Alcoholic Cirrhosis Symptoms, Causes, Risks and Treatment

Alcoholic Cirrhosis Symptoms

Cirrhosis is one of several diseases caused by alcohol. It’s the most serious type of alcohol-related liver damage. A mild liver problem called fatty liver disease usually heals on its own once a person stops drinking. A more serious condition called alcoholic hepatitis is usually not life-threatening if the person stops drinking and seeks treatment.

If it isn’t treated and the person keeps drinking, alcoholic hepatitis can lead to alcoholic cirrhosis. Cirrhosis of the liver can also develop in people who don’t have a history of fatty liver disease or hepatitis.

Alcoholic cirrhosis causes several serious symptoms that may require immediate medical attention. The early stage of liver cirrhosis may not cause noticeable symptoms. As the disease progresses, symptoms get worse.

Symptoms of alcohol-induced liver cirrhosis include:

Alcoholic cirrhosis causes several serious symptoms that may require immediate medical attention. The early stage of liver cirrhosis may not cause noticeable symptoms. As the disease progresses, symptoms get worse.

Early symptoms and signs of cirrhosis include:

• Nausea
• Loss of appetite
• Feeling weak or tired
• Fever
• Unexpected weight loss

As liver function gets worse, other more commonly recognized alcoholic cirrhosis symptoms appear including:

• Itchy skin
• Easy bruising and bleeding
• Yellow tint to your skin or the whites of your eyes (jaundice)
• Swelling (edema) in your legs, feet and ankles
• Fluid buildup in your belly/abdomen (ascites)
• Brownish or orange color to your urine
• Light-colored stools
• Blood in your stool
• Confusion, difficulty thinking, memory loss, personality changes.
• Redness in the palms of your hands.
• Spider-like blood vessels that surround small, red spots on your skin (telangiectasias)
• In women: premature menopause (no longer having your menstrual period)
• In men: loss of sex drive, enlarged breasts (gynecomastia), shrunken testicles.

Types of Alcoholic Liver Disease and their Symptoms

There are three different types of liver conditions associated with excessive alcohol intake: fatty liver, alcoholic cirrhosis of the liver, and alcoholic hepatitis.

Fatty liver occurs as a result of fatty build-up, which occurs in the liver cells. Fatty liver is not a serious condition, and it usually has no symptoms. The disease will usually go away on its own, once the person changes their dietary and drinking habits. Only if a person continues drinking, the fatty liver disease may progress to hepatitis.

Alcoholic cirrhosis is a scarring of the liver tissue in response to the damage that occurs repeatedly over many years. The scarring occurs during the process in which the liver tries to repair itself. Cirrhosis usually has no signs and symptoms until the late phase. When the symptoms occur, they include fatigue, easy bleeding, and bruising, fluid accumulation in the abdomen, loss of appetite, nausea, swelling in the legs, and weight loss.

Alcoholic hepatitis is an inflammation of the liver. The inflammation can be very mild or extremely severe. In mild cases, the individual may not feel any symptoms. However, the blood test may reveal elevated levels of liver enzymes. In severe cases, the individual may feel nausea, pain in the upper right quadrant of the abdomen, and may develop jaundice, or yellowing of the skin and eye whites. In most severe cases, the liver may fail and cause blood clotting problems, confusion, coma and bleeding into the guts. This may be a fatal condition.

Differentiation between Alcoholic Hepatitis and Alcoholic Cirrhosis

People who drink alcohol can still develop liver inflammation and injury, even if they never contract the hepatitis virus. This is because excessive alcohol consumption can lead to alcoholic hepatitis.

Although in many individuals the affected liver is able to regenerate its tissue and retain its function, severe hepatitis may progress to scarring of the liver tissue (i.e., fibrosis), cirrhosis, liver cancer (i.e., hepatocellular carcinoma), and chronic liver dysfunction. Hepatitis can have numerous causes, such as excessive alcohol consumption or infection by certain bacteria or viruses. One common cause of hepatitis is infection with one of several types of viruses (e.g., hepatitis A, B, or C viruses).

Alcoholic hepatitis is a separate condition from Hepatitis C Virus— it is a severe consequence of long-term alcohol abuse that lasts at least 20 years. Hepatitis due to both Hepatitis C Virus (HCV) and alcohol abuse can coexist. In fact, Hepatitis C Virus (HCV) infection is becoming a leading cause of cirrhosis, liver failure, and hepatocellular carcinoma. It is important to note that the Hepatitis C Virus is contagious. If a person is unsure if they have contracted the infection, they should take safety precautions to prevent others from coming into contact with their blood. 

Early studies had reported that Hepatitis C Virus (HCV) infection (as well as infections with the hepatitis B virus) was particularly common among alcoholics, affecting 35 percent of alcohol-dependent people. However, those studies did not exclude the role of other potential risk factors, such as intravenous drug abuse and receipt of blood transfusions.

The study found that actively drinking alcoholic patients were more likely to show evidence of HCV in the blood than control patients, suggesting that alcoholism in some way is a predisposing factor for HCV infection. This conclusion is consistent with the prior observation that the presence of inflammation in the liver is strongly associated with the presence of antibodies to HCV in alcoholic patients who have no other known risk factors for the infection.

What Causes Cirrhosis?

Cirrhosis has different causes. Some people with cirrhosis have more than one cause of liver damage.

Most common causes

The most common causes of cirrhosis are:

• Alcoholic liver disease—damage to the liver and its function due to alcohol abuse
• Nonalcoholic fatty liver disease
• Chronic hepatitis C
• Chronic hepatitis B

Less common causes

Some of the less common causes of cirrhosis include:

• Autoimmune hepatitis
• Diseases that damage, destroy, or block bile ducts, such as primary biliary cholangitis and primary sclerosing cholangitis
• Inherited liver diseases—diseases passed from parents to children through genes—that affect how the liver works, such as Wilson disease, hemochromatosis, and alpha-1-antitrypsin deficiency 
• Long-term use of certain medicines 
• Chronic heart failure with liver congestion, a condition in which blood flow out of the liver is slowed.

Alcoholic Cirrhosis Treatment

The goal of alcoholic cirrhosis treatment is to restore some or all normal functioning to the liver. Abstinence from alcohol can have a great effect on survival even in people 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. Thus, the treatment for alcohol-related liver disease and treatment for alcohol use disorder go hand in hand.

The first step in treatment is to help the individual stop drinking. This may involve an inpatient 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. However, the person must complete a rehab program and go through alcoholism treatment before this is even an option.

Treatment Goals for Alcoholic Cirrhosis Symptoms

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

Medically Assisted Detox

Usually, the first step in inpatient alcohol 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, alcohol 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.

During your rehab, 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.

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.