How Alcohol Damages The Liver

The liver is one of the most important organs in the human body. As the largest solid organ (and the largest gland) in the body, a human liver weighs between 1.3 kg and 1.8 kg and holds roughly 15% of the bodies blood supply. [1] But what happens to this organ when we drink? This post looks at how alcohol affects the liver.

With over 500 functions that range from processing food to combating infections and storing vitamins, the liver is also one of the hardest working organs in the body. [2] Despite this, many people are not fully aware of the need to protect their liver from alcohol damage.

Alcohol and Your Liver

One of the things most likely to cause serious liver damage is sustained alcohol consumption or abuse. Studies show that a large proportion of heavy drinkers develop serious liver disease in later life. Instances of alcoholic hepatitis and cirrhosis are increased too. [3]

The connection between alcohol and liver damage is not news to most people, of course, but many people do not understand just how alcohol interacts with and damages the liver. This damage, whether compounded by genetic and hereditary factors or not, is caused by the way in which the liver metabolises alcohol.

One of the main ways in which the body processes alcohol is through the enzyme alcohol dehydrogenase (ADH) which converts alcohol into acetaldehyde through a process of oxidisation. [4] Acetaldehyde is incredibly toxic to the body, as are many of the other compounds created as a result of alcohol metabolization.

Drinking infrequently or within recommended limits controls liver damage. But those who drink heavily, regularly, or who abuse alcohol as a result of addiction can cause serious and lasting damage surprisingly quickly.

Alcohol-Related Liver Diseases (ARLD)

Broadly speaking Alcohol-Related Liver Disease (or ARLD) has four stages. Beginning with the development of fatty liver disease (FLD), it moves to alcoholic hepatitis, hepatic encephalopathy, and finally liver cirrhosis.

Read on below to discover the different stages of liver disease and the symptoms you can look out for.

1. Fatty Liver Disease

The first stage of ARLD is caused by the accumulation of fat in the liver; when alcohol is metabolised the liver often stores it as fat and processes it later. [5] When too much fat builds up, however, it causes increasingly severe damage to the liver and can result in the development of more serious conditions.

Fatty liver disease is caused by a sedentary lifestyle and poor diet. This is why it is classified as either ARFLD (alcohol-related fatty liver disease) or NAFLD (non-alcohol related fatty liver disease.) This can often be reversed through abstinence, exercises, and long-term improvements to diet.

Symptoms of Fatty Liver Disease

FLD is known for being asymptomatic, especially in the early stages, which makes it hard to catch. Some patients may experience discomfort or pain in the upper-right abdomen or extreme fatigue but FLD generally remains undiagnosed until liver health deteriorates further (unless a medical practitioner has another reason to assess your liver health.) [6]

2. Alcoholic Hepatitis

Over time FLD and continued alcohol consumption can lead to the development of alcoholic hepatitis. This is caused by the damage that acetaldehyde does to the liver; eventually, the liver becomes inflamed and cannot function to its full capabilities. [7]

While this is most common amongst heavy drinkers, alcoholic hepatitis can occur in those who drink infrequently or lightly. Long-term abstinence from alcohol consumption can often reverse alcoholic hepatitis by allowing the liver to heal.

Symptoms of Alcoholic Hepatitis

Abdominal pains, bloating, vomiting, appetite loss, fever, jaundice, fatigue, and male impotence. [8]

3. Hepatic Encephalopathy (& More)

Hepatic Encephalopathy means loss of brain function which occurs as a result of impaired liver function. When the body is unable to rid itself of toxins, they stay in the bloodstream and can make their way to the brain. This can take many forms, for example, hypoalbuminemia which occurs when levels of albumin in the body are depressed.

Symptoms of Hepatic Encephalopathy 

The most common symptoms of hepatic encephalopathy are swelling across the body, weakness, fluid around the lungs, cramps, loss of appetite, altered consciousness, coma, and, in some cases, death. [9]

4. Liver Cirrhosis

Cirrhosis of the liver is a condition that occurs when the liver becomes so scarred (a process called fibrosis) that it seriously impairs function. This happens because the scarred surface makes it difficult for fluids to be filtered through the liver.

