Author & Research Contributor
Published in 2026 | VOLUME 03, JULY ISSUE 07Alcoholic liver disease (ALD) is a major cause of chronic liver disease and liver-related mortality worldwide. It represents a spectrum of hepatic disorders ranging from simple steatosis and alcoholic steatohepatitis to fibrosis, cirrhosis, hepatocellular carcinoma, and hepatic encephalopathy. Chronic excessive alcohol consumption is the principal risk factor for ALD, although genetic susceptibility, nutritional status, immune dysregulation, oxidative stress, and environmental factors also contribute significantly to disease progression. Ethanol metabolism through alcohol dehydrogenase, cytochrome P450 2E1, and catalase generates acetaldehyde and reactive oxygen species, leading to hepatocellular injury, inflammation, and fibrosis. Early stages of ALD are often asymptomatic, making timely diagnosis challenging. Diagnosis is based on a combination of clinical history, laboratory investigations, non-invasive imaging techniques such as ultrasonography and transient elastography, serum biomarkers, and liver biopsy when indicated. Complete alcohol abstinence remains the cornerstone of treatment and is the most effective intervention for preventing disease progression. Current management strategies include nutritional support, pharmacological therapy for alcohol use disorder, corticosteroids for selected patients with severe alcoholic hepatitis, and liver transplantation for end-stage liver disease. Recent advances in understanding the molecular mechanisms of ALD have led to the investigation of novel therapeutic approaches targeting oxidative stress, inflammation, fibrosis, liver regeneration, and the gut–liver axis. Although these emerging therapies show considerable promise, further clinical studies are required to establish their efficacy and long-term safety. This review summarizes the epidemiology, pathogenesis, clinical spectrum, diagnosis, current management strategies, and emerging therapeutic approaches for alcoholic liver disease, highlighting recent advances and future directions aimed at improving patient outcomes.
Alcoholic liver disease, Alcoholic hepatitis, Hepatic steatosis, Liver fibrosis, Cirrhosis, Hepatocellular carcinoma, Oxidative stress, Alcohol abstinence, Liver transplantation.