Does Fatty Liver always lead to Cirrho... - British Liver Trust

British Liver Trust

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Does Fatty Liver always lead to Cirrhosis?

Hanc profile image


Following my post Now Really Worried about 16 days ago, summerised here:

(Hi all, I posted tis post in mid January, this year:

Hi, early last year due to a lot of personal problems I started daily drinking between 10-12 pints of lager a day starting about mid February 2017. I had an ultrasound done in May 2017 which showed a fatty liver, so I stopped drinking at the end of July and started eating right and exercising. I got a fibroscan done on the 26th of October 2017 by a Hepatologist and the reading was 3.9 Kpa and he said no damage, but Within the last 2 months I have had a couple of major traumas, which has sent me on a 8 week binge of 10-12 lagers a day (very irresponsible I know). Could this have caused me to develop cirrhosis in this time? I have stopped now. Thanks in advance for any help.

Since this post I have been really stupid and thoughtless. My Mum and the person I relied on most died in mid February and I felt completely and unbearably lost and went back on the drink 10-12 pints a night to numb the pain as I was so depressed, I know I have let her down but with my history of depression i felt unable to cope. I have stopped now 5 days in but that makes nearly 6 months of daily drinking and I am now really worried that I have done some serious damage to my liver, I am so annoyed as I have let my Mum down and after a good Fibroscan reading of 3.9 Kpa last October 2017 I feel like I've thrown it all away and am really worried I've now got cirrhosis. Any help or feedback would be much appreciated. Thanks in advance.)

My G.P has referred me for an ultrasound this Monday 2nd July 2018, as I had a mild fatty liver in May 2017 and a Fibroscan of 3.9 Kpa in October 2017, I of course am very worried as I've been drinking for nearly 7 months daily. My question is does fatty liver always progress to Cirrhosis. Thde reason I ask is that in most studies I have read about 10 % of all alcoholics get Cirrhosis but all get Fatty Liver, so this would suggest to me that not everyone with Fatty Liver progresses to Cirrhosis. Does anyone have any more inforamtion on this? As you can imagine I am very worried about my scan and am in no way asking if it's OK to drink, I ask in the light of the scan last May to this one. I am just confused as the information seems to suggest that not everyone with Fatty Liver progresses to Cirrhosis, mt G.P suggests it's 10-20 %. Any help and information would be much appteciated. Thanks in advance for any help on this matter.

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Ok. I'm not going to sugar coat this ..... if you continue to binge drink like you do yes your fatty liver will become cirrhosis. If you still continue to drink other major organs will begin to fail and your life could be cut drastically short.

Im sorry you're going through some challenging times at the moment but these binges are not going to help you through it or solve your problems. You have to face them and deal with them with a clear head. Alcohol will become just another problem you'll have to deal with so get some councelling and get the booze out of your life before its too late.


Hey Hanc, It's very much to do with why you have a fatty liver; for you it's booze and ensuring no further liver injury is completely in your power (I'm in no way suggesting it's easy) basically, fatty liver is not a self fulfilling prophecy, for many it's the first and only stage... if a liver friendly life style is adopted. It's reversible too. Most liver injury goes from, inflammatory response, then fatty deposits, then fibrosis, then much more serious cirrhosis. Your previous tests suggest you are at a stage that's no where near irreversible. Perhaps your concern about your health could be turned into a new approach to your health - never wanting to feel this anxious or regretful again. It's bloody difficult I know but your recent upset is unlikely to have proved irredeemable. Good luck.

You got two great replies already. Fatty liver is considered a form of liver disease and is normally the first stage of many other liver diseases superceding fatty liver. The hepoatocytes become fatty, blood supply gets cut off to them and it leads to necrosis of the liver cells. The cells die off and then that becomes fibrosis. Continuing to drink will only speed up the process of this happening. Many physicians and people sugar-coat fatty liver as, "oh it isn't that bad". However, if you drink and have fatty liver there's a good chance of it turning into cirrhosis contrary to what a few people on here will say. Fatty liver is the first stage of Alcoholic Liver Disease. The best thing to do is read stories about cirrhosis, look at pictures of it and see how deadly and horrible it is. Most people subconsciously believe it won't happen to them and that's a defense mechanism to keep doing what you enjoy, that being drinking. However, that's the type of thinking that lands people in troubled water. You're at a cross roads right now, stop drinking, your liver will heal and you can go on to live a happy healthy life. Continue to drink and you'll most likely end up crossing that red line. Cirrhosis will lead to HE, acisties, varcie bleeds, cancer, kidney failure, congestive heart failure, pulmonary hypertension, ect. I'm telling you this as both somebody who went to school for medicine and somebody who was on the same path, just my issue was painkillers with paracetamol. If you end up with a case of Alcoholic Hepatitis it greatly increases the chance of fatty liver turning into cirrhosis and speeds up the time it takes to get there. I had drug induced hepatitis from the Paracetamol and it was the worse thing I've ever gone through and I was a combat medic, was injured and medically discharged and had a spinal tumor. That says a lot for how bad an ailing liver can be.

