Successful treatment for alcoholic liver disease often depends on whether someone is willing to stop drinking alcohol, and make changes to their lifestyle.
Stopping drinking alcohol
Treatment for alcoholic liver disease involves stopping drinking alcohol. This is known as abstinence. Abstinence can be vital depending on what stage your alcoholic liver disease is at. For example, if you have:
- alcoholic fatty liver disease, you should consider at least two weeks of abstinence before drinking again
- alcoholic hepatitis, life-long abstinence from alcohol is recommended
- cirrhosis, life-long abstinence is essential to prevent you from dying of liver failure
An estimated 70% of people with alcoholic liver disease have an alcohol dependency problem. There is additional alcohol support and advice available to help them stop drinking.
Many people with a dependence on alcohol find it useful to attend self-help groups. One of the most well known is Alcoholics Anonymous.
Medication for abstinence
Medication is available to help people abstain from alcohol. Disulfiram (sold under the brand name Antabuse) can be used if you are trying to abstain but are concerned that you may relapse, or have relapsed in the past. Acamprosate is another medication sometimes used to aid alcohol withdrawal.
Disulfiram causes extremely unpleasant physical reactions if you drink any alcohol, including nausea and vomiting. This deters you from drinking alcohol.
These medications must be prescribed and monitored by a specialist clinic or health professional.
Nutritional therapy is another important part of treating alcoholic liver disease.
Most people with alcoholic liver disease are also malnourished for a number of reasons. These include poor diet, loss of appetite and loss of liver function, which interferes with the digestion of important nutrients.
Research has also found that being malnourished makes the liver more vulnerable to the harmful effects of alcohol.
A high-calorie diet that contains plenty of protein and carbohydrates is usually recommended for people with alcoholic liver disease. You may also be advised to take mineral and vitamin supplements.
Your GP can advise you on a suitable diet or, in some cases, refer you to a dietitian.
In the most serious cases of malnutrition, nutrients may need to be provided through a feeding tube that is inserted directly into your stomach.
Medication for treating symptoms
The use of medication to treat alcoholic liver disease is controversial. Many experts have argued that there is limited evidence for its effectiveness.
With severe alcoholic hepatitis, treatment in hospital may be necessary. Specific treatment with corticosteroids or pentoxifylline medication may be used to reduce inflammation of the liver.
Several medications have been used to treat cirrhosis, including:
- anabolic steroids (a more powerful type of steroid medication)
- propylthiouracil (a type of medicine originally designed to treat overactive thyroid glands)
- colchicine (a medication originally designed to treat gout)
There is a lack of good-quality evidence that these medications are effective in treating alcoholic liver disease.
In the most serious cases of cirrhosis, the liver loses its ability to function, leading to liver failure. Once the liver has failed, medication will only work for several years and a liver transplant is currently the only way to cure liver failure.
Most transplant centres expect you to commit to not drinking alcohol for the rest of your life. You usually have to abstain from drinking alcohol for at least three months before you are considered suitable for a transplant.