Unlike fibrosis and fatty liver disease, cirrhosis cannot be cured. Those who continue to drink after being diagnosed with alcohol-related cirrhosis have a 50% chance of living for another 5 years.

Symptoms of Liver Cirrhosis

Jaundice, portal hypertension, skin itching as well as fatigue and more general symptoms.

Alcohol-Related Liver Disease: The Risk Factors

ARLD is not a guaranteed outcome for those who drink heavily; even those who struggle with serious alcohol addiction may not develop alcohol-related liver disease. This fact alone shows that there are a number of risk factors to consider. The main factors which influence the likelihood of ARLD are:

• Gender
• Diet and lifestyle
• Genetic variations
• Infection with hepatitis C
• Tobacco and coffee consumption
• Alcohol consumption

Each of these factors influences the likelihood of ARLD, for example, women develop cirrhosis at a lower cumulative dose of alcohol than men, and those who have hepatitis C are more likely to face further complications such as fibrosis and cirrhosis.

What to Do When Struggling With Alcohol Addiction

Alcohol addiction presents a huge risk to your liver health, but also your life if you have already been diagnosed with liver disease. Contact your doctor if you are struggling to reduce your alcohol consumption.

Treatment and Recovery For Alcohol-Related Liver Disease

The liver is a fantastically resilient organ, in fact, it is the body’s only regenerative organ and can recover from surprisingly severe damage by itself when given the correct environment in which to do so.

One of the biggest factors in allowing the liver to recover from damage is abstinence from alcohol. Cessation of drinking is necessary for healing from any kind of liver damage but becomes more important as the level of damage increases.

Can the Liver Recover From ARLD?

In most cases, yes. Fatty liver disease and alcoholic hepatitis can be reversed with sustained abstinence and healthy living, so long as there are no co-occurring medical conditions that might impair this.

If you have pre-existing liver conditions that are unrelated to alcohol, or you have hepatitis C recovery may be harder. Once the damage progresses to the point at which cirrhosis sets in the liver will no longer be able to heal itself.

At this stage, a liver transplant may be the only treatment option available to you. If, however, you have small amounts of liver fibrosis (scarring) then abstinence will help to prevent further damage before a transplant is needed.

How Quickly Does the Liver Heal After Alcohol Damage?

This does depend on the level and type of damage involved, but the liver will begin to heal very quickly. For example, if an overdose was to destroy 50 – 60% of your body’s healthy liver cells, it could repair itself entirely within 30 days assuming you abstain from drugs and alcohol and have no underlying health concerns.

Likewise, if you have developed any level of fibrosis your liver will not be able to heal the scar tissue. Talk to your doctor to gain an understanding of how long your body will take to heal, and whether or not you can expect it to heal fully.

Helping the Body Heal After Liver Damage

If you have been told that you have liver damage or impairment and you want to help your body heal there are some important steps you should take. Stop drinking for the foreseeable future and seriously moderate any future intake.

Secondly, analyse your diet to ensure that you are getting enough nutrients. Thirdly, exercise, and up your water intake. Finally, ask your doctor for advice as to other harmful substances you should avoid; some painkillers, for example, are hard on the liver.

References

[1] https://britishlivertrust.org.uk/information-and-support/liver-health-2/abouttheliver/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846480/

[3] https://pubs.niaaa.nih.gov/publications/arh21-1/05.pdf

[4] http://remedy.bnssgccg.nhs.uk/media/1455/alcohol-liver-disease.pdf

[5] https://www.endoscopyplus.co.uk/information/hepatology/fatty-liver-disease/

[6] https://www.quitalcohol.com/alcohol-abuse/what-alcohol-does-to-the-liver

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124878/

[8] https://www.sciencedirect.com/science/article/pii/S2542568418300333

[9] https://www.journal-of-hepatology.eu/article/S0168-8278(18)32618-7/fulltext

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