Alcohol-Associated Liver Disease

Fatty Liver Disease Related to Alcohol

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Alcohol-associated liver disease (ALD) can cause a range of health problems, including inflammation and fat buildup in the liver, cirrhosis, liver failure, and more. As its name suggests, the main cause is excessive alcohol consumption. If you are diagnosed with alcohol-associated liver disease, Duke hepatologists and other specialists can help you control your drinking and improve your liver health. They are experts in identifying the disease early so treatment can begin before permanent liver damage occurs.  

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Causes of Alcohol-Associated Liver Disease 

A healthy liver breaks down alcohol so it can be eliminated from the body. This process generates harmful substances that can damage liver cells and cause liver inflammation. The more alcohol that you drink, the greater potential for liver damage. The risk of developing alcohol-associated liver disease is higher for heavy drinkers who are women and for people who have obesity and other liver diseases. 

Because alcohol-associated liver disease typically occurs without symptoms, you can have the disease without knowing it, especially in the early stages. If you abstain from drinking, liver damage may be reversed. However, if the condition progresses, liver inflammation and cirrosis (severe liver scarring) can occur. The final stage of alcoholic steatohepatitis is severe and irreversible liver cirrhosis. 

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Diagnosing Alcohol-Associated Liver Disease

It is important to talk to your doctor honestly about your alcohol consumption. This information can help them determine if you are at risk for or already have alcohol-associated liver disease. Your doctor will also ask about your medical history and perform a thorough physical exam to check for an enlarged liver and jaundice (yellowing of the skin and whites of your eyes).  

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Treating Alcohol-Associated Liver Disease

Treatments Overview

The most important thing you can do to halt the progression of alcohol-associated liver disease is to avoid alcohol altogether. Even a little alcohol can further damage your liver. As a Duke patient, you have access to an array of specialists, including mental health professionals, to help you achieve this goal. You may also benefit from one or more of the following treatments.

Nutritional Counseling 


We work closely with Duke’s dietitians and weight loss specialists, who may recommend nutritional and lifestyle changes to help you manage your condition.

Managing Risk Factors 


If you have risk factors for fatty liver disease such as Type 2 diabetes, obesity, or high blood pressure, we can refer you to endocrinologists, weight loss experts, cardiologists, and others to help you improve your health. No medication can stop or reverse fatty liver disease. However, medications for risk factors such as Type 2 diabetes may improve your liver health.

Treating Complications  


If autoimmune hepatitis leads to cirrhosis and other health problems, our hepatologists will work with other specialists to recommend the most effective treatment for your condition.

Liver Transplant


A liver transplant may be the best option if you have advanced cirrhosis. Your treatment team will carefully evaluate your condition to determine if this is the right option for you. We have one of the best and highest volume liver transplant programs in the country and maintain outstanding survival rates.

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Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our gastroenterology and GI surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 10/02/2023 by