Liver disease

Dear Ask The Doctor: My husband is 34 and he is an alcoholic. He has been trying to cut down but anytime there is a holiday or reason to celebrate he still drinks heavily, about 10 beers or more in a single day. For years he drank more than a six pack of beer everyday. I am worried that he is starting to display some symptoms of liver damage such as fatigue, intermittent diarrhea and vomiting and he also has some small areas of skin pigment change. I am wondering if there are other sypmtoms to look out for but I am also worried he has already damaged his liver too much.

Dear Tom:

I know how worried you are about your husband’s probable liver condition. Certainly chronic alcohol consumption is one of the most common causes of liver disease.

In alcoholic liver disease, damage to the liver results from excessive and prolonged alcohol use. In general, the amount of alcohol consumed (how much and how often) determines the risk and degree of liver damage. The amount of alcohol that causes liver damage varies from person to person. Heavy drinkers usually first develop symptoms during their 30s and tend to develop severe problems by their 40s.

Fat accumulation (fatty liver or steatosis) is considered the first stage of the disease. People usually have no symptoms. In some people, the liver is enlarged, tender, or both. This stage is completely reversible if the person stops drinking alcohol.

Inflammation (alcoholic hepatitis): People may have a fever, jaundice, fatigue, under nutrition, and a tender, painful, enlarged liver. Spiderlike veins may appear. This stage has already caused damage to the liver.

Lastly Cirrhosis: People may have few symptoms or the same symptoms as those of people with alcoholic hepatitis. Complications of cirrhosis develop in some but not all. This is the last stage which is not reversible.

If people with alcoholic liver disease continue to drink alcohol, liver damage progresses and is usually fatal. If drinking stops, some damage may be reversed, and such people are likely to live longer. I would suggest your husband to have a routine evaluation and some blood work to estimate his liver function. I wish you the best.