Alcohol-related Liver Disease
Alcohol-related liver disease ranges from reversible steatosis through alcohol-related hepatitis to cirrhosis; assess both the liver stage and alcohol-use disorder because abstinence, nutrition and specialist care change prognosis at every stage.
Definition
Alcohol-related liver disease is liver injury caused or contributed to by alcohol, spanning steatosis, alcohol-related hepatitis and cirrhosis. Assessment must address the stage of liver disease and the coexisting alcohol-use disorder.
First principles
Alcohol-related liver disease is a spectrum, not one diagnosis
Steatosis is fat accumulation and may improve with abstinence. Alcohol-related hepatitis is an acute inflammatory syndrome with jaundice and hepatocellular injury, often on a background of chronic disease. Cirrhosis is advanced architectural scarring with portal hypertension and loss of synthetic function. A person can move between stages or present with acute-on-chronic liver failure, so the clinical stage and complications must be assessed rather than inferred from alcohol history alone.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.

