Alcoholic liver disease develops after regular consumption of alcohol. Pathogenesis of the condition is as follows. Ethanol is metabolized in the liver leading to increased NAD/NADH ratio. this causes increased fatty acid synthesis and less oxidation. This fatty acid deposits in the hepatocytes causing fatty liver. Acetaldehyde from ethanol metabolism directly damages the hepatocytes. Ethanol also has 2 indirect effects. It causes enhancement of effects of other toxins on liver. It also converts hepatocytes to myo fibroblasts leading to fibrosis.