Alcohol-Related Liver Disease: Spectrum of Disease, Natural History, and Outcomes.

Alcohol-related liver disease (ALD) is a common cause of liver-related mortality and a leading indication for transplantation. On histopathology, bland steatosis is generally nonprogressive while steatohepatitis can lead to progressive fibrosis and eventually cirrhosis. Symptoms of ALD are minimal until the development of cirrhosis or alcohol-related hepatitis. Noninvasive testing can stage asymptomatic ALD and estimate prognosis. Alcohol abstinence remains the cornerstone of treatment of ALD. Treating comorbid liver diseases such as viral hepatitis or metabolic risk factors are also important to prevent ALD progression.