Now Accepting Blue Cross Blue Shield. Call Today!

Alcohol-Related Liver Disease (ARLD): Causes, Symptoms & Treatment

Last Updated: November 9, 2023

Editorial Policy | Research Policy

Chronic and excessive alcohol consumption can lead to alcohol-related liver disease, with symptoms that become more severe and noticeable as ARLD advances.

Alcohol-related liver disease (ARLD) is a term that encompasses several different liver conditions that result from excessive alcohol consumption over a prolonged period. ARLD is a significant global health concern, affecting millions of individuals worldwide. It is important for people who drink to understand ARLD and the potential dangers it can bring to those who drink heavily. 

What Is Alcohol-Related Liver Disease?

ARLD is an umbrella term that refers to liver damage caused by excessive alcohol intake. It can manifest in forms ranging from fatty liver to more severe conditions like cirrhosis. The liver, a vital organ, has the critical tasks of detoxifying the blood, aiding digestion and regulating essential nutrients in the body. Persistent alcohol abuse can significantly impair its functions, leading to life-threatening complications.

Causes of Alcohol-Related Liver Disease

Chronic and excessive alcohol consumption causes ARLD, ultimately leading to inflammation and damage to the liver cells. This damage subsequently results in scarring (fibrosis) and impedes the liver’s ability to function properly. The risk of developing ARLD is directly proportional to the amount and frequency of alcohol consumed, with other factors like genetics and diet playing a contributory role. While other causes of liver disease besides alcohol use exist, alcohol is the only cause of ARLD specifically.

ARLD Symptoms

The symptoms of ARLD will vary based on how advanced the condition is. They will be different for everyone, and those just starting to develop ARLD may not experience any symptoms.

Early Symptoms of ARLD

In its initial stages, ARLD may present with non-specific symptoms like fatigue, weakness and loss of appetite. These symptoms are often dismissed or unnoticed and can even be attributed to the side effects of chronic alcohol use. Some people might experience abdominal pain, especially in the liver area, and unexplained weight loss. The early symptoms are generally mild but can progressively worsen if alcohol consumption continues.

Advanced Symptoms of ARLD

As ARLD advances, the symptoms become more severe and noticeable. These symptoms can be more dangerous and include yellowing of the skin and eyes (jaundice), accumulation of fluid in the abdomen (ascites) and confusion. In severe cases, internal bleeding, profound weakness or multi-organ failure can occur, requiring immediate medical attention.

Alcohol and Liver Function

Alcohol is a toxic substance, placing stress on the liver as it works to filter and remove alcohol and its byproducts from the bloodstream. Prolonged exposure to alcohol and its byproducts can lead to liver damage, impairing the liver’s ability to detoxify the blood, synthesize proteins, store vitamins and perform the many other important functions it is responsible for.

Stages of ARLD

ARLD refers to the progression of different liver conditions. These three conditions typically develop one after another, with each one causing the conditions that lead to the development of the next. During each stage, the symptoms of ARLD become more serious. While ARLD can be reversed in the earlier stages, the last stage is permanent and causes lasting effects. 

Alcoholic Fatty Liver Disease

Fatty liver disease from alcohol, also called alcoholic hepatosteatosis, is the earliest and most reversible stage of ARLD. This stage is caused by the accumulation of excess fat within liver cells. This accumulation is usually a direct response to excessive alcohol consumption and typically does not cause any discernible symptoms. Early intervention and abstinence from alcohol at this stage can often reverse the damage entirely.

Alcoholic Hepatitis

Alcoholic hepatitis is a more severe progression of ARLD. In this stage, the presence of fat in the liver results in inflammation of the liver cells. This can cause symptoms such as fever, jaundice and abdominal pain. Hepatitis requires immediate medical attention and intervention to prevent further disease progression. While alcoholic hepatitis can be reversed by stopping alcohol, it is very close to resulting in permanent liver damage.


Cirrhosis is the final and most severe stage of ARLD. In this stage, inflammation causes scar tissue to develop in the liver, damaging liver cells and severely impeding the liver’s normal functions. The damage at this stage is permanent and can lead to many serious liver problems. A liver transplant is typically the only viable treatment option and is not generally available to those using alcohol.

