Liver tenderness from a one-night bender?

Originally Published: April 10, 2009 - Last Updated / Reviewed On: February 14, 2014
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Dear Alice,

I am a 23 year old female who enjoys a few glasses of wine but, in my opinion, doesn't drink more than the average college student. A few weeks ago, I had quite a bit to drink and haven't felt the same since. I am dizzy, forgetful, confused and my liver is very tender to the touch. I have continued to have a few glasses of wine a couple nights out of the week and it seems to be the only thing that gets me back to feeling "normal." Is this a normal way to feel or should I be concerned?

Sincerely,
Social Drinker

Dear Social Drinker,

Alcohol is often a ubiquitous part of the social scene on college campuses, making it difficult to distinguish occasional or "social drinking" from higher-risk drinking. Even what seems to be a modest amount of alcohol or "average" level of drinking can lead to serious health problems, including alcohol addiction. It's unclear how much you've been drinking, and each person's alcohol tolerance is different. However, anytime you experience lasting pain or mental confusion, those are red flags that something is not right. Trust your instincts, and make an appointment with a health care provider or counselor to talk about your drinking habits.

The liver tenderness you mentioned can have a variety of causes including hepatitis, mononucleosis, cancer, fatty liver disease, and alcohol abuse. Just one alcohol binge or even moderate repeated drinking can lead to alcoholic hepatitis, a condition that causes the liver to become painfully enlarged. According to the Mayo Clinic, symptoms of alcoholic hepatitis include:

  • Loss of appetite
  • Abdominal pain and tenderness
  • Nausea and vomiting, sometimes with blood
  • Paleness or yellowing of the skin and whites of the eyes (jaundice)
  • Fever
  • Abdominal swelling due to fluid accumulation
  • Mental confusion
  • Fatigue
  • Dry mouth or unusual thirst
  • Lightheadedness
  • Unexpected, rapid weight gain

These symptoms may worsen after a bout of heavy drinking, which may explain why you haven't felt the same since your last bender. Although it can be difficult to stop drinking for a variety of reasons, the most effective treatment for alcoholic hepatitis is complete abstinence from alcohol. Without treatment, this condition will often progress to cirrhosis of the liver. Severe liver damage is irreversible, so it's important to seek medical attention right away.

You mentioned that having a few glasses of wine seems to be the only way to ease your symptoms and help you feel "normal." These are signs of alcohol dependence, or the body's chemical addiction to alcohol. Physical dependence on alcohol develops gradually. Drinking alcohol affects several chemicals in the brain including: gamma-aminobutyric acid or GABA, which limits impulsiveness; glutamate, which excites the nervous system; and dopamine, a pleasure chemical. Over time, heavy drinking can upset the balance of these chemicals. In turn, the body craves alcohol to restore good feelings or avoid negative ones. People with alcohol dependence may experience withdrawal symptoms like tremors, insomnia, nausea, and anxiety if they drink less than usual or stop drinking altogether.

For people who are addicted to alcohol or just enjoy drinking socially, it can be tough to drink less or stop completely. Ultimately, it's up to you to decide if and how much you want to drink. Many people benefit from reflecting on the role of alcohol in her/his life either through self-exploration or through discussions with a neutral party (counselor, health care professional, spiritual advisor, family member, etc).

If you want to make a change, there are several ways to get help. If you are a Columbia student, you can make an appointment with a clinician at Medical Services (Morningside) or the Student Health Service (CUMC). You might also want to consider contacting Counseling and Psychological Services (Morningside) or the Mental Health Service (CUMC).

There are also a variety of resources off-campus. To start, you may want to read Alcohol withdrawal symptoms? in the Go Ask Alice! archives for more information about alcohol dependence and recovery and a list of helpful organizations for people struggling with alcohol use. Changing your drinking habits is not easy, but you've already taken the first step by writing. By reaching out a bit further to friends and health professionals, you can gather support to help you take control of your drinking and stay healthy. Good luck!

Alice