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Alcoholic Fatty Liver Disease (AFLD)

Learn more about symptoms, risk factors and treatment options.

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What is it?

Alcoholic fatty liver disease (AFLD) impacts people who drink alcohol a lot over a long period of time. It occurs when too much fat builds up the liver. It can progress through three major phases:

  • Alcohol-induced fatty liver – All livers contain some fat, but the liver’s normal fat level is 5 to 10 percent. If you have AFLD, you can have additional fatty deposits in the liver, causing the liver to swell. 

For information on fatty liver disease not caused by alcohol, check out our summary of Nonalcoholic Fatty Liver Disease (NAFLD), now called MASLD.

  • Alcoholic hepatitis – If AFLD progresses, the liver becomes inflamed. As the liver tries to heal itself, it leaves behind scar tissue. If too much scar tissue builds up, it leads to the final stage of AFLD.
  • Liver cirrhosis – When there is too much scar tissue, the liver can no longer function. This is called cirrhosis of the liver.

You can have NAFLD and AFLD at the same time

Symptoms

AFLD often has no symptoms, although you may notice upper abdominal tenderness on the right side, fatigue, weakness and weight loss.

Symptoms of alcoholic hepatitis include:

  • Jaundice, which is yellowing of the skin and the whites of the eyes 
  • Pain in the upper-right side of the abdomen 
  • Low-grade fever 
  • Weakness 
  • Nausea and vomiting 
  • Loss of appetite

Liver cirrhosis symptoms can also include:

  • Enlarged spleen
  • Malnutrition
  • Intestinal bleeding
  • Fluid buildup in the belly
  • Kidney or liver failure
  • Confusion
  • Liver cancer

When to see a doctor

If you have any symptoms of AFLD, make an appointment with your doctor. Early detection, diagnosis and treatment can prevent your condition from getting worse.

If you want to control your drinking but are having trouble cutting back on alcohol, you’re not alone. Your doctor can connect you with support, resources and treatments that can help.

Causes and risk factors

AFLD is caused by heavy alcohol use over time. However, not everyone who drinks a lot will develop AFLD.

In addition to alcohol use, conditions that can contribute to AFLD or make AFLD worse are hepatitis C and malnutrition. Other risk factors for AFLD include:

  • Certain genetic factors
  • Being overweight or obese
  • Being a woman
  • Being Black or Hispanic
  • Binge drinking

Treatment options

If you have AFLD, the most important thing to do is to stop drinking alcohol. Your doctor may also recommend diet changes or medication. Your AFLD treatment plan may include:

  • Treatment for symptoms of alcohol withdrawal
  • Medical detoxification from alcohol
  • Nutritional support
  • Recovery programs for alcohol addiction
  • Treatment for AFLD complications
  • Liver transplant

Testing

Your doctor can help determine if you have AFLD. They may recommend the following tests or procedures:

  • Liver biopsy
  • Blood test
  • Imaging tests

Prevention

AFLD is a preventable condition. The most important thing to do is to avoid alcohol, or to drink alcohol in moderation. Also, pay attention to medications you’re taking that may affect your liver.

Be sure to get treatment for other liver conditions, like hepatitis C, that could make AFLD worse.

Additional conditions

Hepatitis B

Primary Biliary Cirrhosis (PBC)

Ulcerative Colitis