Alcohol-Related Liver Disease (ARLD): Causes, Symptoms & Treatment

Last Updated: February 1, 2024

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Understanding alcohol-related liver disease (ARLD) and its effects is vital for anyone who enjoys alcoholic beverages. The choices you make today will impact your liver health in the future. Understanding this impact now is very important to avoid long-term problems later. By knowing the effects of ARLD and how to recognize and manage them, you can ensure your liver health for years to come.

What Is Alcohol-Related Liver Disease?

Alcohol-related liver disease (ARLD) is an umbrella term that describes conditions affecting the liver caused by excessive alcohol consumption over an extended period. Several different types of ARLD and various stages of severity can occur. While not everyone who drinks heavily will develop ARLD, the risk increases with the quantity and duration of alcohol consumption.

Causes of Alcohol-Related Liver Disease

The cause of ARLD is prolonged heavy drinking. While secondary causes may increase the risk of ARLD, alcohol use is the only factor that can actually cause it. The liver processes alcohol, but when consumed excessively, this process can damage liver cells. Over time, this damage can lead to inflammation, scarring, and other effects, resulting in various stages of ARLD.

ARLD Symptoms

Because the term ARLD encompasses several different conditions, the symptoms of ARLD will vary. Symptoms often break down into two categories: early symptoms that occur as ARLD is starting and late symptoms that happen when ARLD becomes more advanced and more serious.

Early Symptoms of ARLD

In the early stages, symptoms of ARLD can be subtle or even non-existent. If symptoms are present, they are often dismissed as less involved. Early signs of ARLD, if present, may include:

  • Fatigue
  • Loss of appetite
  • Mild abdominal pain
  • Unintentional weight loss
  • Nausea

These symptoms’ low severity does not mean they are not severe. They often warn that something more ominous is about to occur.

Advanced Symptoms of ARLD

As ARLD progresses, more severe symptoms can occur. These symptoms can seriously impact your health, increasing the risk that the condition can cause you harm or even become fatal. Advanced symptoms of ARLD include:

  • Jaundice (yellowing of the skin and eyes)
  • Bruising easily
  • Swelling in the legs and abdomen
  • Mental confusion or memory problems
  • Pronounced abdominal pain
  • Darkening of urine color
  • Pale stool color
  • Internal bleeding 

Anyone with these symptoms needs to seek immediate medical help, as they can indicate that the liver disease is becoming dangerous.

Alcohol and Liver Function

Your liver is a vital organ with the primary role of filtering toxins from your blood and aiding in the digestion of food. When someone drinks alcohol, their liver works hard to process it, breaking down the alcohol into a less toxic substance. However, excessive alcohol consumption can hinder the liver’s ability to function effectively, eventually leading to damage. Over time, the constant processing of large amounts of alcohol can strain the liver, causing ARLD.

Stages of ARLD

There are three main types of ARLD. These three conditions are progressive, with each state causing the next. While each stage of ARLD is its own disease, they are often considered stages of ARLD due to their progressive nature.

Alcoholic Fatty Liver Disease

Alcoholic fatty liver disease, also called alcoholic hepatosteatosis, is the earliest stage of ARLD. In this condition, excessive fat buildup develops in your liver cells due to the effects of alcohol.. You might not even realize you have it, as it typically either doesn’t show any symptoms or only creates vague, unspecific symptoms. Alcoholic fatty liver disease is unlikely to have significant adverse effects and is usually reversible if you stop drinking alcohol.

Alcoholic Hepatitis

Alcoholic hepatitis is the second stage of ARLD and is the stage in which symptoms become more serious. In this stage, your liver becomes inflamed due to fat buildup in the liver. Symptoms can range from mild, like nausea and weight loss, to severe, such as jaundice or liver failure. Immediate medical intervention is crucial if this condition develops. While alcoholic hepatitis is typically reversible if you stop drinking, it can quickly lead to permanent damage.


