Alcohol and the Liver

Of all the organs in the body, none is more exposed to the effects of alcohol than your liver. More than 80% of the alcohol you consume will pass through the liver to be detoxified before being passed around the rest of your body. Long-term alcohol abuse can cause profound, even irreparable damage to this vital organ.

Why is the Liver Important?

The liver is the second most complex organ in your body, after your brain. It takes care of a variety of functions, including:

  • Fighting diseases and infection
  • Regulation of blood sugar and cholesterol levels
  • Aiding digestion
  • Filtering of toxins from the blood

Every time you subject your liver to the alcohol filtering process, some of the liver cells die. Fortunately, the liver also has the ability to regenerate. Therefore, most of the cells are replaced for as long as the liver is at full capacity. However, years of heavy alcohol consumption will mean that your liver won’t be at full capacity for long.

How Alcohol Damages your Liver

Misusing alcohol over a prolonged period of time causes permanent liver damage. When this happens, you’ll develop alcohol-related liver disease (ARLD). The number of people that have ARLD in the UK has been on a gradual incline over recent decades, keeping pace with the rising number of people with alcohol overuse/misuse problems.

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Stages of Liver Damage by Alcohol

Generally, there are three main stages of alcohol-related liver disease. In some cases, each of these stages happen in sequence, whereas in others, they can occur concurrently.

Alcoholic Fatty Liver Disease

If you drink a large amount of alcohol, fat will most likely build up in your liver. This is known as alcoholic fatty liver disease and it is the first stage of ARLD. Fatty liver disease almost never causes any noticeable symptoms, but can be picked up in routine hospital checks. When you’re diagnosed with alcoholic fatty liver disease, it’s a warning sign that you’re drinking at a level that is harmful to your body. If you quit alcohol at this point, your liver will return to normal, because fatty liver

disease is reversible. In fact, within two weeks of stopping alcohol abuse, your liver will go back to normal.

Alcoholic Hepatitis

Alcoholic hepatitis is a serious condition that can develop when you abuse alcohol for too long. It is different from other forms of hepatitis, as it is not infectious. It can also occur instantly if you drink an extremely large amount of alcohol in a short period of time. Most people begin to understand that their health is suffering as a result of alcohol abuse during this phase, though you can still reverse all damage by permanently quitting alcohol if you do so early on. However, when the severity of alcohol hepatitis increases, it becomes life-threatening. Many people die from this stage of ARLD every year, with many of them unaware they even have liver damage.

Cirrhosis

Cirrhosis is the development of heavy scarring throughout the liver which impedes its ability to function correctly. At this stage of ARLD, the liver has taken on significant damage, but there may not be any obvious symptoms. Cirrhosis is not reversible, but if you quit alcohol immediately, you can prevent further damage to your liver and significantly improve your life expectancy. There is a 50% chance of death within five years for anyone that refuses to quit alcohol after being diagnosed with cirrhosis.

Causes of Alcoholic Liver Disease

The main cause of ARLD is, unsurprisingly, drinking too much alcohol. If you continue consuming above the safe drinking limits regularly, you’re increasing the risk of developing ARLD. If you engage in binge drinking (consuming too much alcohol in a short period of time), you can develop fatty liver disease and in some cases, progress to alcoholic hepatitis. If you drink more than the recommended limits of alcohol regularly over a number of years, you’re most likely to develop a serious type of ARLD.

How much Alcohol is Dangerous to the Liver?

It is safe to abstain from alcohol generally or only take a few glasses once in a while. However, if you can’t abstain, ensure you don’t go above 14 units of alcohol each week. You shouldn’t consume that amount in one sitting either: it’s recommended the 14 units be spread over at least three days.

Signs and Symptoms of an Alcoholic Liver

One of the main features of alcoholic liver disease is that there might be no noticeable symptoms. They may appear slowly, at which point heavy damage could already have been done. The signs and symptoms of an alcoholic liver are very much dependent on how well it is working. The symptoms generally worsen after a prolonged period of heavy alcohol consumption.

