Symptoms, Causes, and Treatment of Alcoholic Cirrhosis

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What is Alcoholic Cirrhosis

Alcoholic cirrhosis happens after years of drinking too much alcohol and is an advanced form of alcohol-induced liver disease. Thirty percent of individuals who drink daily at least eight to sixteen ounces of hard liquor or the equivalent for fifteen or more years will develop cirrhosis. If a person has alcoholic cirrhosis, it is likely that the liver has not been functioning well for a long time.

If You Have Alcohol-Induced Liver Disease, You May Have Had:

  • Fatty Liver Disease (steatosis): A condition caused by abnormal levels of fat in the liver.
  • Alcoholic Hepatitis: A condition caused by continued alcohol use that results in long-term (chronic) inflammation in the liver.
  • Alcoholic Cirrhosis: An advanced stage of alcoholic liver disease that causes the liver to become stiff, swollen, and barely able to do its job.

There are still no FDA-approved pharmacological or nutritional therapies for treating patients with alcoholic liver disease. that is why discontinuance of drinking (avoidance) is an essential part of therapy. Liver transplantation remains the life-saving strategy for patients with end-stage alcoholic liver disease. This is according to NCBI [1].

Statistics of Alcohol Interaction in Human Body

  • In 2018, of the 83,517 liver disease deaths among individuals ages 12 and older, 42.8 percent involved alcohol. Among males, 52,499 liver disease deaths occurred, and 45.4 percent involved alcohol. Moreover, among females, 31,018 liver disease deaths occurred, and 38.5 percent involved alcohol. This is according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) [2]
  • In 2013, liver cirrhosis was the 12th leading cause of death in the United States, with a total of 37,890 deaths—1,585 more than in 2012. Among all liver cirrhosis deaths in 2013, 47.9 percent were alcohol-related. The proportion of alcohol-related cirrhosis was highest (76.5 percent) among deaths of person ages 25–34, followed by deaths of person ages 35–44, at 70.0 percent. Based on the information from NIAAA [3]
  • In 2009, alcohol-related liver disease was the primary cause of almost 1 in 3 liver transplants in the United States, according to NIAAA [4].
Alcoholic Cirrhosis
Alcoholism is a devastating, potentially fatal disease. The primary symptom of having it is telling everyone–including yourself–that you are not an alcoholic.
  • In 2019, 85.6 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 69.5 percent reported that they drank in the past year; 54.9 percent reported that they drank in the past month, according to NIAAA [5].

Symptoms of Alcoholic Cirrhosis

  • Pain over the liver
  • Fever
  • Weakness
  • Nausea and vomiting
  • Appetite loss
  • Yellowing of the skin and eyes (jaundice)
  • Portal hypertension (increased resistance to blood flow through the liver)
  • Enlarged spleen
  • Poor nutrition
  • Bleeding in the intestines
  • Ascites (fluid build-up in the belly)
  • Kidney failure
  • Confusion
  • Liver cancer

Causes of Alcoholic Cirrhosis

There are many causes of cirrhosis.

Major Causes include:

  • Long-term alcohol abuse
  • Chronic hepatitis
  • Hereditary defects in iron or copper metabolism
  • Prolonged exposure to toxins

Alcoholic Cirrhosis Treatment

The goal of treatment is to restore some or all normal functioning to the liver. According to NCBI [6], abstinence can have a great impact on survival even in patients with decompensated cirrhosis. However, if you have alcohol-related cirrhosis or alcoholic hepatitis and do not stop drinking, no medical or surgical treatment can prevent liver failure.

Alcoholic Cirrhosis
Just be honest. Be honest with yourself, be honest with everybody else.

The first step in treatment is to help the person stop drinking. This may involve an alcohol treatment program. Sometimes diet changes are advised, too. The liver is often able to fix some of the damage caused by alcohol so you can live a normal life. The scarring from cirrhosis is sometimes partially reversible, and when liver tissue loss is severe enough to cause liver failure, most of the damage may be permanent. However, the damage won’t have any chance of reversing if you continue to drink alcohol.

In some cases, a liver transplant may be considered. Alcoholic cirrhosis is a leading indicator of orthotopic liver transplant (OLT) in North America, according to NCBI [7]. However, the person must complete a rehab program and go through alcohol detox before this is even an option.