How Is ARLD Diagnosed?

Diagnosing ARLD depends on the person and how far the disease has progressed. A diagnosis of ARLD will be made partially based on the symptoms and history of alcohol use and medical tests. Someone who suspects they could have ARLD should always see a doctor for a diagnosis and never attempt to diagnose themselves.

Blood Tests

Blood tests are important for diagnosing ARLD, as they can reveal abnormalities in liver enzymes that signal potential liver dysfunction. They provide a preliminary insight into the liver’s condition and indicate whether further, more detailed testing is required. Elevated liver enzymes often suggest inflammation or damage to the liver cells. They can help serve as early indicators of disease before serious symptoms are present. 

Imaging Tests

Advanced imaging tests such as ultrasounds, CT scans and MRIs can be used to visually examine the liver’s structure, assessing it for any abnormalities, damages or scarring indicative of ARLD. Imaging provides information about the liver’s condition and plays a role in confirming the diagnosis of ARLD. Identifying structural changes and damage aids in discerning the severity and progression of the disease.

Liver Biopsy

A liver biopsy involves removing a small piece of the liver and examining it under a powerful microscope. This procedure is important in confirming a diagnosis of ARLD and provides invaluable insight into the extent and type of liver damage. A biopsy is especially important when other tests are inconclusive and can help provide a definitive diagnosis.

Prevention and Treatment Options for ARLD

Ideally, ARLD should be prevented before it occurs. If it develops, treating it as quickly as possible is vital to preventing the damage progression and reversing as much damage as possible.

Stopping Drinking Alcohol (Abstinence)

The most important step for either preventing or treating ARLD is stopping alcohol use. ARLD is caused by alcohol, and by quitting drinking, you can avoid ARLD if it hasn’t developed.

If ARLD is already present, stopping alcohol will still help. Fatty liver and hepatitis caused by alcohol use will go away if you stop drinking. Even if you have cirrhosis, hepatitis will also be present, contributing to symptoms. While cirrhosis will remain, stopping alcohol and reducing hepatitis can help reduce your overall symptoms. 

Managing Withdrawal Symptoms

Abstaining from alcohol is fundamental in treating ARLD, but managing the withdrawal symptoms can be challenging and potentially dangerous. Medical intervention might be necessary to effectively manage severe symptoms such as tremors, anxiety and seizures. Managing withdrawal symptoms is important to achieving and sustaining abstinence.

Relapse Prevention

Relapse prevention is important to sustaining long-term sobriety when addiction has developed. It typically requires a combination of counseling and therapy. Relapse prevention strategies are designed to equip individuals with the necessary tools and coping mechanisms to manage triggers and high-risk situations effectively. These strategies help ensure long-term sobriety, avoiding the risk of further ARLD progression.

Alcohol Rehab

Alcohol rehabilitation is ideal for someone who has an alcohol addiction and wants to stay sober. It begins once physical withdrawal is over and offers a structured approach to treating alcohol dependency by addressing the physical and psychological aspects of addiction. Rehab helps prevent further alcohol use and progression of ARLD.

Support Groups

Support groups, like Alcoholics Anonymous, can also augment rehab and relapse prevention, ultimately decreasing the risk of worsening ARLD. These groups offer a community of peers who share similar experiences, providing an environment of understanding and support. Regular attendance at support group meetings can significantly bolster one’s resolve and contribute to continued sobriety.

Balanced Diet and Nutrition

Maintaining a balanced diet rich in fruits, vegetables and lean proteins and low in fats and sugars can help promote liver recovery and overall health. Proper nutrition aids in strengthening the immune system, reducing inflammation and promoting liver regeneration. A balanced diet alone won’t cure ARLD or help cirrhosis; however, it can promote good health and help speed recovery when you stop drinking.

Medication for Symptoms

Medications are an important part of treating symptoms and complications associated with ARLD. Several medications can help with different symptoms that develop. A doctor must prescribe medications for ARLD, which will be far more effective if combined with alcohol abstinence. 

