Symptoms:

Changes start in the liver as inflammation (hepatitis) and lead to fatty liver and cirrhosis. Cirrhosis is the final phase of alcoholic liver disease.

Symptoms may not be present until the disease is advanced, and may include:

• Abdominal pain and tenderness
• Dry mouth
• Excessive thirst
• Fatigue
• Fever
• Fluid collection in the abdomen (ascites)
• Jaundice
• Loss of appetite
• Mental confusion
• Nausea
• Unintentional weight gain (because of fluid collection)

Other symptoms that can occur with this disease:

• Abnormally dark or light skin
• Agitation
• Bloody, dark black, or tarry bowel movements (melena)
• Breast development in males
• Changing mood
• Confusion (encephalopathy)
  • Changed level of consciousness
  • Hallucinations
  • Impaired short- or long-term memory
• Difficulty paying attention (attention deficit)
• Impaired ability to concentrate
• Impaired judgment
• Light-headedness or fainting, especially when standing
• Paleness
• Rapid heart rate (tachycardia) when rising to standing position
• Redness on feet or hands
• Slow, sluggish, lethargic movement
• Vomiting blood or material that looks like coffee grounds

Symptoms vary based on the severity of the disease. They are usually worse after a recent period of heavy drinking.

Signs and tests:

• CBC
• Liver biopsy
• Liver function tests such as ALP
• Serum ferritin

Tests to rule out other diseases include:

• Abdominal CT scan
• Blood tests for other causes of liver disease
• Ultrasound of the abdomen