Alcohol-related liver disease (ARLD)

Alcohol-related liver disease may not cause symptoms early. As it worsens, symptoms include jaundice, swelling and confusion.

You can get help from a GP if you think you have alcohol-related liver disease. You may need emergency medical help, depending on your symptoms.

Alcohol-related liver disease is diagnosed using questions about drinking and tests such as blood tests, scans or biopsy.

Stopping drinking alcohol is the main treatment for alcohol-related liver disease. Severe cases may need hospital care.

Drinking less or not at all reduces your risk of alcohol-related liver disease. Get support to cut down.

Alcohol-related liver disease (ARLD) does not always cause symptoms in the early stages.

Early symptoms of ARLD may include:

• feeling very tired (fatigue)
• feeling less hungry than usual
• losing weight without trying
• feeling sick (nausea) or being sick (vomiting)
• pain or discomfort in the upper right side of your tummy (abdomen)

As liver damage gets worse, symptoms may include:

• yellowing of the skin or whites of the eyes (jaundice) – yellowing of the skin may be harder to see on black or brown skin
• a high temperature
• swelling of the tummy caused by a build-up of fluid
• swollen legs
• your hands shaking
• blood in your vomit or poo (poo may look black, vomit may look like coffee grounds)
• problems with confusion, concentration and memory

Get medical help if you think you might have alcohol-related liver disease (ARLD). Do not wait for symptoms to get worse.

• you have symptoms of liver disease
• you're worried about your drinking or you want help to stop

You're worried alcohol may be affecting your liver and:

• you vomit blood or your poo is black and looks sticky
• you have pain in your tummy (abdomen)
• you have difficulty breathing or shortness of breath
• you feel suddenly confused, feel dizzy or have difficulty staying awake

Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.

Bring any medicines you take with you.

To diagnose alcohol-related liver disease (ARLD), a doctor will ask about your drinking and how it's affecting your life.

They may also do some tests to see if your drinking is affecting your liver.

Tests may include:

• blood tests to check your liver health
• scans such as an ultrasound or CT scan
• a liver biopsy (a small sample taken from your liver for testing)

Alcohol-related liver disease (ARLD) develops over months or years of drinking too much alcohol. There are 3 stages of ARLD, depending on how serious the liver damage is.

If you stop drinking, your liver can often recover.

The later stages of ARLD are harder to treat and more likely to have serious complications.

The aim of treatment for alcohol-related liver disease (ARLD) is usually to help you stop drinking alcohol completely. This is important whatever stage of ARLD you have.

If you need help to stop drinking, your GP or a specialist alcohol addiction service can help you reduce your drinking safely and offer support.

Support may include:

• talking therapies such as cognitive behavioural therapy (CBT)
• medicines to help you stop drinking alcohol safely or to reduce alcohol cravings
• support groups, such as Alcoholics Anonymous

If your liver is badly damaged, you may need treatment in hospital. You may be considered for a liver transplant.

If you regularly drink too much alcohol it can be very dangerous to stop drinking suddenly. Get medical help before you try to stop drinking.

Alcohol-related liver disease (ARLD) is caused by regularly drinking too much alcohol.

You're more like to develop ARLD if you drink too much and you:

• already have a liver condition, such as hepatitis C
• have diabetes, especially type 2 diabetes
• are overweight or obese
• have a family history of alcohol-related diseases and addiction

ARLD develops more quickly and at lower drinking levels in women than in men. Anyone can get ARLD.

Drinking less alcohol, or not drinking at all, reduces your risk of alcohol-related liver disease (ARLD) and helps prevent serious liver damage.

If you do drink alcohol, it's recommended to drink no more than 14 units a week, spread across 3 days or more. Half a pint of beer or a single shot of spirits each have about 1 unit of alcohol.

Alcohol-related liver disease (ARLD) can be life-threatening.

It can cause serious complications, including:

• liver failure
• fluid build‑up in your tummy (abdomen)
• internal bleeding
• problems with confusion, concentration and memory
• liver cancer
• kidney damage

You may need treatment to support you living with these conditions.

Alcohol-related liver disease (ARLD) can be a difficult condition to live with, both physically and emotionally.

Stopping drinking can be difficult. You can get support from your GP or alcohol addiction support services.

There are also charities and peer-support groups where you can get support from other people going through the same thing.

Support for stopping drinking

Organisations offering support for people trying to stop drinking, including helplines and support groups, include:

• Alcoholics Anonymous
• Alcohol Change
• SMART Recovery

Support for liver problems

You can get information and support for anyone affected by liver disease from Liver UK.

• Website: liveruk.org/
• Helpline: 0800 652 7330
• Liver UK: local support groups
• Liver UK: online community

Support for friends, family and carers

Organisations offering information and support for friends, family and carers, including helplines and support groups, include:

• Al-Anon UK: family groups
• SMART Recovery: family and friends programme
• Alcohol Change UK: help for family and friends