The first indications of an alcoholic liver include:

  • Small spider-like blood vessels on your skin
  • Pain around your stomach
  • Nausea
  • Loss of energy
  • Loss of appetite
  • Weight loss

Deeper symptoms of an alcoholic liver include:

  • Jaundice (yellow colour in skin, eyes or mucosal membranes)
  • Build-up of fluid in the legs (edema)
  • Build-up of fluid in the abdomen (ascites)
  • Red palms
  • Pale stool
  • Impotence and testes shrinking in men
  • Abnormal bleeding when injured
  • Thinking problems

Factors that Increase your risk of Alcohol-Related Liver Disease

Although excessive drinking is the main cause of developing ARLD, there are other factors that can increase your chances. These include:

  • Genetic disposition (if you have a family history of alcohol dependence and ARLD, there is a high chance you will develop it).
  • Existing liver problems (hepatitis is the most obvious).
  • Being a woman (women are more vulnerable to the dangers of alcohol use).
  • Race/ethnicity (ARLD affects all races, but some ethnicities are more at risk than others).
  • Malnutrition (a heavy alcohol user will most likely look malnourished, as they eat poorly and because alcohol and its byproducts will hinder the nutrient absorption properties of the body. When there are no nutrients, liver damage is sped up).

How Alcohol and Gut Fungus team up to Damage your Liver

According to a new study, there is a relationship between the micro-organisms in your intestine and alcohol-related liver damage. The study, by researchers at the University of California San Diego, showed how intestinal fungi can interact with alcohol to cause damage. It also showed that the use of anti-fungal compounds can help in the management and treatment of ARLD. However, at the end of the research, the scientists still agreed that the best way to avoid ARLD is to abstain from alcohol or to stay within responsible limits, as much as possible.

The intestinal fungi in question occur naturally in most human beings and using anti-fungal compounds in a bid to continue consuming large quantities of alcohol is not cost-effective – and, most importantly, remains unapproved by the relevant medical bodies.

Complications of Alcohol-Related Liver Disease

In the last few decades, there’s been an increase in the number of people who have died from ARLD. Alongside smoking and high blood pressure, alcohol is now one of the most common causes of death in the UK. The life-threatening complications of ARLD include:

  • Liver cancer
  • Cirrhosis
  • Kidney failure
  • Accumulation of toxins in the brain
  • Internal bleeding

What is Alcoholic Liver Cirrhosis?

This is the most advanced stage of liver disease as a result of alcohol abuse and addiction, usually just referred to as cirrhosis. When someone develops the first stage of ARLD (which is fatty liver disease) and still doesn’t quit consuming alcohol, then progression to cirrhosis over the long-term is almost inevitable. However, there have been cases where people first experienced cirrhosis without going through the other stages of ARLD beforehand.

Symptoms of Alcoholic Liver Cirrhosis

The symptoms of alcoholic liver cirrhosis really come to the fore when a person is between the ages of 30 to 40. In the early stages, your body might be able to compensate for the limited function of your liver. However, as the disease progresses, the body won’t be able to cope and symptoms will become more noticeable. The main symptoms of cirrhosis are similar to other alcohol-related liver disorders and include jaundice, vein blood pressure (portal hypertension) and severe skin itching.

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Causes of Alcoholic Liver Cirrhosis

The major reason why alcoholic liver cirrhosis occurs is due to repeated and excessive alcohol abuse. When the liver begins to develop scars as a result of alcohol-induced cell death, the body won’t be able to produce enough proteins or keep toxins away from the blood like it should. It’s important to keep in mind that there are other forms of cirrhosis that can be caused by numerous factors. However, only alcohol intake can cause alcoholic liver cirrhosis.

People at Risk from Alcoholic Liver Cirrhosis

You’re at risk of alcoholic liver cirrhosis if you abuse alcohol. Heavy drinking is defined as the consumption of five or more units of alcohol in one sitting (at least five times a month or more).

You’re also genetically at risk of developing alcoholic liver cirrhosis, as some people are born with a deficiency in the enzymes that help to eliminate alcohol. You could develop alcoholic liver cirrhosis if you are obese or regularly eat food that is high in fats. Hepatitis C patients also have a higher chance of developing the condition.

