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The liver is the largest solid internal organ, and it is necessary for critical functions such as ridding the body of toxins. Alcohol is toxic in any amount, and this means that it is primarily going to affect the liver. [2]

Even one instance of drinking excessive alcohol can cause significant damage. The liver metabolises liquor while also being responsible for maintaining balance within many delicate body systems which means any potential damage can negatively affect a person for their entire life.

This organ is also the only one in the human body that can regenerate damaged cells. Unfortunately, for people who routinely drink in excess, this leads to scar tissue being developed over time as the liver continuously heals from the ravages of alcohol. [1]

Scarring can make it difficult or impossible for the liver to fulfil its many vital responsibilities.

Other essential liver functions include the following.

  • The liver is responsible for the production and elimination of bile
  • It also eliminates cholesterol, drugs, and hormones within the body
  • The liver metabolises fats, carbohydrates, and proteins
  • It is responsible for enzyme activation
  • It stores vitamins, minerals, and glycogen
  • The liver synthesises plasma proteins and clotting factors

Risk Factors For Alcoholic Liver Disease

There are several risk factors for developing alcoholic liver disease. This disease is characterised by inflammation of the liver and extreme tissue damage.

Some people are prone to suffering from severe adverse health effects, while others only show mild symptoms. Heavy drinking over only a few days can be enough to cause alcoholic liver disease. [5]

Several key factors have contributory effects, including the following:[2] [3]

  • Age
  • Gender
  • Weight
  • Genetics
  • Diet
  • Co-occurring liver issues including Hepatitis C
  • Excessive drinking over a long period

Signs of Mild and Acute Liver Damage Due to Alcohol Use

We already know that this organ is in charge of a lot of critical bodily functions. That means anytime it is working at less than one hundred per cent, the body will suffer.

This can take the form of low blood sugar, body aches, and general feelings of being unwell. By the time signs point towards the liver being unhealthy with outwardly visible symptoms then usually extensive damage has already taken place.

This can include fat and scar tissue buildup or extensive inflammation of the liver cells. [3]

Some signs of alcoholic liver disease can be had to spot alone, but cumulatively they paint a pretty dismal picture.

So, what are the first signs of liver damage from alcohol? The initial stages include the following: [3]

  • Stomach pains, nausea, and abdominal swelling
  • Tenderness around the liver
  • Unusual weight loss
  • Unexplained fatigue and feelings of weakness
  • Red palms and white fingernails
  • Diarrhoea

Once the damage reaches acute stages, the symptoms may include ones listed here: [3]

  • Immune system issues (e.g., getting sick more often)
  • Jaundice (e.g., yellowing around the eyes and skin)
  • Ankles or feet visibly swelling
  • Fever
  • Skin itching for no discernible reason
  • Bruising and bleeding very easily
  • Personality and memory problems
  • Confusion and cognitive decline
  • Unusually dark urine
  • Liver failure

Timeline of Liver Damage

In the beginning, there are usually few or no visible symptoms that point towards any issues. This means that it is crucial to get regular check-ups with a medical professional if you find yourself at high risk of alcoholic liver disease so that any damage can be caught and treated immediately.

Because of the way that this organ can repair itself, getting medical help quickly will usually mean that a minimum of symptoms is experienced, and the liver can be protected from any long-term effects.

There are three known stages of alcoholic liver disease. They include fatty liver, alcoholic hepatitis, and liver cirrhosis. [3]

1. Fatty Liver Disease

Fatty liver (e.g., steatosis) can develop after even a single drinking session. Anyone who habitually drinks in excess will have fatty deposits around their liver.

This is the stage of alcoholic liver disease, and the effect on different systems of the body will begin quickly. [3]

2. Alcoholic Hepatitis

The second stage is alcoholic hepatitis which is an inflammation of the organ’s cells. At this point, the damage will become severe enough that the liver will begin creating scar tissue as a result of the continuous cell regeneration taking place to combat the fibrosis. [3]

At this stage, it is possible to revert the liver to a healthy and functional state, especially if the individual stops drinking entirely.

