Gastroenterology and hepatology
Alcohol-related liver disease
The spectrum from steatosis to cirrhosis, standard drinks and the NHMRC limits, AUDIT-C and biomarkers including PEth, staging fibrosis when alcohol inflates liver stiffness, withdrawal and Wernicke, relapse-prevention drugs in liver disease, and transplant.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Alcohol causes a spectrum: steatosis in most heavy drinkers, steatohepatitis, progressive fibrosis, cirrhosis and HCC. Alcohol-associated hepatitis is a distinct acute syndrome and has its own note: Alcohol-induced hepatitis.
- Risk rises with dose and duration. Roughly 10 to 20% of people drinking heavily for years develop cirrhosis.
- Most present late, with decompensation. Screen drinkers with LFTs and non-invasive fibrosis tests, and ask every patient with liver disease about alcohol.
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Sources
- Jophlin LL et al. ACG Clinical Guideline: Alcohol-Associated Liver Disease. Am J Gastroenterol 2024;119:30-54American College of Gastroenterology, 2024
- Crabb DW et al. Diagnosis and Treatment of Alcohol-Associated Liver Diseases: 2019 Practice Guidance From the American Association for the Study of Liver Diseases. Hepatology 2020;71:306-33American Association for the Study of Liver Diseases, 2019
- EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. J Hepatol 2018;69:154-81European Association for the Study of the Liver, 2018
- Australian guidelines to reduce health risks from drinking alcoholAU/NZNational Health and Medical Research Council, 2020
- Haber P, Riordan B et al. Guidelines for the Treatment of Alcohol Problems (4th edition)AU/NZUniversity of Sydney (Specialty of Addiction Medicine) for the Australian Government Department of Health, 2021
- Assessing Fitness to Drive for commercial and private vehicle driversAU/NZAustroads and National Transport Commission, 2022
- Campral (acamprosate calcium) Australian Product Information, section 4.3 (contraindicated with serum creatinine over 120 micromol/L and Child-Pugh C)AU/NZAlphapharm (Viatris), revised 18 July 2023
- Last updated
- 14 November 2026
What changed
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