The last and most severe stage of ARLD is cirrhosis. In cirrhosis, the inflammation of the liver leads to scarring of the liver tissue. Over time, this scarring will hinder the liver’s functionality. The more scarring there is, the less the liver can function. While stopping alcohol use can reverse inflammation, it will not reverse scarring. Cirrhosis can lead to several complications and is often irreversible, underscoring the importance of early detection and treatment.

How Is ARLD Diagnosed?

Diagnosing ARLD as early as possible is crucial for treating it effectively and reducing the risk of serious complications. The diagnosis often involves a comprehensive clinical assessment paired with laboratory tests and imaging procedures, which thoroughly understand the liver’s health status and guide the subsequent treatment.

Blood Tests

Blood tests are foundational in diagnosing liver conditions. These tests precisely measure the level of liver enzymes in the bloodstream. Elevated enzyme levels can indicate if the liver is inflamed or damaged as an early warning system for potential complications. 

Imaging Tests

Medical imaging, such as ultrasounds, CT scans, and MRIs, provide a non-invasive method to see what is happening in the liver. Imaging can capture a range of abnormalities, from liver enlargement to tumors or other structural anomalies. Imaging often plays a vital role in diagnosing liver disorders.

Liver Biopsy

A liver biopsy is one of the most definitive ways of diagnosing liver diseases. A clinician extracts a small tissue sample from the liver during this procedure for detailed analysis. The piece examination goes under a microscope for signs of inflammation, fat accumulation, and scarring. Through this method, your doctor can gain in-depth insights into the extent and type of liver damage.


Endoscopy involves using a flexible tube equipped with a camera to look at the inside of your esophagus. For those with liver disease, it is used to identify varices (enlarged veins) in the esophagus or stomach. The presence of varices can be a red flag, suggesting advanced liver disease or the onset of cirrhosis. Varices themselves are also a severe complication of liver disease that need to be tested for using endoscopy.

Prevention and Treatment Options for ARLD

There are two key parts to treating ARLD. Because ARLD is caused and worsened by alcohol use, treatment often focuses on helping the person with ARLD to stop drinking, thus helping avoid continued damage. In addition to stopping alcohol, treating the ARLD is essential. These two treatment components must be in place to effectively manage ARLD.

Stopping Drinking Alcohol (Abstinence)

Stopping alcohol use is essential in ARLD treatment. Abstinence from alcohol can halt the progression of liver damage, allowing the organ to heal and recover as much as possible. For many, stopping alcohol can be challenging, given its addictive nature and its role in some people’s lives. However, with professional help, anyone can navigate the path to sobriety and achieve improved liver health.

Managing Withdrawal Symptoms

The most challenging part of stopping alcohol use is the withdrawal symptoms that this can create. Mild symptoms may manifest as irritability, sleep disturbances, or anxiety. However, more severe symptoms can escalate to seizures, hallucinations, and other dangerous complications. 

Due to the potential risks of alcohol withdrawal, seeking medical supervision and guidance is essential. Getting professional help will also increase the likelihood that you will successfully get off of alcohol, allowing your liver a chance to heal. 

Relapse Prevention

Stopping alcohol is only half the challenge. Staying away from alcohol can be equally tricky. Maintaining sobriety presents its own challenges, with relapse being a common hurdle. 

Taking steps to help prevent relapse is essential to avoid continued damage to your liver. Relapse prevention strategies, such as cognitive behavioral therapy, individual counseling, and group sessions, are invaluable tools that help you avoid relapse in the future and ensure your long-term sobriety.

Alcohol Rehab

Rehab is often an ideal option after you have gotten through alcohol withdrawal. Rehab centers offer a structured and supportive environment critical for recovery. They help you prevent relapse by equipping you with the tools and mindset needed to overcome cravings and stay sober.