3. Alcoholic Cirrhosis

The final stage is liver cirrhosis which is responsible for a large percentage of alcohol-related deaths. [3] By this point, the very structure of the organ is damaged permanently by scar tissue. It can lead to stiffening of blood vessels, among other things.

Liver cirrhosis impedes the liver’s functioning to the point where it can have negative effects on the kidney, brain, and other areas. A liver transplant is often the only permanent solution to this level of damage.

However, there are some treatments such as Polyunsaturated Lecithin which are known to help with the buildup of scar tissue. [3]

Treatments for Alcoholic Hepatitis and Alcoholic Fatty Liver Disease

Both fatty liver and alcoholic hepatitis can be reversed with the correct treatments. Abstaining from drinking will be encouraged as well since any toxins being screened through the already damaged organ can aggravate it.

Not drinking for several weeks can be enough to reverse fatty liver. Below are the treatments recommended for these first stages of alcoholic liver disease. [3]

1. Corticosteroids

Corticosteroids are used as a way to diminish inflammation. They have also been proven to help in later stages as well. [3]

They are not recommended if there is no change after a week because long-term corticosteroid use can cause problems of its own. [6]

2. Nutrition and Antioxidants

Antioxidants and proper nutrition can help combat some of the symptoms. [3]

Malnutrition is prevalent in people with liver problems. A dietician and hepatologist will be able to provide healthy guidelines for changes to diet to make sure you get the antioxidants, vitamins, and nutrition that you need.

3. Antibiotics and Immune System Inhibitors

Antibiotics can help with harmful bacteria, negative immune system responses, and they are also known to cause a decrease in inflammation. [3]

Treatments for Alcoholic Cirrhosis

Once this final stage is reached there are fewer options for treatment. Abstaining will be necessary to stop any further decline, but at this point, the damage is already done and cannot be fully reversed

. There are some treatments like Polyunsaturated Lecithin, which has mixed results but might slow or pause some of the worst symptoms. [3]

Liver Transplant

When the liver stops working and no treatments help, then there is no choice but to get a transplant. To avoid reaching this stage, anyone with alcoholic cirrhosis will need to abstain from all alcohol and let their liver recover.

In some cases, the liver damage may be too severe and then it is necessary to create lifestyle changes that will be conducive to a successful organ transplant.

Ways to Prevent Alcoholic Liver Disease

Everyone, regardless of their risk factors, has steps they can take to prevent alcohol damage to the liver. These are all important, and doing only one or two will not do enough.

They must all be addressed and adhered to in order to be effective. Even one day of drinking too much can be enough to cause fatty liver and start inhibiting its functionality.

1. Follow a Proper Diet

Your liver will be able to do its job better and metabolise the toxins in alcohol more efficiently if you are eating a proper, nutritious diet. A dietician can provide a healthy eating plan.

2. Abstaining or Drinking Within Healthy Limits

Drinking in moderation or completely abstaining will make the most significant difference in the health of your liver. Even with mild forms of liver disease, it is best to stop drinking entirely to give your body time to recover before going back to ingesting a healthy amount.

The rule of thumb is that men should have no more than two drinks per day. Women should have no more than one. Pregnant women, anyone who is recovering from an alcohol abuse disorder, and anyone taking medications that can interact with alcohol should not be drinking at all.

3. Exercise

Being overweight is one of the top reasons for developing fatty liver and consequent inflammation and scar accumulation. Exercising will keep your body in top shape and able to better metabolise alcohol.

Treating Co-Occurring Medical Issues

There are several co-occurring medical disorders which can significantly increase the risk of alcoholic liver disease. Monitoring, treating, and recovering from these other complicating diagnoses will make it easier for the liver to do its work without adverse repercussions.

Do Not Abuse Over the Counter Medications

There medications that can cause added stress to the liver, such as Tylenol, ephedra, and statins. If you ignore the instructions for how often to use them, then it can lead to a worsening of symptoms.

References

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860520/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513682/

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

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643281/

[5] https://surgery.ucsf.edu/conditions–procedures/alcoholic-liver-disease.aspx

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913072/#s4title