Gastroenterology & NutritionPending review

Alcohol-related Liver Disease

A dose- and time-dependent spectrum from reversible fatty change through inflammation to irreversible scarring, so the stage a patient is at determines whether stopping alcohol can still reverse the damage.

In a nutshell

Alcohol injures the liver in a predictable sequence: fat accumulation (fully reversible), then hepatocyte injury and inflammation (alcoholic hepatitis, potentially fatal acutely), then fibrosis and cirrhosis (irreversible). Where the patient sits on this spectrum determines whether abstinence can still reverse the damage.

Classic presentation

A patient with a history of heavy alcohol use presenting with jaundice, tender hepatomegaly and malaise (acute alcoholic hepatitis), or found incidentally to have deranged LFTs and a bright liver on ultrasound (fatty liver).

Key points

Steatosis is fully reversible with abstinence; once bridging fibrosis and regenerative nodules form (cirrhosis), the change is permanent.

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Educational content pending clinical review. Not medical advice.