Alcohol Abuse and Liver Damage
The liver plays an important role in the body’s metabolic processes. In addition to its other roles, it breaks down nutrients like fat into substances the body can use and stores them until energy is needed. The liver also converts toxic substances into harmless substances that can be released safely. It’s even responsible for metabolizing carbs to keep blood sugar levels stable.
When alcohol is consumed, the liver must metabolize it and convert it into a safe substance. The liver can only handle a certain amount of alcohol at once, though, before it struggles to process it. In the liver, alcohol metabolization produces acetaldehyde, a toxic enzyme that damages the liver cells and leads to permanent scarring. Alcohol abuse in the form of heavy and/or regular drinking can lead to alcoholic liver disease, a chronic disease that comes in many forms. Alcohol is the primary cause of liver disease.
Fatty Liver Disease
The first stage of alcoholic liver disease is called fatty liver disease, or a build-up of fat in the liver. Fatty liver can happen after a single case of binge drinking and it’s usually reversible by quitting alcohol. It isn’t believed to be a predisposition to chronic liver disease like hepatitis and cirrhosis, but it can worsen if drinking continues.In most cases, fatty liver has no symptoms, but it can cause inflammation that leads to confusion, abdominal pain, weakness, and fatigue.
Alcohol abuse frequently leads to alcoholic hepatitis. Anywhere from 10% to 35% of heavy drinkers will develop alcoholic hepatitis, or inflammation of the liver. The disease causes a build-up of fat in the liver cells, inflammation, and scarring that impair the liver’s ability to function. This disease can cause symptoms such as:
- Jaundice, or a yellow hue of the eyes and skin
- Stomach aches
- Nausea and vomiting
- Unexplained weight loss
Alcoholic hepatitis can be mild to severe. While still mild, quitting alcohol and seeking treatment may reverse the disease. When severe, it can lead to a build-up of fluid in the body, liver and kidney failure, and behavioral changes and confusion when toxins build up and cannot be broken down by the liver.
Cirrhosis is advanced liver disease. As liver damage advances, scar tissue replaces healthy liver tissue and makes it difficult for the liver to function at all. Permanent scarring is the last stage of alcoholic liver disease. When cirrhosis begins, it can progress to total liver failure, which quickly damages the kidneys. Between 10% and 20% of heavy drinkers eventually develop alcoholic cirrhosis. This disease can develop even in people who do not have alcoholic hepatitis.Alcoholic cirrhosis is a serious and life-threatening condition. It can cause jaundice, itching, easy bruising, weakness, fatigue, and a loss of appetite. Complications can include:
- Fluid in the peritoneal cavity and abdominal swelling
- Hepatic encephalopathy, or a loss of brain function due to a build-up of toxins
- Hepatorenal syndrome, or a serious and rapid deterioration of kidney function
- Hepatopulmonary syndrome, which causes shortness of breath and low oxygen levels
- Overactive spleen which removes blood cells too soon
- Liver cancer
While cirrhosis is very serious, most people with alcohol-induced cirrhosis who quit drinking experience an improvement in their liver function. When cirrhosis is advanced, a liver transplant may be the only treatment option.
Early Symptoms Are Not Always Apparent
Some people do not have any symptoms of alcoholic liver disease until the disease progresses to hepatitis or cirrhosis, but others show early signs. Symptoms of liver disease often show up more frequently after binge drinking and may include jaundice, abdominal discomfort, swelling in the abdomen or legs, weight loss, dark bowel movements, confusion, fatigue, and nausea.People with a family history of alcoholic liver disease are at higher risk for the disease. The risk of alcoholic liver disease also increases with poor nutrition, frequent heavy drinking, and binge drinking. Binge drinking may also lead to acute alcoholic hepatitis, a life-threatening condition that can occur after just 4-5 drinks.
Treating Alcoholic Liver Disease
Prompt treatment and quitting alcohol is the best way to stop the progression of liver disease and even reverse mild damage to the liver. Someone with alcoholic fatty liver or mild alcoholic hepatitis who stops drinking can typically recover fully. Even with mild cirrhosis, quitting drinking forever can often stop the progress of the disease permanently. In severe cases of liver damage, a transplant may be the only treatment option.People who are drinking more than they should and have trouble quitting are usually advised to enter a treatment program that includes detox and/or a support group. Quitting drinking cold turkey can cause serious withdrawal symptoms in people who have been drinking for many years and/or drink heavily. This process should be medically supervised to prevent life-threatening complications of quitting.