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Alcohol-Associated Liver Disease

Alcohol-associated liver disease is a serious condition caused by prolonged and excessive alcohol consumption, leading to liver damage and impaired liver function. It is one of the most common causes of chronic liver disease and can progress from mild liver abnormalities to severe complications, including cirrhosis and liver failure.

Several factors influence the development and progression of alcohol-associated liver (ALD), including alcohol consumption, genetic predisposition, gender (women are more vulnerable to ALD due to differences in alcohol metabolism), nutritional deficiencies as poor diet and lack of essential nutrients can exacerbate liver damage, and co-existing liver conditions such as viral hepatitis or metabolic dysfunction-associated steatotic liver disease (MASLD) increase the risk of severe liver damage.

Alcohol-associated liver disease progresses through several stages:

  • Alcoholic fatty liver disease (steatosis) – the earliest stage, characterized by fat accumulation in liver cells. It is often reversible with abstinence from alcohol.
  • Alcoholic hepatitis – inflammation of the liver caused by continued alcohol consumption. Symptoms may include jaundice, fever, nausea, and abdominal pain.
  • Liver fibrosis and cirrhosis – chronic inflammation leads to scar tissue formation, impairing liver function and increasing the risk of liver failure and liver cancer.

Alcohol-associated liver disease symptoms vary depending on the disease stage and may include:

  • Fatigue and weakness
  • Loss of appetite and weight loss
  • Jaundice (yellowing of the skin and eyes)
  • Swelling in the abdomen and legs (ascites and edema)
  • Increased bruising and bleeding
  • Confusion and cognitive impairment (hepatic encephalopathy).

Diagnosing alcohol-associated liver disease involves:

  • Blood tests to assess liver function and detect markers of liver inflammation.
  • Imaging studies - Ultrasound, MRI, or CT scans to evaluate liver structure.
  • FibroScan or liver biopsy to assess liver fibrosis and confirm the extent of damage.

The most effective way to manage alcohol-associated liver disease is to stop alcohol consumption. Other treatment options include:

  • Alcohol cessation programs. Medical and psychological support for alcohol dependency.
  • Nutritional support. A healthy diet to restore essential nutrients and improve liver function.
  • Medications. To reduce inflammation, manage symptoms, and prevent complications.
  • Liver transplantation. In cases of end-stage liver disease, transplantation may be the only viable option.

At Karolinska University Hospital, our experienced team can provide comprehensive diagnosis, treatment, and rehabilitation.

Gastroenterology

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Liver Transplant

Karolinska University Hospital runs one of the more extensive liver surgery units in the Nordics, and has a special assignment for liver transplants on behalf of the Swedish National Board of Health and Welfare. Both children and adults undergo transplants with excellent results at Karolinska. Liver Transplant

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