpatient rehab, but it becomes difficult to think of more options of treatment for this condition. There are a variety of treatment methods currently available. According to the National Institute on Alcohol Abuse and Alcoholism, there are three types of treatment: 

  • Behavioral Treatments for alcoholism: Are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial.
  • Medications for alcoholism: Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.
  • Peer-Support Groups for alcoholism: Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support. Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals.
 Alcoholic Cirrhosis
Behavioral Treatments for alcoholism are aimed at changing drinking behavior through counseling.

Reclaim Your Life From Alcoholic Cirrhosis by Treating Alcoholism

Between 10 and 20 percent of heavy drinkers will develop alcoholic cirrhosis. Alcoholic cirrhosis is the most advanced form of liver disease that’s related to drinking alcohol. The best way to avoid or recover from this disease is to stop alcohol consumption, but If you suffer from alcoholism, stopping drinking may be a challenge, even if that involves your wellbeing. 

We Level Up Washington can provide you, or someone you love, the tools to recover from alcoholism with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.