How Alcohol Affects Male and Female Livers Differently

Many studies have highlighted how women are more at risk of developing ARLD. This is because they do not have the same level of enzymes in their stomachs to break down alcohol compared to men. This means that as a woman who heavily consumes alcohol, your liver will be working a lot harder than the average male’s, leading to more scars and quick deterioration.

Other Diseases Related to Alcohol

Apart from liver diseases, researchers have linked alcohol consumption to more than 60 other diseases. This is because alcohol has a myriad of effects on the body, some of which are yet to be fully documented by scientists.

Anaemia: When you drink heavily, the amount of oxygenated blood in your body is very low. This is known as anaemia. Some of the related symptoms include shortness of breath, fatigue and light-headedness.

Cancer : When you drink heavily, you are putting yourself at risk of developing at least one form of cancer. This is because acetaldehyde (which is one of the end results of broken-down alcohol) is a strong carcinogen. Some of the cancer types that can develop include:

  • Colorectal cancer
  • Liver cancer
  • Breast cancer
  • Larynx cancer
  • Throat cancer
  • Mouth cancer

The cancer risk is even higher in alcohol abusers that are also heavy drinkers.

Cardiovascular Disease: If you are a heavy drinker or one who has a habit of consuming a large amount of alcohol at once (binge drinking), you stand the risk of platelets turning into clots, resulting in a heart attack or stroke. In people that have survived a heart attack once, binge drinking doubles their risk of death. Heavy drinking can also result in the weakening and eventual failure of the heart muscles (cardiomyopathy). It can also lead to fibrillation, which is the non-rhythmical twitching of the heart’s main chambers. When this happens, loss of consciousness occurs and without immediate treatment, death follows thereafter.

Dementia: The brain shrinks at an average of about 1.9% per decade as we age. However, heavy drinking speeds up the process of the shrinkage, especially in specific regions of the brain. This leads to memory loss and other symptoms of dementia. Heavy drinking also has subtle (but sometimes major) effects on your ability to think, plan, make judgements, solve problems and perform other functions that require you to use your brain. Even when alcohol doesn’t trigger dementia on its own, the nutritional deficiencies that accompany heavy drinking can trigger other forms of dementia.

Depression: It has been established that alcohol abuse generally leads to depression. There are still arguments about the order of existence in affected individuals (as to which comes first between alcohol and depression), but there’s no denying the fact that both can go hand in hand. While some people only become depressed after they start drinking heavily, others start drinking as a coping mechanism against depression.

Seizures: Even when there is no history of epilepsy, heavy drinking can cause epilepsy and trigger seizures. It can also ruin the potency of convulsion-treating medications.

Gout: Gout is a painful condition, where uric acid crystals are formed in the joints. The development of gout is largely hereditary, but alcohol can trigger it. Where gout already exists, alcohol can make it worse.

High Blood Pressure: Consuming too much alcohol can lead to the disorientation of the part of the nervous system that controls the closing and opening of blood vessels when the body needs to respond to external factors, such as temperature, stress, physical activities etc. When you drink heavily, your blood pressure will rise. Over a period of time, this effect can become chronic, leading to a myriad of problems that may include stroke, heart disease and kidney disease.

Infectious Disease: Heavy drinking can reduce the efficacy of the immune system. This makes it easier for infections to take hold. Some of the infections that occur include pneumonia, tuberculosis, HIV/AIDS and other sexually transmitted infections. If you drink heavily, you are three times more likely to engage in risky sexual behaviour – sometimes without full knowledge of your actions. This can lead to the contraction of sexually transmitted diseases.

Nerve Damage: Heavy drinkers can also suffer from alcoholic neuropathy, which is mostly a form of nerve damage. With this condition, the individual will suffer a painful pins-and-needles feeling, numbness in the arms and legs, muscle weakness, inability to control bowel movements, erectile dysfunction and more. This condition occurs because alcohol is toxic to nerve cells. Additionally, the nutritional deficiencies that are common with heavy drinking also affect nerve function.

Inflammation of the Pancreas: Heavy drinking can lead to inflammation of the pancreas. Chronic pancreatitis, as it’s known, hinders the digestive process. This leads to severe abdominal pain and constant diarrhoea. More than half the cases of chronic pancreatitis are borne of pancreatitis, with gallstones being at fault for the rest.