Support Groups

Support groups play an essential role in helping you stay sober. Support groups, such as Alcoholics Anonymous or local sobriety circles, bring together individuals navigating similar challenges. These groups offer a safe space for sharing experiences, gaining insights, and drawing strength from collective resilience. Regular interactions with your peers can bolster your commitment to sobriety and provide consistent encouragement as you continue your efforts.

Balanced Diet and Nutrition

Diet and nutrition play a role in the overall recovery from ARLD. Nutrient-rich foods can bolster liver function, combat inflammation, and enhance overall vitality. A balanced diet, rich in antioxidants, lean proteins, and essential fatty acids, supports liver detoxification and regeneration. Diet alone cannot heal your liver, but following a healthy diet can help your liver heal faster.

Medication for Symptoms

Medical treatments and medication are essential with the advanced forms of ARLD. Your doctor can use medications to manage the symptoms and complications that can arise from the condition. Depending on the severity and type of symptoms, medications can mitigate inflammation, manage pain, or address other related challenges. Staying in close consultation with a hepatologist or primary care physician ensures that medication regimes are optimally tailored to meet your needs.

Liver Transplant

In the most severe instances of ARLD where cirrhosis has developed, a transplant might be the only possible treatment option. This significant procedure involves replacing the damaged liver with a healthy one sourced from a donor. Though complex and demanding, a successful liver transplant can offer a renewed lease on life. 

Those with ARLD will often not be eligible for a liver transplant, as there is a shortage of organs available, and alcohol use will damage a new liver. To ensure that a new liver is treated responsibly, at least six months of continuous sobriety is often necessary to be eligible for a liver transplant.

Complications of ARLD

Beyond its immediate impact on liver function, ARLD can lead to various secondary complications. These complications can be debilitating and even life-threatening, emphasizing the importance of comprehensive care and continuous monitoring for those diagnosed with ARLD.

Portal Hypertension and Varices

Portal hypertension is a condition with excessive pressure within the liver’s vein system due to impaired liver function. This heightened pressure can result in the formation of varices, or enlarged veins, in the esophagus and stomach. These swollen veins are prone to rupture and bleeding, leading to internal bleeding and severe health implications. Regular screening for portal hypertension and its associated complications is essential for those with advanced ARLD.


Ascites occur when fluid leaks from veins and accumulates in the abdominal cavity. Liver disease causes ascites by causing decreased levels of albumin, a protein that helps keep fluid in the veins. 

Beyond the discomfort and physical swelling, ascites can pressure the lungs and cause respiratory problems. Medical interventions, ranging from medications that reduce fluid in the blood to physically draining off the excess fluid, can help manage and alleviate this condition in the short term. Long-term ascites can be problematic, and treating the underlying liver condition is essential.

Hepatic Encephalopathy

Hepatic encephalopathy occurs when the liver fails to clear a toxin called ammonia from the bloodstream effectively. The buildup of ammonia causes inflammation in the brain. Symptoms can range from mild confusion or drowsiness to severe cognitive disruptions, coma, or even death. Some medications can help reduce ammonia levels, but treating the underlying liver problem is the only long-term solution.

Liver Cancer

Those with ARLD have a heightened risk of developing liver cancer. The presence of inflammation and scarring in the liver causes damage to liver cells that can result in cancerous growth. Liver cancer can be deadly, even if detected early; however, early detection improves the prognosis and offers a broader array of treatment options. 

Prevent ARLD Complications with Professional Alcohol Addiction Treatment in South Jersey

If you or someone you love struggles with alcohol addiction, don’t wait and see if liver problems occur. Regardless of the impact on your liver, the time to stop is now. Seeking timely, professional treatment can make a difference, helping you avoid the life-threatening risks that alcohol addiction can bring.

At The Recovery Village Cherry Hill at Cooper Drug and Alcohol Rehab, we know how difficult it can be to stop alcohol. We are committed to your success and can help you get through withdrawal as safely and comfortably as possible, then go on to maintain your newfound sobriety. Contact us today to start on your journey to lasting recovery.


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Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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