What is alcoholic fatty liver disease?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

The liver is the first organ to take damage from heavy drinking. When you drink, your liver struggles to process the constant flow of alcohol in your blood. Over months or years of excessive drinking, your liver cells become overwhelmed and start storing fat, leading to alcoholic fatty liver disease (AFLD).

A 2023 medical reference article (Patel and Mueller) states that 90% of people who drink over 60 grams of alcohol every day will develop fatty liver. Most people won’t notice any symptoms until their liver is seriously damaged. Without stopping alcohol use, up to 20% of fatty liver cases progress to permanent liver damage.

Your liver has an amazing ability to heal when you stop drinking. Let Ardu help you take that crucial first step toward recovery with our professional addiction rehab program.

What are the stages of alcoholic liver disease?

Alcoholic liver disease (ALD) is damage to your liver caused by long-term heavy drinking. Your liver, which normally filters toxins and breaks down nutrients, becomes overwhelmed by constant alcohol exposure. The disease progresses through several stages, becoming more severe if drinking continues.

Alcoholic fatty liver (steatosis or steatotic liver disease) is the earliest stage where fat builds up in your liver cells. This happens in over 90% of heavy drinkers. At this stage, the damage can be reversed if you stop drinking.
Alcoholic hepatitis causes your liver to flare up and swell. Patients show symptoms such as jaundice, fever, and abdominal pain. This stage of liver disease can be mild or severe, and while some damage may heal with sobriety, severe cases can be life-threatening.
Alcoholic fibrosis is when scar tissue begins replacing healthy liver tissue. Early fibrosis can improve if you quit drinking, but continued alcohol use leads to more scarring.
Alcohol-related cirrhosis is the final, most serious stage. Large amounts of scar tissue permanently damage your liver’s structure. While additional damage can be avoided by quitting alcohol, the liver scarring is irreversible and can lead to liver failure if drinking continues.

Early-stage liver disease, particularly fatty liver, can heal if you stop drinking in time.

How does alcohol cause fatty liver disease?

Your liver is your body’s primary defense against toxins, including alcohol. It can process small amounts of alcohol without immediate serious damage, but regular binge drinking overwhelms your liver’s natural filtration system and forces it to prioritize processing alcohol over its other vital functions.

This disrupts normal liver metabolism. Combined with alcohol’s direct toxic effects on liver cells, it triggers a cascade of harmful changes that lead to fat accumulation in your liver tissue. Here’s what happens:

Your liver activates two main enzymes: alcohol dehydrogenase turns alcohol into acetaldehyde, and aldehyde dehydrogenase converts that acetaldehyde into acetate. Both substances are toxic and damage liver cells directly.
The conversion process dramatically increases nicotinamide adenine dinucleotide (NADH), a molecule crucial for energy metabolism. The body shifts its metabolic balance and forces the liver to produce glycerol phosphate, which combines with fatty acids to create triglycerides (the main form of fat stored in liver cells).
Your liver becomes progressively less efficient at breaking down and removing these accumulated fats because alcohol impairs the function of proteins responsible for fat transport.
The buildup of acetaldehyde creates harmful free radicals that cause oxidative stress, further damaging liver cells and making them even less capable of processing fats.
The increasingly accumulated fat triggers an inflammatory response where your immune system sends white blood cells to your liver, which triggers more inflammation and damage.
The constant strain causes liver cells to start dying while surviving cells become surrounded by scar tissue as your body attempts to repair the damage.
Without stopping alcohol use, this cycle of damage, inflammation, and scarring progresses from fatty liver to alcoholic hepatitis and eventually cirrhosis, where large portions of your liver become permanently scarred.

Alcohol is a toxin that triggers widespread inflammation, cell death, and DNA damage. People with alcohol-related liver disease face higher risks of liver cancer and liver failure than those with other types of liver disease.

The only way to stop and reverse the devastating effects of alcohol on your body is to stop drinking. Alcohol use disorder (AUD) changes your brain chemistry and behavior patterns, so many people find it extremely difficult to break free without professional help.

Ardu is here for you. We offer personalized alcohol rehabilitation programs that address the physical and psychological aspects of addiction. Our expert team provides evidence-based therapies, counseling, group support, and holistic treatments to help you build a sustainable sober life.