Speaking as someone who's been down that road of fatty liver to alcoholic hep to eventually mild cirrhosis class A Child-Pugh due to stop/starts with two close family deaths, (carer over 2 years for one), rare incurable cancer (me), depression etc, i'll only say what others have said. You have to stop....before it's too late. I'm 1 year plus nearly 6 months sober. You are at a crossroads and it would be sad for you/all those who love you, if you don't take the right path. With cirrhosis, it's a game changer re life...quality of...and a chronic health issue irreversible lifelong. You have the chance now to reverse any damage and it seems to me that help from others may be needed eg AA. Over time/abstinence, the desire to drink dissipates marginally more every day sober. I've no desire to drink at all now and this heatwave, normally a trigger for me years feel no desire to all...ok i love coffee. You'll be happy you did stop, if you do, in years to come. You've got that chance now. Good luck !!

Thanks all for the great and kind answers and information. I have also been referred to an addiction councillor and want to stop desperately. I was not asking the question because I want to continue to drink. I was/am just confused that all literature, alot medical and information from my G.P and Hepatologist, say that all alcoholics and even heavy drinkers get fatty Liver, but only 10-20 % of all alcoholics get Cirrhosis, so surely this suggests that Fatty Liver doesn't always lead to Cirrhosis, as then all alcoholics get a Fatty Liver, but only 10-20 % get Cirrhosis. So surely all of you that have said Alcoholic Fatty liver always leads to Cirrhosis are plain wrong (please don't read this as cheeky but the numbers don't add up or all alcoholics would get Cirrhosis and only 10 % do even though they mst have fatty liver). I am just looking for honest facts, believe me I don't need sugar coating to stop me drinking, Also I was asking out of worry as to any more damage that could be caused from my last ultrasound. Thanks for the kind replies all and please don't take my reply for an excuse to continue to drink, but making statements that all Alcoholic Fatty Liver will lead to Cirrhosis would just be plain Medically wrong.

Please don't think I am being ungrateful for your advice, I just don't get the statistics.

This is from the British Liver Trust's own Web Site on Liver Disease:

"Alcohol and cirrhosis

Almost everyone who drinks too much alcohol will suffer some liver damage, but this does not necessarily turn into cirrhosis. As many as nine out of ten people who drink to excess will develop a fatty liver, with one in ten progressing to cirrhosis.

In general, the more you drink, the greater your chance of developing alcohol related hepatitis or cirrhosis. A poor diet may make the problem worse.

All types of alcoholic drinks can lead to liver disease. If you have cirrhosis – whether it is caused by alcohol or not – you should not drink alcohol at all."

So that doe not suggest that all those with Alcoholic Fatty Liver get Cirrhosis, but 1 in 10 so how can you say that all those with Alcoholic Fatty Liver will get Cirrhosis when this is clearly not the case. I'm sorry for being a pain in the butt, but scare tactics only make me more anxious no matter how well intentioned, especially if they are not fact and as far as I know no one on this forum is able to give unequivical, medical advice as fact and I am only after the facts.

But I do appreciate the support and advice on stopping drinking as I know it harms more than just the liver and I thank all of you who responded to me very much, I want to stop drinking and am seeking help and appreciate all of yours so much, Thank you all very much for your kindness and sorry if I sound crass I don't mean to, but my question was very specific as the title says.

Mymichelle007 profile image
Mymichelle007 in reply to Hanc

Hi Hanc-

I was diagnosed with Fatty liver disease from years of binge drinking. My diagnosis was through both CT scan and ultrasound. I also had a fibroscan six months later which was 4.2. My liver blood work has always been normal, with the exception of slight elevations directly after a binge episode. My GGT score has even come back as low as 9. With all that being said, what you read is correct. There is no rhyme or reason why some heavy drinkers develop cirrhosis and why others don’t. Fatty liver disease is just that though... a liver disease...brought on (in our cases) from alcohol abuse....some develop fatty liver disease from just having a poor diet. My hepatologist also tested me for Alpha 1 Antitrypsin deficiency, which is thought to be gentically linked to, and a reason why some are more predisposed to developing lung or liver diseases such as cirrhosis. Which could suggest some genetic influences. I don’t have that deficiency.

I hope that helps you out a little in your quest for answers. I did decide to quit drinking because it scared me enough that I can’t imagine the possibility of an irreversible disease such as cirrhosis. Unfortunately, none of us have a crystal ball and we can’t know which one of us will get cirrhosis and which one won’t . Fatty liver disease is still your liver presenting damage and, again in our case, that damage is from drinking.

I wish you much health and happiness in your journey.


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Ignore statistics. If you happen to be the 1 in 10, statistics go out the window! I'd do everything in my power to prevent myself from becoming that 1 in 10

L x

Absolutely, very sound advice.

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Hi Hancock. How are you getting on ?

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Sorry ..... predictive text for you !!!! ......Hanc

Lol, no problem Laura, I have been alcohol free for seven weeks now and eating more healthy, feel alot better for it. I am also seeing an addiction councillor for one to one councilling once a week which is really helping. I am really greatful for your kind advice and support along with everyone else's on this forum, it really is a great site, with warm caring people and I am very appreciative to you all. Thanks again.

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