Liver_disease_(alcoholic)

In many cases, people with alcohol-related liver disease (ARLD) don't have any noticeable symptoms untiltheir liver is badly damaged.

Early symptoms

If you do experience early symptoms of ARLD, theseare often quite vague, such as:

• abdominal (tummy) pain
• loss of appetite
• fatigue
• feeling sick
• diarrhoea
• feeling generally unwell

Advanced symptoms

Asthe liver becomes more severely damaged, more obvious and serious symptoms can develop, such as:

• yellowing of the skin and whites of the eyes ( jaundice )
• swelling in the legs, ankles and feet, due toa build-up of fluid ( oedema )
• swelling in your abdomen, due toa build-up of fluid known as ascites
• a high temperature (fever)and shivering attacks
• very itchy skin
• hair loss
• unusually curved fingertips and nails ( clubbed fingers )
• blotchy redpalms
• significant weight loss
• weakness and muscle wasting
• confusion and memory problems, trouble sleeping ( insomnia ) and changes in your personality due to a build-up of toxins in the brain
• vomiting blood and black, tarry stools due tointernal bleeding
• a tendency to bleed and bruise more easily, such as frequent nosebleeds and bleeding gums
• increased sensitivity to alcohol and drugs (because the liver can't process them)

When to seek medical advice

ARLDdoesn't often cause symptoms until it's reached an advanced stage. If you misuse alcohol, you may have liver damage, even though you have none of the symptoms above.

Read about alcohol misuse (drinking too much) .

Contact your GP for adviceif you have a history of regular alcohol misuse.

A good way to assess your history and pattern of drinking is to use a short test known as the CAGE test, which consists of four questions:

• Have you ever thought you should cut down on your drinking?
• Have people annoyed you by criticising your drinking?
• Have you ever felt guilty about your drinking?
• Have you ever drunk an " eye-opener ", which means: have you ever drunk alcohol first thing in the morning to get over a hangover and steady your nerves?

If you answer "yes" to one or more of the questions above, you may have an alcohol problem and are advised to see your GP.

See your GP as soon as possibleif you have symptoms of advanced ARLD.

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