Symptoms of alcoholic fatty liver disease

Your body might not show obvious signs of alcoholic fatty liver disease at first, but as your liver becomes more damaged, these symptoms can appear and worsen. Early symptoms of AFLD include:

Fatigue and weakness.
Unexplained weight loss.
Loss of appetite.
Nausea.
Pain or discomfort in the upper right abdomen.
Small spider-like blood vessels under your skin.

Without treatment and continued drinking, liver damage worsens over months or years. Watch for these more advanced signs of AFLD:

Yellowing of skin and eyes (jaundice).
Swelling in legs and ankles.
Swollen abdomen (ascites).
Dark urine.
Pale or bloody stools.
Frequent bruising.
Confusion or difficulty concentrating.
Extreme thirst.
Memory problems.
Trembling hands.

Once the liver has endured significant damage, symptoms become life-threatening. They include:

Severe abdominal pain.
High fever.
Vomiting blood.
Mental confusion or disorientation.
Extreme drowsiness.
Dark, tar-like stools.

If you notice any of these symptoms, even the early signs of liver damage, seek medical treatment immediately. Early treatment gives you the best chance of recovery.

Alcoholic vs. non-alcoholic fatty liver disease

Alcoholic and non-alcoholic fatty liver disease (NAFLD) lead to dangerous fat accumulation in your liver, but they behave and progress differently. Here are the main differences:

Alcoholic fatty liver develops directly from excessive alcohol consumption, typically over months or years of heavy use. Non-alcoholic fatty liver occurs when obesity, diabetes, or high cholesterol cause fat to build up, even without drinking.
Alcohol-related damage happens faster and can become severe within months of heavy drinking. NAFLD usually develops slowly over the years and may cause less severe inflammation.
The symptoms of AFLD are often noticeable; jaundice and severe swelling appear early on. Non-alcoholic fatty liver can remain symptomless for years before showing subtle signs.
To treat alcoholic fatty liver, the patient needs to stop alcohol use. Your liver can heal from alcoholic damage within months if you stop drinking in time. Weight, cholesterol, and diabetes management help reverse NAFLD.

Both conditions can lead to cirrhosis and liver failure if left untreated, but catching them early gives you the best chance of recovery.

Can you repair liver damage from alcohol?

Your liver has a remarkable ability to heal itself from alcohol damage, but this is only possible if you stop drinking and the damage hasn’t reached the point of cirrhosis. Once you quit alcohol, healing begins almost immediately.

Osna, et. al. postulate that early-stage fatty liver can heal completely in just six weeks after quitting alcohol, and more severe damage often improves significantly within a year of sobriety. They also maintain that once alcohol use leads to cirrhosis, the scarring is permanent and irreversible.

According to a 2021 study, severe alcohol-related liver damage can significantly improve if you quit drinking and maintain sobriety. Patients with advanced liver disease have better survival rates and improved liver function when they stop drinking, though healing takes longer than with early-stage damage.

How long does it take to reverse fatty liver from alcohol?

Early-stage alcoholic fatty liver can begin healing within weeks of complete alcohol cessation. Healing time is different for everyone, and it varies based on the severity and duration of alcohol use. Regardless of how often and how much you drank in the past, complete recovery requires maintaining full-term sobriety.

Here’s how your liver begins healing as soon as you stop drinking:

Within 24 hours, your liver shifts its focus to processing other toxins it couldn’t handle while filtering alcohol.
After 3 days, liver enzymes start returning to normal levels.
By day 7, liver cells begin their regeneration process.
Within 2 weeks, you may notice increased energy levels as liver function improves.
After 1 month, fatty deposits begin breaking down, with liver fat decreasing up to 15%.
By month 2, blood circulation in your liver improves significantly.
Around month 3, blood sugar levels stabilize as liver function continues improving.
At month 4, new, healthy liver cells replace many damaged ones.
Between months 6–12, your liver’s capacity to filter toxins and process nutrients reaches optimal levels.
After one year of sobriety, most people who haven’t developed cirrhosis show dramatic improvements in overall liver health and function.

To heal your liver, you must stop drinking alcohol, eat a healthy diet, exercise, and avoid any medications that can damage your liver. Still, many people continue to drink alcohol even when they know it’s destroying their liver and overall health.

