Alcoholic Liver Disease: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Alcoholic Liver Disease?
A hepatologist, a doctor who treats liver disease, usually treats alcoholic liver disease. A gastroenterologist, a doctor who treats the digestive system, often cares for it too. Many people also need help to stop drinking. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is alcoholic liver disease?
Alcoholic liver disease is damage to the liver and its function from drinking too much alcohol.
The damage builds up in stages. It can start with fat in the liver, called alcohol-associated steatosis. It can then lead to swelling of the liver, called alcoholic hepatitis. Over time, scarring and cirrhosis can occur. Cirrhosis is the final phase of alcoholic liver disease.
Symptoms
There may be no symptoms at first. Symptoms tend to be worse after a period of heavy drinking. Early signs include:
- Loss of energy.
- Poor appetite and weight loss.
- Nausea.
- Belly pain.
- Small, red spider-like blood vessels on the skin.
As the liver works less well, symptoms can include:
- Fluid buildup in the legs (edema) and the abdomen (ascites).
- Yellow skin or eyes (jaundice).
- Easy bruising and abnormal bleeding.
- Confusion or problems thinking.
- Pale or clay-colored stools.
Causes and who gets it
Years of heavy drinking cause most cases. But alcoholic liver disease does not occur in all heavy drinkers. The chances go up the longer you have been drinking and the more alcohol you consume. You do not have to get drunk for the disease to happen.
It is most common in people between 40 and 50 years of age. Men are more likely to have this problem. However, women may develop the disease after less exposure to alcohol than men. Some people may have an inherited risk for the disease.
How doctors diagnose it
Doctors do a physical exam to look for an enlarged liver, fluid in the belly, jaundice, and red spider-like blood vessels on the skin. Tests may include a complete blood count, which counts your blood cells, liver function tests, and coagulation studies, which check how well your blood clots.
Imaging tests such as an abdominal ultrasound, a CT scan, or an MRI can show the liver. In some cases, a liver biopsy is done. A small piece of the liver is taken and looked at under a microscope.
Treatment
One important step is to stop drinking alcohol. If you have alcoholic liver disease, you should not drink any alcohol. If you have been drinking heavily, do not stop all at once on your own. Alcohol withdrawal can be serious, so ask your doctor to help you stop safely. Talk openly with your provider about your alcohol intake. Also ask about all medicines you take, including herbs, supplements, and medicines from the store shelf.
In the hospital, people with severe alcoholic hepatitis may be given a steroid medicine, called a corticosteroid. Poor nutrition is common, so the care team may also add nutrition support. Other care includes a healthy diet that is low in salt. Doctors may suggest vaccines for the flu, hepatitis A and hepatitis B, pneumococcal pneumonia, and COVID-19. Water pills, called diuretics, help remove extra fluid. Vitamin K or blood products can prevent excess bleeding. Procedures can treat swollen veins in the esophagus, the tube from the mouth to the stomach, or remove fluid from the abdomen.
When cirrhosis reaches end-stage liver disease, a liver transplant may be needed. Transplant teams usually want a period without alcohol first, often about 6 months.
When to see a doctor
Contact your provider if you develop symptoms after a long period of heavy drinking, or if you worry that drinking may be harming your health. Call 911 or go to the emergency room if belly swelling is new or suddenly gets worse, or if you have new confusion or a change in alertness. Do the same if you have belly or chest pain, a fever above 101 F (38.3 C), a seizure, hallucinations, or an irregular heartbeat. Do the same if you vomit blood or vomit more than once a day, have rectal bleeding or shortness of breath, or if yellowing of the skin or eyes is new or gets worse quickly.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either doctor can check your liver with blood tests and help you cut back or stop drinking. They can also coordinate your care if you need a liver specialist.
Common questions
Can my liver heal if I stop drinking?
It depends on how much damage there is. Alcoholic liver disease is treatable if it is caught before it causes severe damage. In case of severe damage, the liver cannot heal or return to normal function.
Do all heavy drinkers get liver disease?
No. Alcoholic liver disease does not occur in all heavy drinkers. The chances go up the longer you have been drinking and the more alcohol you consume.
Why do women get it with less alcohol?
Women may develop the disease after less exposure to alcohol than men. Some people may also have an inherited risk for the disease.
What is cirrhosis?
Cirrhosis is scarring of the liver. It is the final phase of alcoholic liver disease. Cirrhosis further worsens the condition and can lead to serious complications.
Sources
- MedlinePlus - Alcoholic Liver Disease
- MedlinePlus - Alcohol Withdrawal
- NIH PMC - Current Medical Treatment of Alcohol-Associated Liver Disease: Nutrition and Pharmacological
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
