Liver Disease From Alcohol: Early Signs
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Drinking excessively or too frequently can cause a number of health problems. Many of these problems are related to the liver. Short and long term effects of alcohol on the liver can be very serious. This organ has a lot of important roles in the body, including contributing to the breakdown of food and production of energy. Another important task is filtering out toxins, including alcohol.
Alcohol abuse increases the risk of damaging the liver. This damage may not cause noticeable symptoms until it is already severe. One of the biggest causes of disease and damage to the organ is preventable: over one-third of deaths from liver complications were related to alcohol.
How Alcohol Affects the Liver?
The liver is tough, and it does an excellent job of removing toxins from the blood. However, when a person drinks too much, too often, or too quickly, it cannot keep up. The accumulating toxins cause damage that over time can lead to illness and disease.
Liver cells need to water to function properly. Alcohol is a diuretic, which means that it causes a lot of water to leave the body. This can lead to dehydration, which in the liver causes it to work less efficiently.
Short term effects of alcohol on the liver also include scarring and inflammation, which over time contribute to a lot of damage. There are two main mechanisms by which alcohol has these effects:
- Toxins from gut bacteria get into the liver during heavy drinking, where they can cause damage.
- The chemical reaction that breaks down alcohol causes oxidative stress that can damage cells over time.
Liver Diseases Caused by Alcohol
The signs of liver damage from alcohol are not always obvious until a lot of harm has been done. By then it is possible that a person is suffering from a liver condition. There are several diseases that affect this important organ and that can be caused by drinking.
Alcoholic Fatty Liver Disease
Regular heavy drinking promotes the buildup of fat in liver cells. Possible symptoms of this include fatigue, swelling, and abdominal discomfort. Blood tests can show elevated enzymes characteristic of disease, but this stage is usually not dangerous. Fatty liver and alcohol disease is often not severe or dangerous, especially because it is reversible.
Stopping or reducing alcohol consumption in response to fatty liver disease can reverse the condition. The organ will return to normal size, typically as early as two weeks after abstinence. However, continuing to drink at this stage can cause the condition to worsen and may lead to hepatitis.
Heavy and regular drinking can also lead to more serious inflammation and scarring, known as alcoholic hepatitis. Over a third of heavy drinkers will develop this condition.
This kind of hepatitis can start out mild and with few symptoms. It typically requires blood tests. Consumption of alcohol affects liver enzymes, so these tests can show elevated enzyme levels and help diagnose disease. At this stage the disease can still be reversed by cutting out alcohol.
Chronic alcoholic hepatitis on the other hand can be serious. It can cause severe complications, such as liver failure or even death. Some of the typical symptoms of chronic hepatitis are:
- A general feeling of being unwell
- Abdominal pain
- Yellowing of the skin and the eyes (jaundice)
- Blood clotting
This more severe form of alcoholic hepatitis requires treatment, including steroids and sometimes the use of a feeding tube.
The most serious liver disease from alcohol consumption is cirrhosis. This occurs when the scarring caused by drinking begins to replace much of the healthy tissue. This is known as fibrosis. The healthy cells die, and the resulting symptoms are similar to those caused by chronic alcoholic hepatitis.
About 10 to 20 percent of heavy drinkers develop cirrhosis after a decade or more of alcohol abuse. This condition is not reversible with abstinence from alcohol or with medications, but stopping drinking can slow or halt the progression of the disease and bring some symptom relief.
Cirrhosis develops in different people at different rates. Some heavy drinkers will never realize that they have fatty liver or hepatitis. The symptoms may not be severe enough to take notice, and then suddenly they develop cirrhosis. It can feel as if this disease sneaks up on a person, but it actually develops in these stages.
The way alcohol affects liver tissue and cells is what causes these diseases, but it also may trigger additional complications:
- Buildup of fluid in the abdomen
- Stomach or esophageal bleeding
- Kidney failure
- Liver cancer
- Brain disorders
These are only some examples of possible complications of heavy and frequent problem drinking.
Diagnosing and Treating Alcohol Liver Diseases
Anyone who drinks heavily should be screened for liver illnesses and damage. A blood test and a physical examination are starting points for diagnosing disease and developing treatment plans.
Are Alcohol-Related Liver Disorders Treatable?
Not all alcohol-related diseases are treatable. Conditions like alcoholic fatty liver disease and alcoholic hepatitis can be treated with abstinence from alcohol. However, a disease like cirrhosis cannot be cured or reversed. It can only be managed to reduce the discomfort and to slow its progression.
How Is An Alcohol-Induced Liver Disease Diagnosed?
A regular physical check-up and a discussion of symptoms is the first step in diagnosing liver conditions. Additionally, doctors use blood tests to look for abnormal function and to rule out other diseases. Alcohol effects on the liver include structural damage, so an ultrasound can show changes or enlargement, and a biopsy may be taken to confirm a diagnosis. The sample can be viewed in a laboratory to confirm scarring and other types of damage caused by alcohol.
What Are Treatment Options?
The treatments that may be used depending on the stage of the disease, the extent of the damage, and an individual’s symptoms and overall health. Some possible treatments include:
- Abstinence. Quitting drinking is strongly recommended for all stages and types of liver conditions.
- Healthy diet. Eating well is important for supporting liver health. Heavy drinkers are often deficient in many nutrients and can benefit from supplements and working with a dietician.
- Medication. Using drugs is not always recommended because it can be an additional strain on the liver. But if complications occur, it may be necessary to deal with other health problems medically.
- A transplant. A transplant may be necessary for those with severe liver damage, especially cirrhosis.
Can One Reverse Liver Damage from Alcoholism?
For people with fatty liver disease or mild alcoholic hepatitis, the prognosis is good. If an individual stops drinking, the conditions will improve and reverse within a couple of weeks.
Severe and chronic hepatitis can be life-threatening it is left untreated. It usually requires a stay in a hospital and medical care. But, with treatment and giving up alcohol, recovery is possible.
Preventing Alcoholic Liver Diseases
Liver damage is difficult and even impossible to treat depending on the severity. The best treatment is prevention, and the best way to avoid the damage is to drink moderately or not at all.
- Moderate drinking for men is no more than two drinks per day or 14 drinks per week.
- For women, moderate drinking is no more than one drink per day and no more than seven drinks per week.
- Pregnant women should not drink any alcohol at all during the entire pregnancy. There is no safe amount or safe time to consume alcohol
One drink is 12 ounces of beer that is about five percent alcohol, five ounces of wine, or 1.5 ounces of liquor. Controlling alcohol intake is crucial to good overall health. Alcoholic liver diseases are 100 percent preventable, so learning to moderate or stop drinking is important for overall health.
- Rocco A, Compare D, Angrisani D, Sanduzzi Zamparelli M, Nardone G. Alcoholic disease: liver and beyond. World J Gastroenterol. 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209531/
- Fuster D, Samet JH. Alcohol Use in Patients with Chronic Liver Disease. N Engl J Med. 2018 Sep 27;379(13):1251-1261. https://www.nejm.org/doi/full/10.1056/NEJMra1715733
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