Stop drinking
The most effective way to treat alcoholic liver disease is to stop drinking. For most people with fatty liver and alcoholic hepatitis the liver will recover and heal itself if they stop drinking.
Even if you have cirrhosis, you will reduce any further damage to your liver and increase your chances of survival if you stop drinking. If you cannot stop, try contacting one of the organisations listed in our section ‘Who else can help?’ pages 31 and 32.
If you have alcoholic liver damage, cutting down will only reduce the rate of damage.
The symptoms of liver damage may disappear when you cut down the amount you drink, but this does not mean that damage is not taking place. Cirrhosis can develop even after drinking just a little too much over the years, with possibly no early warning signs of disease. Treatments are available that will alleviate the symptoms of cirrhosis, but they cannot reverse it.
Diet
Drinking alcohol can lead to malnutrition. The consumption of empty calories, a loss of appetite and malabsorption (poor absorption of food nutrients) caused by alcohol’s toxic effect on the gut can all play a part in this. For this reason, eating well is important in helping your liver recover.
If you have alcoholic liver damage it is likely that you lack vitamins, in particular thiamine (a B vitamin that helps the body convert carbohydrates into energy), and your doctor may have to prescribe vitamin supplements
Other treatments
If you have severe alcoholic hepatitis you may have to be admitted to hospital. Steroids (drugs used to control the inflammation of your liver) may be used if you are very ill and can improve your chance of survival from between 60 and 70 per cent to between 90 and 95 per cent if you are free of infection and have no internal bleeding from your gut.
For people with alcoholic cirrhosis there is no specific treatment other than to stop drinking or, if available, undergo a liver transplant. This can only happen if you are a suitable ‘candidate’.
Liver transplants
For some people with cirrhosis and/or life-threatening liver complications, a transplant may be the only option.
In the UK, alcoholic cirrhosis is the most common reason people need a liver transplant (and runs only second to hepatitis C in Europe as a whole). Only patients whose liver disease fails to improve after a period of abstinence (usually six months) are considered candidates for transplantation in the UK. If you are a candidate for a transplant you will be carefully assessed and may be put on the waiting list for a donor liver. If you continue to drink you will not be offered a transplant.
If doctors consider that you need a liver transplant then you are unlikely to survive for more than a few years without one.
A liver transplant is a major operation – after all, the liver is a major organ. One in twenty people do not survive the operation. If the transplant is successful you will need to take drugs for the rest of your life to stop your body rejecting the donor liver.
Survival following a liver transplant is improving all the time, with about three quarters of those having a successful transplant now living longer than five years.
If your liver transplant is alcohol-related, you will be required to abstain from alcohol permanently in order to remain in good health.