Dear Alice,

How does the use of alcohol damage the liver?

Dear Reader,

Way to be proactive about investigating how substances can impact the body! For most folks, low-risk use of alcohol doesn't seem to damage the liver. The misuse and abuse of alcohol may have a long-lasting impact on the liver. The liver breaks down and eliminates toxins, converts excess blood sugar to glycogen for energy storage, and performs many other crucial functions. As such, excess alcohol use may put strain on the liver and may contribute to a number of health conditions, especially if used in a high-risk manner.

Alcohol-related liver disease is generally diagnosed in the following three (sometimes overlapping) categories. High-risk use of alcohol (including chronic drinking or binge drinking) can cause a condition called alcoholic fatty liver disease. At this stage, fat buildup occurs in the liver and sometimes (but not always) leads to discomfort and fatigue. This blockage prevents oxygen and other nutrients from getting to the liver cells, as the blood supply is restricted. The good news: fatty liver usually reverses if a person stops consuming alcohol. However, continuing to drink heavily can lead to more severe complications including the next stage of alcohol-related liver disease.

Another condition is called alcoholic hepatitis, which is characterized by inflammation of the liver caused by alcohol use. Note that while alcoholic hepatitis is associated with heavy drinking, it can occur in moderate drinkers too — some risk factors include sex assigned at birth, obesity, and genetic factors. Symptoms may include fever, fatigue, weight loss, nausea, vomiting, and abdominal pain and tenderness. If mild, the condition may reverse over time if a person stops drinking. However, if it's more acute, it may lead to additional complications including high blood pressure in the liver, enlarged veins, kidney failure, and cirrhosis.

Cirrhosis is the most severe alcohol-related liver disease. The condition occurs when the liver continually repairs itself from damage, resulting in scar tissue buildup that can prevent the liver from functioning properly. Warning signs of cirrhosis include jaundice (yellowing of the skin and the whites of the eyes), fatigue, and a swelling of the abdomen and lower extremities. While the damage from it may not be able to be undone, diagnosis and treatment may minimize future damage.

Folks who are diagnosed with alcohol-related liver conditions may be treated in multiple ways. First and foremost, they're encouraged to stop consuming alcohol. Additional treatments may include monitoring the person's nutrition, medications to reduce liver inflammation, and in advanced cases of cirrhosis, liver transplants. Drinking alcohol in a lower-risk manner, abstaining from alcohol, and avoiding mixing alcohol with other medications can minimize the risk of the alcohol-related liver disease. 

If you or someone you know is looking to change drinking habits or better understand a relationship with substances, speaking with a health care provider or health promotion specialist may be useful. If you’d like to learn more about other health effects of alcohol (on more than just the liver), or view some strategies for evaluating your relationship with alcohol, the National Institute of Health offers some helpful resources.

Cheers to your health!

Alice!

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