Cirrhosis occurs typically after decades of chronic abuse, though significant variability (in terms of duration and dose of alcohol necessary)

Can occur in concert w/other chronic liver disease (e.g. hepatitis c, fatty liver, etc.)

With portal hyperension--> hematemesis/other blood loss, edema, abdominal swelling

AST:ALT ratio often > 2:1; t bili, alk phos, ggt, inr, cbc may be abnormal based on extent of disease (ie if cirrhosis)
Consider ruling out other liver diseases with labs, imaging as indicated based on age, other historical features; NAFLD/NASH, chronic hep B, chronic hep C, alpha-1 anti-trypsin, hemochromatosis, auto-immune hepatitis, Wilson's disease, DILI, other

Alcohol Induced Liver Disease