Successful treatment for alcohol-related liver disease (ARLD) often depends on whether someone is willing to stop drinking alcohol and make changes to their lifestyle.

Stopping drinking alcohol

Treatment for ARLD involves stopping drinking alcohol. This is known as abstinence, which can be vital depending on what stage the condition is at. If you have fatty liver disease, the damage may be reversed if you abstain from alcohol for a period of time (this could be months or years).

After this point, it's usually safe to start drinking again if you stick to the NHS guidelines on alcohol units. However, it's important to check with your doctor first.

If you have a more serious form of ARLD (alcoholic hepatitis or cirrhosis) lifelong abstinence is recommended. 

Withdrawal symptoms

If you're abstaining from alcohol, you may suffer withdrawal symptoms. These will be at their worst for the first 48 hours, but should start to improve as your body adjusts to being without alcohol. This usually takes 3 to 7 days from the time of your last drink.

Many people initially experience disturbed sleep when abstaining from alcohol, but in most cases their sleep pattern returns to normal within a month.

Some people need to stay in hospital or a specialist rehabilitation clinic during the initial withdrawal phases so their progress can be closely monitored.

If you're staying at home, you'll regularly see a nurse or another health professional. You might see them at home, your GP surgery or a specialist NHS service.

Preventing relapses

Once you have stopped drinking, you may need further treatment to help ensure you do not start drinking again. The first treatment usually offered is psychological therapy. This involves seeing a therapist to talk about your thoughts and feelings, and how these affect your behaviour and wellbeing.

If psychological therapy alone is not effective, you may also need medicine to help you abstain from alcohol, such as: 

• acamprosate
• disulfiram
• naltrexone

Self-help groups

Many people with alcohol dependence find it useful to attend self-help groups to help them stop drinking. One of the most well-known is Alcoholics Anonymous (see the AA website for details), but there are many other groups that can help.

Diet and nutrition

Malnutrition is common in people with ARLD, so it's important to eat a balanced diet to make sure you get all the nutrients you need.

Avoiding salty foods and not adding salt to foods you eat can reduce your risk of developing swelling in your legs, feet and tummy caused by a build-up of fluid.

The damage to your liver can also mean it's unable to store glycogen, a carbohydrate that provides short-term energy.

When this happens, the body uses its own muscle tissue to provide energy between meals, which leads to muscle wasting and weakness. This means you may need extra energy and protein in your diet.

Healthy snacking between meals can top up your calories and protein. It may also be helpful to eat 3 or 4 small meals a day, rather than 1 or 2 large meals.

Your GP can advise you on a suitable diet or, in some cases, refer you to a dietitian. In the most serious cases of malnutrition, nutrients may need to be provided through a feeding tube inserted through the nose and into the stomach.

Liver transplants

In the most serious cases of ARLD, the liver loses its ability to function, leading to liver failure. A liver transplant is currently the only way to cure irreversible liver failure.