Treatment

The most important part of treatment in all forms of alcoholic liver disease is to stop drinking, preferably for life. At the stage of fatty liver and alcoholic hepatitis this would lead to complete resolution of the condition and, even for patients with cirrhosis, stopping drinking improves survival.

Patients with the more severe forms of alcoholic hepatitis, with signs of profound jaundice and abnormal blood clotting, require admission to hospital, ideally under the supervision of a doctor with a particular interest in liver disease.  These patients have up to a 50% death rate at 3 months and require intensive therapy. Steroids (drugs used to control inflammation in the body) may be used in some patients as they have been shown to improve mortality.  There is a significant risk that the liver will go on to develop cirrhosis if drinking alcohol continues or sometimes even if it doesn’t.

The amount of alcohol that it is safe to drink varies from one person to another.  People who have already developed alcoholic hepatitis or cirrhosis can damage their livers even further if they continue to drink. 

Cutting down only reduces the rate of damage.

Symptoms due to alcoholic liver damage such as pain or jaundice may well disappear if drinking is cut down, but this doesn’t mean that damage is no longer taking place.  Cirrhosis can develop even after drinking only a little too much over the years, and there may be no early warning symptoms.

Diet

Diet is also important - eat a well balanced diet, if necessary with supplements prescribed by a doctor.  Nutrition can play an important part in treatment and the doctor may refer you to a State Registered Dietician for advice. 

Other treatments

For patients with advanced alcoholic hepatitis, admission to hospital and more intensive therapy is required and steroids may also be prescribed.

Unfortunately, no specific treatments have been shown to improve the outcome of patients with established cirrhosis.  

Stopping drinking, therefore, remains the mainstay of treatment along with standard therapy for the complications of cirrhosis including oesophageal varices, encephalopathy and ascites.

Transplantation

For some people with cirrhosis who develop life-threatening complications, liver transplantation is an option. 

Many factors must be taken into consideration, including a continuing alcohol problem and the effect alcohol has already had on the health of other parts of the body such as the heart and brain, general health and whether the patient is strong enough physically and mentally to withstand the major surgical procedure. 

Most people will have stopped drinking for at least six months before being accepted for liver transplantation.