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Early Signs of Alcohol-Related Liver Damage

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Connection Between Alcohol & Liver Damage 

While moderate alcohol use will not typically affect liver function, chronic alcohol use can lead to liver damage and alcohol related liver disease (ARLD), also known as alcoholic liver disease. 

Not all liver damage is due to alcohol use. In fact, there are over 100 types of liver disease out there.9 Other causes of liver damage include:9

  • Genetics
  • Poor diet
  • Obesity
  • Viruses
  • Autoimmune diseases
  • Medication reactions
  • Drugs
  • Toxic chemicals

If you have alcohol-related liver damage, it is recommended that you stop drinking.11

Alcohol is one of the most common causes of liver cirrhosis. It’s second only to hepatitis C virus (HCV) infection, and it contributes to about a quarter of cases of liver cirrhosis.1

10 Early Signs of Liver Damage From Alcohol 

Alcohol-related liver damage refers to liver complications that arise as a result of alcohol use. 

Nearly all men who consume four drinks per day, and all women who consume about two drinks per day, show evidence of liver damage. But less than half will develop a serious form of liver disease.4

People who suffer from alcohol use disorder (AUD) are at a higher risk of developing liver damage. AUD refers to a pattern of drinking that causes the drinker distress or harm, which may be either mild or severe.10

Men are more likely to develop alcoholic-related liver damage than women. But women may develop liver damage with less exposure to alcohol than men.5

There are some early signs of liver damage to keep in mind. While alcoholic liver disease may be asymptomatic, severe liver disease may lead to portal hypertension, jaundice, and brain disease (encephalopathy).

The most common early signs of liver damage from alcohol include:

  1. Digestive tract symptoms like nausea, vomiting, and diarrhea
  2. Abdominal pain
  3. Loss of appetite
  4. Low energy levels
  5. Intense hangovers
  6. Trouble sleeping
  7. Strong effects of caffeine
  8. Severe reactions to medications
  9. Skin issues
  10. Weight loss


As liver damage progresses through the three stages below, these symptoms of liver disease will likely worsen. New symptoms like yellowing of the skin may also start to occur.

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What are the Stages of Alcohol-Related Liver Disease?

There are three stages of alcohol-related liver disease. The stages of liver disease increase in severity over time:

1. Alcoholic Fatty Liver Disease

Alcoholic fatty liver disease refers to when excess fat builds up in the liver due to heavy alcohol use. Fatty liver disease is the first phase of alcohol-related liver disease, and it is still treatable.1

Alcoholic fatty liver disease is also known as hepatic steatosis.8 ​​Almost everyone who drinks heavily develops fatty liver disease at some point.

Symptoms of alcoholic liver disease:

  • Feeling sick with or without fever
  • Unexplained weight loss
  • Loss of appetite
  • Confusion
  • Nausea with or without vomiting
  • Vomiting blood
  • Passing blood in stool 
  • Jaundice

2. Alcoholic Hepatitis/Liver Fibrosis 

Alcoholic hepatitis/liver fibrosis is the second stage of alcohol-related liver disease. It refers to inflammation of the liver.

Alcoholic hepatitis happens when the cells in the liver become inflamed.1 This can last for years and progressively get worse over time. It may even become life-threatening.

Symptoms of alcoholic hepatitis include:

  • Inflammation of the liver
  • Swelling of the liver
  • Fever
  • Jaundice
  • Nausea with or without vomiting
  • Abdominal pain
  • Abdominal tenderness

3. Alcoholic Cirrhosis of the Liver

Alcoholic cirrhosis is the final stage of alcohol-related liver damage. Alcoholic cirrhosis happens when scar tissue takes over normal liver tissue. This is the most intense stage of alcoholic liver disease.

Somewhere between 10 and 20 percent of people who drink heavily develop alcoholic cirrhosis. This generally happens after about 10 or more years of drinking alcohol.

Unfortunately, if liver damage reaches this stage, it may not be reversible. At this point, symptoms may include: 

  • Behavioral changes
  • Confusion
  • Enlarged spleen
  • Fluid accumulation in the abdomen (also known as ascites)
  • High blood pressure in the liver (also known as portal hypertension)
  • Bleeding from esophagus’ veins (also known as esophageal varices)

How is Alcohol-Related Liver Damage Diagnosed?

