What is Alcohol-related Liver Disease (ALD)?

ALD is caused by excessive consumption of alcohol. Over many years this can result in serious and permanent damage to your liver. Each time your liver filters alcohol, some of the liver cells die. The liver can develop new cells (known as regeneration), but prolonged alcohol misuse over many years can reduce its ability to regenerate. This can result in serious and permanent damage to the liver.

ALD develops in three main stages:

  1. Alcoholic fatty liver disease (steatosis): excessive alcohol consumption causes fat to build up in the liver. It often goes unnoticed because it does not tend to cause any symptoms. It is very common amongst people who drink heavily but it will normally go away if you stop drinking alcohol.
  2. Alcoholic hepatitis: the liver cells become inflamed. Inflammation is the body's natural means of protecting itself from harm. Ongoing inflammation causes scar tissue to build up. When the scar tissue builds up faster than it can be broken down and removed this is known as fibrosis. Even if significant levels of fibrosis are present the liver is generally still able to function normally. If you stop drinking alcohol there is a good chance that the liver will recover from this damage over time.
  3. Cirrhosis: If a person continues to consume too much alcohol the inflammation and fibrosis will continue to spread. Over time, usually many years, this can lead to cirrhosis which is where the amount of fibrosis has become so extensive that it will prevent the liver from being able to function normally.


How do you get ALD?

ALD is caused by excessive consumption of alcohol. This can either be caused by binge drinking an excessive amount of alcohol over a relatively short space of time or by consistently drinking more than the recommended limits of alcohol over many years.

What are the symptoms of ALD?

In the early stages of the disease there are often no noticeable symptoms. Only when the liver is badly damaged do symptoms become more obvious.

Possible early symptoms to be aware of are:

  • tiredness/fatigue
  • abdominal pain
  • loss of appetite
  • feeling sick
  • diarrhoea
  • feeling generally unwell

As ALD progresses to alcoholic hepatitis, it is also possible to experience fever and jaundice (yellowing of the whites of the eyes and skin).

ALD can eventually progress to cirrhosis. To find out more about the symptoms of cirrhosis click here.

How is ALD diagnosed?

Diagnosis is often made via a blood test called a Liver Function Test (LFT). This test measures levels of enzymes and proteins which indicate how well the liver is working. When the results of this test are judged to be abnormal it can indicate a problem in the liver. However, even if you have ALD the results of this test may still show that the liver is working normally.

Once the condition has been diagnosed further tests may be required to assess which stage of the disease is present.

An abdominal ultrasound scan and/or a Fibroscan (a specialist type of ultrasound) may be used to assess whether or not cirrhosis is present.

A liver biopsy can give a more precise assessment of how much fibrosis is present.

What is the treatment for ALD?

If you have been diagnosed with alcohol-related hepatitis or cirrhosis the only way to prevent further liver damage is to give up drinking alcohol completely. Depending on the extent of the existing damage the liver may begin to repair itself once alcohol consumption is stopped.

Many people who have alcohol-related health problems aren’t alcohol dependent. Despite not being alcohol dependent it can still be very difficult to stop drinking, particularly in cultures where drinking alcohol is strongly associated with social events.

Click here to download the Drinks Tracker and Days Off apps that can help you to monitor how much you are drinking and motivate you to have some alcohol free days

If you are physically addicted to alcohol, medical supervision may be required to safely reduce your alcohol levels. It can be dangerous to stop drinking very suddenly. Your doctor can recommend the best form of treatment for you.

Is there any support for ALD?

For help and support with alcohol consumption speak to your physician or visit:

Alcohol Concern UK

Alcohol Awareness Specialist Resources

What do patients with ALD say about LiverMultiScan?

Click here to read an account from a patient with ALD who took part in the Patient LiverMultiScan study.