Final answer:
The initial pathological change in alcoholic liver disease is the formation of fatty liver due to abnormal fat accumulation in liver cells, which can lead to cirrhosis, characterized by fibrous tissue replacing liver cells.
Step-by-step explanation:
The initial pathological change in alcoholic liver disease is the development of fatty liver, which is characterized by the abnormal accumulation of fats in the liver cells. When the lipid content rises significantly, it disrupts the liver's normal functions. This condition may progress to more severe forms of liver disease, such as alcoholic hepatitis and finally cirrhosis, which involves the replacement of liver cells with fibrous tissue, leading to progressive loss of liver function. The oxidation of ethanol to acetaldehyde, a toxic substance catalyzed by alcohol dehydrogenase, plays a central role in liver damage, as elevated acetaldehyde levels have harmful effects on liver cells.