Alcohol-related liver damage can be diagnosed with a few types of tests. For example, your doctor may administer a blood test to help determine liver function.6

Imaging tests like an ultrasound scan, a CT scan, and an MRI scan can also take a look at the liver scarring.6

Your doctor may also do a liver biopsy to take a sample of the liver cells and send them out to a laboratory for testing. Or they may perform an endoscopy, which refers to passing a camera down through your esophagus and into your stomach.6

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Treatment Options for Liver Damage

Liver damage is common and treatable in the early stages. If you have alcohol-related liver damage, your doctor will tell you to stop drinking.3

Likewise, your doctor may put you on a low-salt, healthy diet. They may also recommend that you get vaccinated for influenza, hepatitis A and B, and pneumococcal pneumonia.3

Some medications they may put you on include diuretics or “water pills” to rid your body of vitamin K buildup, as well as blood medications to prevent excess bleeding. Medications for mental fog and antibiotics for infections may also be necessary.3

In more severe cases of liver damage, such as the development of enlarged veins in the esophagus, endoscopic treatments may be required. 

Abdominal fluid removal (paracentesis) or the placement of a transjugular intrahepatic portosystemic shunt (TIPS), which repairs liver blood flow, are possible treatments.3

If damage is too far done, a liver transplant may be necessary.

Seek professional medical advice to determine which treatment option is best for you.

Can Early Liver Damage be Reversed?

Fortunately, early liver damage may be reversible. Your liver can actually repair itself and regenerate over time.9

If you do not detect alcoholic-related liver damage early, it can cause permanent issues that can lead to more health complications later on. 

For example, cirrhosis can lead to kidney problems and cause intestinal bleeding, fluid buildup in the belly, and severe infections. About 50 percent of people with cirrhosis also have gallstones.2

Liver damage can also lead to liver failure or liver cancer, which are life-threatening conditions.9

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Treatment for Alcohol Misuse & Addiction

If you or someone you know is struggling with binge drinking, alcohol misuse, or addiction, speak with an addiction specialist today. Help is available.

First, know that you’re not alone. More than 14 million people 18 years old and above cope with AUD.10 And many of them don’t seek treatment.

Treatment comes in various forms. For example, you may visit a therapist to talk about the triggers that drive you to drink. Other types of treatment include family counseling, marital counseling, and behavioral therapy, among others.10

You may also choose to take medications that help assist the process. There are currently three types of medications that are approved in the United States to help people with alcohol addictions stop or cut back on their drinking. They can also help prevent relapse. 

These medications include: 

  • Naltrexone, which helps people reduce drinking 
  • Acamprosate, which should aid in abstinence
  • Disulfiram blocks the body’s breakdown of alcohol, which can cause undesirable symptoms that, ideally, discourage drinking10

Alternatively, support groups exist to support you along the road to recovery. Alcoholics Anonymous is just one example.10

Updated on April 26, 2022
11 sources cited
  1. Alcohol-Related Liver Disease.” American Liver Foundation, 13 May 2021.
  2. Alcoholic Liver Disease.” Johns Hopkins Medicine.
  3. Alcoholic Liver Disease.” Mount Sinai Health System.
  4. Alcoholic Liver Disease: Introduction.” Hopkins Medicine.
  5. Alcoholic Liver Disease: Medlineplus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine.
  6. Nhs Choices, NHS.
  7. Osna, Natalia A, et al. “Alcoholic Liver Disease: Pathogenesis and Current Management.” Alcohol Research : Current Reviews, National Institute on Alcohol Abuse and Alcoholism, 2017.
  8. Patel, Roshan. “Alcoholic Liver Disease.” StatPearls [Internet]., U.S. National Library of Medicine, 26 July 2021.
  9. The Progression of Liver Disease.” American Liver Foundation, 1 Sept. 2021.
  10. Treatment for Alcohol Problems: Finding and Getting Help.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services.
  11. Treatment for Cirrhosis.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services.

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