Liver Transplant

No treatment can cure cirrhosis once it develops. The only way to reverse cirrhosis is by obtaining a liver transplant. This procedure involves replacing the damaged liver with a healthy one from a donor. While a liver transplant can significantly improve and prolong life, it is usually only an option for those who have proven they can abstain from alcohol. Due to the scarcity of organs, you will typically have to remain sober for at least six months to be eligible for a liver transplant.

Complications of ARLD

ARLD can lead to many dangerous complications. These complications often require hospitalization and advanced treatments. Stopping alcohol use is vital if complications of ARLD occur.

Portal Hypertension and Varices

Portal hypertension, or high pressure in the veins of the liver, is one potential complication of ARLD. This condition causes veins in the esophagus or stomach to enlarge. These enlarged veins have a high risk of rupturing, leading to life-threatening internal bleeding. Early detection and management of portal hypertension and varices are essential to prevent bleeding and other complications.


Ascites is abnormal fluid accumulation within the abdominal cavity, often leading to marked discomfort and swelling. This fluid accumulation can disrupt your body’s normal function and become dangerous if not addressed. It is a common complication in the advanced stages of ARLD and requires medical intervention to remove the fluid. 

Hepatic Encephalopathy

Hepatic encephalopathy is a severe complication of ARLD. In this condition, toxins normally removed by the liver build up in the bloodstream. These toxins cause inflammation in the brain, potentially leading to confusion, disorientation and, in severe cases, coma.

Liver Cancer

ARLD significantly elevates the risk of developing liver cancer. Regular monitoring and early intervention are critical in managing this risk and ensuring timely treatment. Detecting liver cancer in its early stages increases the chances of successful treatment and improves prognosis; however, stopping alcohol is the most effective way to reduce the risk of liver cancer.

Prevent ARLD Complications With Professional Alcohol Addiction Treatment in Kansas City

Alcohol-related liver disease is serious and potentially life-threatening. Someone at risk for ARLD or beginning to experience liver problems caused by their drinking needs to stop using alcohol immediately. There is no other way to treat or reduce the effects of ARLD effectively.

At The Recovery Village Kansas City, we offer many services, from medical treatment to psychological counseling and support groups, focused on holistic recovery. We know that stopping alcohol use isn’t easy and are committed to helping you or your loved one become sober and avoid the effects of ARLD. Contact us today to learn how we can help you achieve lasting sobriety.


MedlinePlus. “Alcohol.” March 22, 2022. Accessed September 22, 2023.

NHS. “Overview: Alcohol-related liver disease.” September 20, 2022. Accessed September 22, 2023

NIDirect. “Alcohol-related liver disease.” 2023. Accessed September 22, 2023.

Patel, Roshan & Mueller, Matthew. “Alcoholic Liver Disease.” StatPearls. July 13, 2023. Accessed September 22, 2023.

MedlinePlus. “Fatty Liver Disease.” April 26, 2017. Accessed September 22, 2023.

Shah, Niraj J.; Royer, Amor; & John, Savio. “Alcoholic Hepatitis.” StatPearls [Internet]. June 5, 2023. Accessed September 22, 2023.

National Institute of Diabetes and Digestive and Kidney Diseases. “Cirrhosis.” 2023. Accessed September 22, 2023.

NHS. “Diagnosis: Alcohol-related liver disease.” September 20, 2022. Accessed September 22, 2023.

National Institute of Diabetes and Digestive and Kidney Diseases. “Liver Biopsy.” August, 2019. Accessed September 22, 2023.

Hofer, Benedikt Silvester; Simbrunner, Benedikt; & et al. “Alcohol Abstinence Improves Prognosis Across All Stages of Portal Hypertension in Alcohol-Related Cirrhosis.” Hepatology. August, 2023. Accessed September 22, 2023.

Frazier, Thomas H. “Treatment of alcoholic liver disease.” Therapeutic Advances in Gastroenterology. January, 2011. Accessed September 22, 2023.

Runyon, Bruce A. “Patient education: Esophageal varices (Beyond the Basics).” UpToDate. August, 2023. Accessed September 22, 2023.

Mandiga, Pujyitha; Foris, Lisa A.; Bollu, Pradeep C. “Hepatic Encephalopathy.” StatPearls. March 6, 2023. Accessed September 22, 2023.