Alcohol-related liver disease (ALD) represents a spectrum of liver damage caused by excessive alcohol consumption. The spectrum ranges from reversible fatty liver through to alcoholic hepatitis, alcohol-related cirrhosis, and hepatocellular carcinoma. The majority of heavy drinkers will not develop ALD despite apparently consuming similar amounts of alcohol in similar circumstances. The cause of this variation is probably multifactorial, and the combinations of factors differ between individuals, but accumulate to cross a threshold of response. This chapter discusses the mechanisms of alcohol-related liver damage and the clinical consequences this leads to.
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