Alcohol-induced liver disease: what to watch for and what to do

One surprising fact: fatty changes in the liver can start after just weeks of heavy drinking. That doesn’t mean everyone who drinks will get permanent damage, but alcohol can harm the liver in stages — and early action changes the outcome. This page gives clear, practical steps so you know what to look for and what works.

How alcohol harms the liver

Alcohol is broken down in the liver, and the byproducts are toxic to liver cells. First comes fatty liver (steatosis) — fat builds up inside liver cells. Keep drinking and inflammation can follow: alcoholic hepatitis causes fever, jaundice, and belly pain. Long-term damage becomes cirrhosis, where scar tissue replaces healthy liver and function drops. Fatty liver is usually reversible if you stop drinking; cirrhosis often is not.

Risk doesn’t only depend on how much you drink. Genetics, diet, obesity, viral hepatitis and some medicines can speed damage. Women tend to develop severe damage at lower alcohol amounts than men.

Signs, tests, and when to seek help

Watch for fatigue, loss of appetite, nausea, yellowing of skin or eyes, itchy skin, swelling in the legs or belly, easy bruising, and confusion. Those are warning signs — especially jaundice or sudden swelling. See a doctor quickly if you have those.

Doctors will check liver blood tests (AST, ALT, GGT, bilirubin), do an ultrasound, and sometimes order a CT or MRI. A liver biopsy or specialized scans can tell how much scarring is present. If tests show advanced disease, referral to a hepatologist or liver clinic is the next step.

Treatment focuses on stopping alcohol and treating complications. For alcoholic hepatitis, hospital care, nutrition support, and short courses of steroids may be used in severe cases. For alcohol dependence, medications like naltrexone or acamprosate, plus counseling or support groups, help reduce relapse. For cirrhosis, treatment manages fluid buildup, portal hypertension and infections; vaccination for hepatitis A and B is recommended.

Practical day-to-day tips: stop drinking or cut back under medical support; avoid acetaminophen and other drugs that strain the liver; eat a balanced diet with enough protein and replace missing vitamins (thiamine is often low in heavy drinkers). Join a support group or ask your doctor about addiction services — quitting alcohol is the single most effective step to protect your liver.

If you’re worried about your drinking or have any symptoms, don’t wait. Early testing and honest talk with a clinician make the biggest difference. Your liver can heal if you act now.