The Symptoms of Alcoholic Hepatitis, Nausea, Fatigue, Abdominal Pain, Weight Loss, Loss of Appetite...

Not where you want to end up...

Alcohol, as we all know well, is not good for us – not good, particularly, for the liver. Chronic alcohol abuse can result in the fatal liver disease called cirrhosis, but cirrhosis is only last of three stages of an umbrella disorder called Alcoholic Liver Disease. Cirrhosis is preceded by alcoholic hepatitis.

The Three Stages of Alcoholic Liver Disease Are:

  • Fatty Liver
  • Alcoholic Hepatitis
  • Cirrhosis

Fatty Liver

The first stage of alcoholic liver disease is fatty liver, and it is just what it sounds like. Alcohol abuse strains the functioning of the liver and causes liver enlargement and firming and fatty deposits in the cells of liver.

Fatty liver does not generally cause notable symptoms and often remains undetected. Sometimes fatty liver will cause tenderness in the upper right area of the abdomen, and fatty liver is generally detectable in blood and ultrasound tests that look for liver abnormalities.

Fatty liver is completely reversible, and the liver will heal itself if the alcohol abuse abates.

Alcoholic Hepatitis

The second progressive stage of alcoholic liver disease is alcoholic hepatitis, and the symptoms of alcoholic hepatitis can range from very mild (or none at all) to very serious. Hepatitis can be fatal, but like fatty liver, alcoholic hepatitis is almost always reversible after the alcohol abuse stops.

Symptoms of alcoholic hepatitis

Alcoholic hepatitis is sometimes elusive. Some sufferers will not notice any appreciable symptoms of their hepatitis.

Symptoms of early or mild stage alcoholic hepatitis are generally not "liver specific". These include:

  • General feelings of fatigue
  • Nausea
  • Diarrhea
  • Abdominal pains
  • Weight loss
  • Loss of appetite

Later stage alcoholic hepatitis may result in more liver specific symptoms such as

  • Jaundice
  • Swollen fluid filled abdomen (Ascites)
  • Bloody vomit
  • Confusion

Some people, even with late stage alcoholic hepatitis, remain asymptomatic.

Alcoholic hepatitis can be fatal and lead to liver failure, liver infection or renal failure.

Alcoholic hepatitis, even if not fatal, will sometimes lead to the third stage of alcoholic liver disease, cirrhosis, unless alcohol consumption stops. The hepatitis is detectable through blood tests (Most alcoholic hepatitis patients will show reduced liver functioning in a blood test) or by ultrasound or liver biopsy.

Beware, up to 20% of heavy drinkers that present with elevated liver function test results are suffering liver damage from causes other than alcohol.

Get a Check Up!

The lesson to be learned from all of this is essentially that alcoholic liver disease is reversible and treatable until the third and final stage, cirrhosis. It is also a fairly silent disorder, and most patients will not present with serious "liver specific" symptoms until things have gotten pretty bad.


If you do have any of the liver specific symptoms that would indicate hepatitis – you cannot wait another day to get checked out and you are at real risk of cirrhosis or even death.

If you drink heavily, and especially if you drink heavily and feel any of the non liver specific symptoms (fatigue, nausea, loss of appetite etc.) you should also ask your doctor to run some liver tests, just to make sure things are still OK.

We heavy drinkers never like to own up to our habits in the doctor's office, knowing full well that our doctor will likely tell us to cut back, and not having much inclination to do that! But Alcoholic Liver Disease is deadly and miserable, and it’s just not worth risking. Tell your doctor the truth about your daily consumption and find out how well your liver is holding up.

Very comprehensive medical overview of Alcoholic Liver Disease

Comments 15 comments

Mighty Mom profile image

Mighty Mom 7 years ago from Where Left is Right, CA

Hi Recoveringaddict, very well crafted and informative hub. You're so right about the heavy drinker not wanting to be honest because he/she doesn't want to be told to cut donwn. Usually it takes the doctor saying "You need to stop NOW or you WILL DIE" for the perosn to get the hint. And sometimes even that isn't enough. Would love to see you write one on the "lovely" and extremely painful progression from cirrhosis to death. It is a horrible way to go. Thanks for raising awareness on issues of substance abuse and recovery. Yours in serenity, MM

sarah.Ge@endstagealcoholism 7 years ago

Very well explained and an informative hub...Thanks

kimh039 profile image

kimh039 6 years ago

a lot of really good information here. Thank you.

Queenie 6 years ago

my partner just died from liver disease cause kings college were neglent of his care

almasi profile image

almasi 5 years ago

Thanks for a very informative hub.

steven 5 years ago

you can not beat it

Islet Langerhands 4 years ago

A scary liver shock

sue 4 years ago

My dad and sister just died of luver diease,both were heavy drinkers, worried about my son as i think his heading same way, this information helps to understand the dangers and how to spot problems, thankyou for your clear, easy read and understandable discription of the problem and information, excellent, thankyou

bigguy 4 years ago

I have been drinking heavily for years. I went to doctor for a check up in my blood test came back With elevated liver counts. I don't have hepatitis b or c What I'm wondering if baby, I do have have.

bigguy 4 years ago

Alcoholic hepatitis. Had an ultrasound this morning. Guess I'll see when the test come back. If that's the case. I honestly don't think I can quit drinking.

Me 4 years ago

I have hepatitis. Have known that for a while. My ggt is through the roof. I understand i need to stop before i hit stage 3. But the question is, how? Ive done alcohol counselling. Ive done aa. Nothing works for me!!! So scared.

Bayliss 4 years ago

ME - why don't you keep doing alcohol counselling and check out recover programs like AVRT - there is a crash course online (just google it) and it has helped a lot of people. Also a support system, other then AA, such as a forum with alcoholics/addicts.

Might help. It is worth a shot!

Lily 4 years ago

Me you might to check out the Sinclair Method---it is helping a lot of people and most humane thing I have seen so far

James Peters profile image

James Peters 4 years ago from Hammond, Indiana

I have a family member that may be in the first stage of alcoholic hepatitis. I did research and wrote an article on it on WordPress the link is So sad to watch.

Abe 21 months ago

I drank heavy for 15+ years. Doctors didn't know what was wrong with me till it was almost too late. I quite cold turkey over a year ago. I had alcoholic hepatitis up until a few months ago, blood tests are normal for the first time. It took over a year for my liver to recover

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