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How Alcohol-Related Liver Disease is treated

There is no specific medical treatment for ARLD. Quitting alcohol for the rest of your life is often the first recommendation. This will reduce the risk of further damage to your liver and ensure it has a good shot at recovery. However, with support, advice and the right alcohol addiction treatment in the most suitable treatment centre, you can make a full recovery.

In a severe case, where the liver has stopped functioning and can’t be repaired by the cessation of alcohol consumption, a liver transplant might be needed. This will only be an option if you’ve developed complications from cirrhosis. You’ll have to stop consuming alcohol while awaiting the transplant (you must have quit six months before you filed for a transplant to begin with) and you can’t go back to drinking alcohol after the transplant has been completed.

Other Possible Remedies for ARLD

Use of medications: some of the medications used in the treatment of ARLD include: S-adenosyl-L-methionine (SAMe), antioxidant supplements, insulin, corticosteroids and calcium channel blockers.

Administration of protein: patients are often provided extra protein in various forms to help reduce the likelihood of the development of brain disease.

Nutrition-based treatment: since alcohol abuse can lead to malnutrition, a nutrition based treatment programme may be required to aid full recovery.

Preventing Alcohol Related Liver Disease

The best way to prevent ARLD is to stop drinking alcohol. If you cannot quit completely, stick to the recommended limits. The recommended alcohol limit is no more than 14 units every week, spread over at least three days. Even as someone that has been a heavy drinker for a long time, cutting down your alcohol intake can bring about many benefits for your liver and overall health.

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Alcohol Addiction Treatment and Recovery

Alcohol dependency leaves you vulnerable to a range of problems such as financial difficulty, work complications, family problems, potential crime, and of course permanent liver damage. If you are able to break free from your addiction, your life and general health can instantly improve.

Are you struggling to quit alcohol abuse? To succeed in your quest, you need to have the motivation to quit alcohol and make a full recovery. The alcohol withdrawal process can be uncomfortable. Therefore, you need a combination of strong will and professional guidance to achieve a complete reversal.

When in an addiction rehabilitation centre, you’ll be first put through an alcohol detox programme. Working with a professional, the detox process will help you to gradually wean off alcohol until you are completely clean. Working with a professional is important, because of the physical and psychological strain placed on your body by withdrawal. It is dangerous to attempt to go it alone.

After the alcohol addiction detox process, you’ll be moved on to the next stage of treatment, which is counselling and therapy. There will be numerous personal and group sessions, all targeted at helping you through the addiction recovery journey.

Find an Alcohol Addiction Treatment Centre

The process of finding an alcohol addiction treatment centre should not be treated with levity, as it is what will determine whether you will make a full recovery or suffer a relapse. A good treatment centre goes beyond aesthetics. Find out the quality of the personnel and the efficacy of the methods deployed for alcohol addiction treatment. There is a wide network of fully accredited alcohol rehabilitation centres that will help you to make a full recovery from addiction and reduce your chances of becoming an ARLD statistic.


FAQs

Why is the Liver Important?

The liver is second only to the brain when it comes to complexity and function, as it plays a vital role in a range of functions, such as fighting diseases and infection, regulation of blood sugar and cholesterol levels, aiding digestion and filtering toxins from the blood. This is why any condition that affects the liver can quickly become fatal.

How does Alcohol Affect the Liver?

Alcohol makes it hard for the liver to carry out it functions by giving it too much work to do and weakening the cells in the liver. When the liver is no longer able to regenerate destroyed cells to carry out its functions effectively, alcohol-related liver disease sets in.

Is there a Safe Level of Drinking?

Yes. It is recommended that you do not consume more than 14 units of alcohol per week. The 14 units must be spread across three days and not taken all in one sitting.

What Factors Increase your Risk of Alcohol-Related Liver Disease?

Factors that increase your risk of developing ARLD include: obesity, genetic disposition (if you have a family history of alcohol dependence and ARLD, there is a high chance you will also develop it), existing liver problems (Hepatitis C), being a woman (women are more vulnerable to the dangers of alcohol use), race/ethnicity, and malnutrition.

