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The symptoms of ALD are often not specific and unrelated to the severity required of the underlying liver disease. Many patients complain of vague symptoms such as fatigue, nausea and vomiting (usually in the morning) and diarrhea or abdominal pain.

Many patients even with advanced ALD, have no symptoms and are incidentally detected by the changes observed in tests carried out for other reasons or just for a regular medical examination.

Decompensated ALD is the most advanced stage of disease (either cirrhosis or severe alcoholic hepatitis). During this period the patient may have:

- Jaundice.

- Ascites (accumulation of fluid in the abdomen that produces marked dilatation sometimes the same).

- Gastrointestinal bleeding, either in the form of hematemesis (vomiting blood) or melena (black stools by the presence of digested blood) or encephalopathy characterized by confusion, behavioral disorders, decreased level of consciousness and even coma.

All these events indicate a serious liver damage and require urgent medical treatment.

credit to: Dr. José María Ladero Quesada, Dr. Matthews Warren, Dr. Christopher P. Day

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