Management of Alcoholic Liver Disease

The essential part of successful management of ALD is abstinence from alcohol. Fatty liver can be entirely reversible and other later presentations can be stabilised and improved with cessation of alcohol.

Continuing to drink is the best predictive indication of a poor outcome [5].


Specific attention to diet has shown to be beneficial in ALD patients. Malnutrition in ALD patients should be improved with a high protein diet (25-35 kcal/kg of ideal body weight).

Studies have shown patients who had at least 2500 kcal per day had improvements in liver function and six month survival than those who had less. Enteral feeding maximises digestion and may improve long-term survival in ALD patients.

Interestingly, although obesity can be an independent risk factor for ALD progression, weight loss has not been shown to be of benefit in alcoholic fatty liver disease and may actually worsen liver injury [5].

Learning Bite

At all stages of ALD, abstinence is key to management.