Treatment Goals for Alcoholic Cirrhosis

  • Preventing further damage to the liver
  • Treating the complications of cirrhosis
  • Preventing liver cancer or detecting it early
  • Liver transplantation

Other Treatments a Doctor May Use

  • 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. That is why the role of nutritionists are crucial in treatment.
  • Extra Protein: Clients in treatment often require extra protein in certain forms to help reduce the likelihood for developing brain disease such as encephalopathy.
  • Liver Transplant: Take note that a person often must be sober for at least six months before they are considered a candidate for liver transplant.

Alcohol abuse is one of the primary causes of liver damage. Unfortunately, alcohol-associated liver disease is the main cause of chronic liver diseases that are life-threatening or permanent. Abstaining from alcohol is the only chance a person has of recovery.

Alcohol Abuse Treatment for People with Alcoholic Cirrhosis

Chronic alcohol use will result in a progression from steatosis to alcoholic hepatitis and then finally to alcoholic cirrhosis. Consequently, the complications associated with the alcohol-related disease can be severe. To emphasize, significant alcoholic cirrhosis can increase the risk for liver cancer, other cancers, kidney failure, and dementia.

For an individual with alcohol use disorder, maintaining abstinence from alcohol requires treatment for alcohol use disorder in addition to treatments for alcohol-related liver disease. Thus, the treatment for alcohol-related liver disease and treatment for an alcohol use disorder go hand in hand.

Medically Assisted Detox

Usually, the first step in inpatient treatment is medically assisted detox. Doctors and addiction specialists monitor clients’ vital signs while alcohol exit the system. Depending on the type of substance a person is detoxing from, withdrawal symptoms may differ.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and withdrawals.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for alcohol use disorder and liver disease are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. Typically, individuals undergoing withdrawal management are administered benzodiazepines under the supervision of an addiction medicine physician, whereas steroids are often used to deal with inflammation of the liver that is associated with alcoholic-related liver disease.

drug and alcohol treatment
Cirrhosis is a catabolic condition and patients will lose muscle mass and potentially become sarcopenic without proper protein intake.

Because individuals who have alcohol-related liver disease often suffer from nutritional deficiencies, physicians may consult with nutritionists and recommend a specific diet. In addition, nutrition therapy, including the use of supplementation and special diets, is often used in the treatment of alcohol-related liver disease.

Integrated Mental Health Care

Alcohol affects mental health, so people may use it to self-medicate undiagnosed disorders. Rehab centers typically provide mental health screenings, diagnoses, and integrated treatment for co-occurring disorders. In addition, holistic and therapeutic approaches are often used to treat recovering addicts with these conditions.

Behavioral Therapies

Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) can improve addicts’ behavior. CBT targets negative and maladaptive thought patterns as it promotes positive emotions and beliefs, while DBT helps clients address conflicting impulses so they can make healthy choices. Both therapies treat substance abuse and mental health disorders. Therapy also empowers clients to identify, avoid and mitigate cues that trigger drug cravings.

Individual and Group Counseling

Addiction and mental health counseling occur in both individual and group settings. One-on-one treatment sessions may address unresolved trauma, unconscious conflicts, and specific struggles, while group sessions often involve training in life skills, stress management, conflict resolution, and social connections. Group counseling also gives clients the chance to share their thoughts and experiences to develop social support, which is essential for lasting recovery.

Find the Right Primary Mental Health Treatment Plan

During your rehabilitation, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

Please, do not try to detox on your own because the detox process can be painful and difficult without medical assistance. It’s hard enough that you are struggling with liver disease. If you or someone you know regularly exceeds these recommended daily limits or is experiencing some early signs of liver disease like Alcoholic Cirrhosis, it is important to intervene early.

Inpatient medical detox and residential primary addiction treatment may be available at our affiliated facility at Level Up West Palm Beach Rehab. For some primary behavioral health treatment clients, medical detox and or addiction rehab may be required first.  If you have a co-occurring severe substance abuse diagnosis, please contact us prior to beginning inpatient mental health therapy. Treatment services may vary. Please call us to learn which treatment options are most suited for your individual needs.

Sources

[1] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513682/

[2] [3] [4] [5] NIAAA -https://www.niaaa.nih.gov/sites/default/files/publications/NIAAA_Alcohol_FactsandStats_102020_0.pdf

[6] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636549/

[7] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036962/

[8] Alcoholic Cirrhosis, Facts and Treatment Options – We Level Up