How does Alcohol-Related Liver Disease Progress?

Alcohol-related liver disease begins with alcoholic fatty liver disease, and progresses to alcoholic hepatitis, before resulting in alcoholic cirrhosis. It is not compulsory for the progression to take this defined route, as some people can experience any combination of these stages, at any point in time.

What are the Complications of Alcohol-Related Liver Disease?

There are different complications associated with ARLD. These include liver cancer, kidney failure, accumulation of toxins in the brain, internal bleeding and ultimately, death.

Who is Likely to Suffer from this Condition?

You’re more likely to suffer from ARLD if you are heavy drinker. The risk is doubled if you also have a family history of the condition, if you’re a woman, if you already have a condition that you’re managing or if you’re malnourished.

How can I Prevent Alcoholic Hepatitis?

The first step in the prevention of alcoholic hepatitis is to quit alcohol completely, once you have been diagnosed with alcoholic fatty liver. See your doctor for medications that can reverse any damage and reduce inflammation. You may also need to review your nutrition plan, as most alcoholics are malnourished.

What Causes Cirrhosis?

Cirrhosis is the end result of severe damage to your liver. Once the liver has lost its regenerating abilities, inflammation and complete shutdown ensue. This is cirrhosis. Most people at this stage only have a few more years to live if they go without urgent medical attention, quit alcohol or perhaps even undergo a liver transplant.

Do all Alcoholics Contract Alcoholic Hepatitis and Eventually Cirrhosis?

No. If an alcoholic curtails their use of alcohol in the early stages of alcoholic liver disease (which is the alcoholic fatty liver stage), they can reverse the damage in a few weeks and avoid the progression to alcoholic hepatitis and cirrhosis. In many cases, no medication is required to reverse the condition at this stage. Simply quitting alcohol is usually enough.

Are there other Dangers from Alcohol Besides how it Affects the Liver?

Yes. Alcohol has been cited as the cause for more than 50 other health conditions aside from liver disease. Even when you don’t consume alcohol long enough to induce a medical condition, it can still put you at risk of taking decisions that can cause you physical, mental, monetary or physiological harm. Think about the poor decisions you might make whilst under the influence of alcohol that could cost you your relationship or your job. There’s also the risk of being involved in an accident that can change your life forever, because you (or someone else in your company) were driving whilst under the influence of alcohol.

What is Alcoholic Hepatitis?

Alcoholic hepatitis is a liver disease that can develop when you abuse alcohol over a long period of time. It is an inflammation of the liver and different from other forms of hepatitis, as it’s not infectious. It can also occur instantly if you drink an extremely large amount of alcohol in one sitting.

Is Alcoholic Hepatitis Different from ‘Fatty Liver’?

Yes. Alcoholic fatty liver happens when fats replace the cells of the liver. It is generally harmless and without symptoms, but is a sign of impending bigger issues with regards to the liver. Alcoholic hepatitis, on the other hand, signifies inflammation of the liver and an advanced stage of liver damage.

How can Alcoholic Hepatitis be Diagnosed?

If you have alcoholic hepatitis, a doctor will require as much information as possible with regards to your health history and alcohol consumption habits. A physical examination will be undertaken to establish whether you have an enlarged liver. After the physical tests, a medical test will be ordered. All or some of the following tests will be requested: ultrasound of the liver, abdominal CT scan, blood clotting tests, liver function test and complete blood count test. Any diagnosis made will then most likely be confirmed with the aid of a liver biopsy.

Is Alcoholic Hepatitis Dangerous?

Yes. Alcoholic hepatitis can make it harder for your liver to keep toxins out of your blood stream: brain damage and coma may follow. If left untreated, this will result in death. However, even if you are taken to a hospital in time, you’re not in the clear by any means. The condition may have already degenerated to liver cirrhosis and at this point, a liver transplant is your only hope.

Can ‘Social Drinkers’ Contract Alcoholic Hepatitis?

Yes. Even though alcoholic hepatitis is more likely to occur in an alcoholic, it can also manifest in people who are casual drinkers. This is because the way the liver processes alcohol varies from one person to the next.

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