Breaking free from alcohol addiction is difficult, especially after years of heavy alcohol use. Never try to quit alone because it can be dangerous to your health. Get safe, professional help from Ardu Recovery Center. At our alcohol detox center, medical experts will guide you safely through alcohol withdrawal and support your recovery process.

What is the life expectancy for patients with AFLD?

Life expectancy with alcohol-related liver disease depends heavily on whether you stop drinking and how severe your liver damage is when you quit. It goes without saying that the earlier you stop, the better your chances of survival.

A group of researchers investigated the long-term survival rates of alcoholic and non-alcoholic fatty liver disease. They found that patients with AFLD have a median survival of 19.5 years after diagnosis. Their survival rates are significantly worse than patients with NAFLD, especially if they develop cirrhosis: 40% of AFLD patients die compared to only 17% of non-alcoholic patients.

Alcoholic fatty liver disease treatment options

Treating alcohol-related liver disease starts with one critical step: you must stop drinking. Here are the treatment options to heal your liver and prevent further damage:

Medical detox supervision: Alcohol withdrawal can be dangerous, especially with liver damage. Professional monitoring prevents complications and manages withdrawal symptoms safely.
Nutritional therapy: A balanced diet rich in B vitamins, protein, and other nutrients helps repair liver cells and reverse alcohol-caused malnutrition. Your body needs proper nutrition to support liver regeneration.
Medical monitoring: Regular blood tests track liver enzymes and function, while imaging scans check for inflammation and scarring. Early detection of complications helps prevent serious problems.
Liver medications: Your doctor may prescribe medications to reduce inflammation, support liver function, and treat specific complications of liver disease.
Lifestyle changes: Regular exercise improves liver function while maintaining a healthy weight reduces strain on your liver. Avoiding certain medications and toxins prevents additional damage.
Health management: Your doctor will keep conditions such as diabetes, high blood pressure, and cholesterol under control to improve liver healing and overall recovery chances.

At Ardu, we provide the first step: medically supervised detox to flush alcohol from your system and monitor your health 24/7 to create the foundation you need to begin liver recovery.

Let us help you start your journey to better liver health today.

Give your liver a fighting chance and get help from Ardu

Breaking free from alcohol dependency can feel overwhelming, especially when you’re facing health concerns, but you don’t have to do this alone. Don’t wait until it’s too late—get the help you need to stop drinking and heal your liver.

At Ardu Recovery Center, we’ve developed a comprehensive recovery program that combines medical expertise with proven rehabilitation strategies to help you achieve lasting sobriety and restore your health.

We offer medical detox services

24/7 medical supervision during alcohol withdrawal
Personalized detox protocols
Regular monitoring of liver function tests
Professional care through the first days of sobriety
Medications to manage withdrawal and reduce discomfort safely

What our rehabilitation services include

Residential treatment in our peaceful Provo facility, where you can focus entirely on your recovery
Personalized therapy programs, including cognitive behavioral therapy (CBT) and motivational enhancement
Dual diagnosis treatment for depression, anxiety, and other mental health conditions that fuel drinking
Comprehensive addiction education to understand alcohol’s effects on your body and mind
Expert nutritional counseling to restore your health and support liver healing
Stress management and coping skills development, including mindfulness practices, meditation, and yoga therapy
Family therapy to rebuild relationships and create a strong support system
Relapse prevention planning and long-term recovery strategies

Take the first step toward healing your liver and reclaiming your life. Contact Ardu online or call us today to learn how our comprehensive treatment plan empowers you to reclaim your life from alcohol.

“…I stayed an additional 30 days where I grew close to all the staff and felt very comfortable there. They introduced me to a huge variety of treatments that would help me stay sober. They taught me how to love myself again. Aftercare options were discussed and I chose an IOP that best fit me. I am very blessed to say that I have remained sober, going on 16 months. Thank you Ardu for helping me start my new life journey.”

—Holly Scott

 5/5

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Alcoholic fatty liver disease FAQ

Can I ever drink alcohol again with fatty liver?

Once you develop alcohol-related liver disease, you should never drink alcohol again. Even small amounts of alcohol can trigger inflammation and restart liver damage. Your liver needs complete abstinence to heal, and any return to drinking increases your risk of developing advanced liver disease and cirrhosis.

