Alcohol-Related Liver Disease

The liver breaks down alcohol, and in the process makes harmful by-products that injure liver cells and cause inflammation. Over years, repeated injury leads to scar tissue. Genetics, nutrition and other conditions affect who is most at risk. Safe limits are hard to define for an individual, and for people with liver disease, no alcohol is the safest choice.

The risk rises with the amount and length of drinking. Not everyone who drinks heavily develops advanced liver disease, and some people are affected at lower levels of drinking than others. Women are generally more vulnerable than men. Obesity, diabetes and other liver diseases such as hepatitis B or C increase the damage.

The doctor asks about drinking in a non-judgmental way, as honest answers lead to better care. Blood tests check liver enzymes, bilirubin, clotting and blood counts. Ultrasound or other scans look at the liver, and FibroScan or blood scores estimate scarring. Other causes of liver disease, such as viral hepatitis, are excluded. A liver biopsy is sometimes needed.

Stopping alcohol is the key treatment. Heavy drinkers should get medical advice before stopping, because withdrawal can be dangerous.

• Tell your doctor honestly how much you drink so withdrawal can be managed safely

• Ask for counselling, support groups or addiction services

• Involve family or a trusted friend for support

• Stop smoking and keep a healthy weight

• Get vaccinated against hepatitis A and B as advised

Good nutrition matters because liver disease and alcohol often cause malnutrition.

• Eat regular meals, including a bedtime snack if your doctor advises

• Eat enough protein; do not cut protein unless your doctor tells you to

• Reduce salt if you have fluid build-up

• Ask about vitamin supplements; deficiencies are common

• Avoid raw shellfish in advanced disease

Medicines are chosen by your doctor, depending on the stage of disease.

• Medicines can help with alcohol withdrawal and cravings under medical supervision

• Severe alcoholic hepatitis may be treated in hospital, sometimes with steroids, if suitable

• Water tablets (diuretics) and other medicines for fluid, bleeding risk or confusion in cirrhosis

• Check with your doctor before taking painkillers or herbal products

Procedures are used for complications and for monitoring.

• Endoscopy to look for and treat swollen veins at risk of bleeding

• Draining abdominal fluid (paracentesis) when it causes discomfort or needs testing

• Ultrasound surveillance for liver cancer if you have cirrhosis

• Liver transplant assessment may be considered in selected people with advanced disease

Stopping alcohol is the single most important step. Fatty liver can often recover fully, and inflammation and early scarring can improve. Even with cirrhosis, stopping alcohol improves survival and lowers the chance of complications. Continued drinking carries the risk of liver failure. Support for stopping, including medical and counselling services, makes success more likely.

• What stage of liver disease do I have?

• Can my liver recover if I stop drinking?

• How can I stop safely, and what support is available?

• Which tests and scans do I need and how often?

• Which medicines and supplements are safe for me?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.