Dear Alice:

I would like to find out about liver problems. My grandmother had a blood test and said she has some sort of liver problem. It's from long-term drinking. Can you please give me some information on this issue? Thank you.


Dear AGOA,

Learning more about your grandmother’s liver problems is a great way to support her. The liver is one of the largest organs in your body and is responsible for several different functions including processing nutrients from food that your body can then use, producing bile, and removing waste products from the body including toxins like alcohol. Because the liver fulfills so many responsibilities within the body, liver damage (either due to alcohol use or not) can have a wide range of effects. Additionally, some people may be at a higher risk for alcohol-related liver damage (more on that in a bit). Fortunately, there are a number of options for your grandmother, even after a diagnosis, to improve her health.

Signs and symptoms of liver damage (both those with alcohol-related diseases and non-alcohol-related diseases) can include:

  • Loss of appetite
  • Nausea and vomiting, sometimes with blood
  • Fever
  • Mental confusion
  • Fatigue
  • Yellowing of the skin and whites of the eyes (also known as jaundice)
  • Abdominal pain/tenderness (because the liver will become enlarged and feel sensitive)
  • Abdominal swelling due to fluid accumulation (also known as ascites)
  • Kidney or liver failure

While there are many different conditions related to the liver (you can learn more about these at the American Liver Foundation website), there are several that are related to alcohol use:

  • Fatty liver is a condition where a build-up of fat occurs in the liver cells. There are rarely symptoms other than fatigue, weakness, and weight-loss. If you have fatty liver disease and stop drinking alcohol, in many cases the disease will reverse course.
  • Alcoholic hepatitis is characterized by inflammation of the liver caused by excessive alcohol use. It typically occurs in those who drink alcohol (in large amounts) over many years. However, not all people who drink heavily will get it and sometimes those who drink more moderately will develop the disease. If you stop drinking early enough, the body can sometimes reverse the damage. If the disease is more advanced, stopping alcohol use will help to prevent possible complications.
  • Cirrhosis is an irreversible condition where scar tissue replaces normal liver tissue. This scar tissue cannot perform liver functions and the more scar tissue there is, the more difficulty the liver will have performing its normal functions.

In order to be diagnosed with a liver condition, a health care provider may do a physical exam, a blood test, a liver biopsy, an imaging test, an ultrasound, a magnetic resonance imaging (MRI), and/or computerized tomography (CT) scans. S/he may also ask about family history.

Not everyone who drinks alcohol excessively will get an alcohol-related liver disease. However, your chances of getting alcohol-related liver disease increase the longer you drink and the more alcohol you consume. Additionally, excessive alcohol use and having cirrhosis can also lead to liver cancer. For someone who drinks alcohol in excess, the following factors may increase the chances of developing liver damage:

  • Gender plays a role as females develop alcoholic hepatitis more often than males.
  • Genetic factors, such as mutations of certain genes, can increase the risk of alcoholic liver disease and some alcohol-associated cancers.
  • Obesity may further complicate damage to the liver due to alcohol use.
  • Malnutrition, due to replacing calories from foods/nutrients with calories from alcohol, can lead to cell damage in the liver.
  • Other types of hepatitis can cause further liver damage.

There are a few recommendations that health care providers typically make when a person has been diagnosed with a liver condition. First and foremost, it’s recommended that she stop consuming alcohol especially for an alcohol-related condition (those with liver conditions not related to alcohol use are also strongly advised to limit or avoid alcohol). A healthy diet that will help her liver to recover from damage and medications prescribed to manage the complications caused by liver damage may also be in order. With some advanced cases of cirrhosis, a liver transplant is sometimes necessary.

In light of all this information, you can support your grandmother by encouraging any efforts she takes to improve her liver and her health. It may also be helpful for you to know that though you can support her, your grandmother has to make health-related decisions for herself. She is ultimately the only one in control of her own body and her behaviors.



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