What is the difference between alcoholic liver disease and cirrhosis?

Generally speaking, although alcoholic liver disease and cirrhosis both belong to liver diseases, they differ in terms of etiology, extent of pathological changes, clinical manifestations, treatment focus, and prognosis. Specific analysis is as follows:

1. Different causes: Alcoholic liver disease is primarily caused by long-term and excessive alcohol consumption. Alcohol and its metabolites directly damage hepatocytes, leading to liver inflammation and fatty degeneration. Cirrhosis has a more complex etiology; while long-term alcohol use can trigger it, it is also associated with viral hepatitis, non-alcoholic fatty liver disease, and other factors. It represents the end-stage outcome of prolonged progression of various chronic liver diseases.

2. Different degrees of pathological changes: In early alcoholic liver disease, the main change is fatty degeneration of hepatocytes. If alcohol is stopped promptly at this stage, liver cells may gradually recover and return to normal. In contrast, cirrhosis involves diffuse liver fibrosis and formation of regenerative nodules (false lobules), widespread irreversible necrosis of hepatocytes, and severe disruption of normal liver structure and function—representing an irreversible pathological state.

3. Different symptoms: Early alcoholic liver disease often presents no obvious symptoms; some patients may only experience fatigue and loss of appetite. As the condition progresses, symptoms such as dull pain in the upper right abdomen and jaundice may appear. During the compensated phase of cirrhosis, symptoms are usually mild or absent. However, in the decompensated phase, serious manifestations such as ascites, esophageal and gastric varices, palmar erythema, and spider angiomas occur. Esophageal and gastric varices may lead to hematemesis (vomiting blood) and melena (black tarry stools).

4. Different treatment focuses: The cornerstone of alcoholic liver disease treatment is complete abstinence from alcohol, combined with hepatoprotective medications to reduce liver cell injury and control inflammation. Specific anti-fibrotic therapy is generally not required. In contrast, cirrhosis management requires identifying the underlying cause first, followed by anti-fibrotic drugs to slow fibrosis progression, symptomatic treatment for complications such as ascites and bleeding, and measures to preserve residual liver function.

5. Different prognoses: With timely intervention during the early or intermediate stages, most cases of alcoholic liver disease can be controlled or even reversed, rarely progressing to severe liver disease. Once cirrhosis enters the decompensated phase, even with aggressive treatment, liver damage is difficult to reverse. Patients experience reduced quality of life and are prone to severe complications such as hepatic encephalopathy and hepatocellular carcinoma, resulting in a relatively poor prognosis.

It is important to maintain liver health in daily life by avoiding long-term heavy drinking, undergoing regular liver function tests and liver ultrasound examinations, and detecting and treating liver abnormalities as early as possible. Patients already diagnosed with liver disease should strictly follow medical advice, maintain a healthy diet and regular lifestyle, and minimize liver burden.