The discussion of alcoholic liver disease and non alcoholic fatty liver disease is not complete without looking at the many similarities and differences between the two conditions. The causative factors of excess fat in the liver in both conditions is obviously quite different, but pathophysiologically, these two liver diseases look very much the same. Another similarity is that ALD and NAFLD are both behaviorally mediated, severe alcohol use being the behavior that mediates ALD, and lifestyle choices leading to obesity, diabetes, and metabolic syndrome being the primary cause for NAFLD. More similarities and differences are seen in the causes and risk factors, symptoms and complications, as well as the treatments and remedies for each disease.
In terms of causes and risk factors, the reason that people develop alcoholic liver disease is simply a result of too much alcohol. If the person who is consuming excessive amounts of alcohol is also obese or malnourished, or has chronic viral hepatitis (especially hepatitis C), they may be more likely to develop ALD. In contrast, the reason that people develop non alcoholic fatty liver disease is less understood, but researchers do know that people who are overweight or obese, have type 2 diabetes or don’t respond well to insulin, have abnormal levels of fats in the blood, or have metabolic syndrome are all more likely to develop NAFLD. Because both ALD and NAFLD are usually preventable and tend to get better as soon as the sufferer stops drinking alcohol or starts making healthier lifestyle choices, they are avoidable in most cases.
As for symptoms and complications, ALD and NAFLD typically occur with few to no symptoms, and both diseases can lead to complications. If symptoms do occur, they are usually associated with more advanced stages of the disease, such as NASH and cirrhosis. In these instances, symptoms include a swollen belly, enlarged blood vessels beneath the skin, abnormally large breasts in men, red palms, and yellowish skin and eyes. Complications of ALD include alcoholic hepatitis and alcoholic cirrhosis, while complications of NAFLD include cirrhosis and cardiovascular disease. Alcoholic hepatitis refers to swelling in the liver which can cause fever, nausea, vomiting, stomach pain, and jaundice whereas alcoholic cirrhosis refers to the buildup of scar tissue in the liver and can cause additional symptoms like ascites, high blood pressure in the liver, bleeding in the body, an enlarged spleen, confusion, changes in behavior, and fatal liver failure.
Lastly, when someone is diagnosed with either alcoholic liver disease or non alcoholic fatty liver disease, there are a number of treatment options and remedies to improve their condition. Changes in drinking habits can greatly improve ALD, while changes in lifestyle can significantly help with NAFLD. Simply put, quitting drinking is the only way to halt the liver damage that occurs with ALD. Should the patient require a medically supervised detox program or a support group to manage withdrawal symptoms and continue on a good path, these are readily available. On the other hand, lifestyle changes are the best way to treat NAFLD. These include losing weight, exercising more, lowering cholesterol levels, managing diabetes, and avoiding substances that can cause harm to the liver.
Resources:
- https://medlineplus.gov/ency/article/000281.htm
- https://www.webmd.com/hepatitis/fatty-liver-disease#1-2