Every drink stresses your already damaged liver, potentially leading to chronic hepatitis and fibrosis. Patients who continue drinking after diagnosis face significantly higher rates of liver failure and may eventually need liver transplantation.

Will six beers a day cause liver damage?

Six beers a day fall into the category of heavy drinking. This level of alcohol consumption significantly increases your risk of developing alcoholic fatty liver disease, which can progress to alcoholic hepatitis and cirrhosis. Regular heavy drinking overwhelms your liver’s ability to process alcohol and repair itself. Medical studies show that consuming more than 4–5 drinks per day leads to hepatic steatosis in 90% of people. Even if you feel fine and show no obvious symptoms of liver damage, this amount of daily drinking is causing progressive liver inflammation and damage.

What is the best drink to flush your liver?

It is a dangerous myth to think that certain alcoholic drinks can “flush” your liver. The only way to help your liver heal is to stop drinking alcohol. Certain natural beverages such as green tea, lemon water, and coffee may support liver health through their antioxidant properties, but they cannot magically heal your liver.

Your liver is your body’s natural detoxification system. It needs time and abstinence to repair itself. Focus on sobriety first, then support your liver’s recovery with a healthy diet, plenty of water, and regular medical monitoring of your liver function.

What is stage 1 liver failure?

Stage 1 of alcohol-related liver disease is fatty liver (hepatic steatosis), where fat accumulates in liver cells due to heavy drinking. At this early stage, there may be elevated liver enzymes but few symptoms. Without stopping alcohol use, it can progress to alcoholic hepatitis, fibrosis, and eventually end-stage liver disease.

Regular physical exams and blood tests can detect fatty liver before serious complications develop. This stage is particularly dangerous because the lack of symptoms often leads people to continue drinking, unaware of the developing liver damage.

What’s the worst alcohol for your liver?

All types of alcohol can cause alcoholic liver disease. Hard liquor can be particularly dangerous because its higher alcohol content makes it easier to consume more alcohol quickly. In reality, the damage depends on how much and how often you drink, not the type of alcohol. Whether it’s beer, wine, or spirits, consuming more than 4–5 drinks per day leads to fat buildup in your liver cells, inflammation, and potential cirrhosis.

What does 20 years of drinking do to your body?

Two decades of heavy drinking causes devastating damage throughout your body, particularly your liver. Most long-term drinkers develop chronic liver disease, starting with fatty liver and often progressing through chronic hepatitis to alcohol-related cirrhosis.

Beyond liver damage, 20 years of alcohol use also causes severe damage to other organs.

Your brain suffers permanent changes, such as memory loss, decreased cognitive function, and increased risk of early-onset dementia.
Your heart muscle weakens significantly, causing irregular heartbeat, high blood pressure, and increased risk of heart failure.
Your pancreas becomes chronically inflamed. The risk of diabetes and severe digestive problems skyrocket.
Your stomach lining erodes, causing chronic ulcers, inflammation, and potentially life-threatening internal bleeding.
Your bones become weak and brittle. You become more prone to fractures and developing osteoporosis.
Your immune system weakens dramatically, reducing your body’s ability to fight off infections and disease.

Resources

Patel, R., & Mueller, M. (2023, July 13). Alcoholic liver disease. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK546632/

Osna NA, Donohue TM Jr, Kharbanda KK. Alcoholic Liver Disease: Pathogenesis and Current Management. Alcohol Res. 2017;38(2):147-161. PMID: 28988570; PMCID: PMC5513682.

Thomes PG, Rasineni K, Saraswathi V, Kharbanda KK, Clemens DL, Sweeney SA, Kubik JL, Donohue TM Jr, Casey CA. Natural Recovery by the Liver and Other Organs after Chronic Alcohol Use. Alcohol Res. 2021 Apr 8;41(1):05. doi: 10.35946/arcr.v41.1.05. PMID: 33868869; PMCID: PMC8041137.

Haflidadottir S, Jonasson JG, Norland H, Einarsdottir SO, Kleiner DE, Lund SH, Björnsson ES. Long-term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease. BMC Gastroenterol. 2014 Sep 27;14:166. doi: 10.1186/1471-230X-14-166. PMID: 25260964; PMCID: PMC4182763.