According to data from the National Institute on Alcohol Abuse and Alcoholism, more than 86% of adults over 18 have reported drinking alcohol at some point in their lives, with 56% having consumed it in the past month. Each year, an estimated 88,000 people die from alcohol-related causes, making alcohol the third leading cause of preventable death in the United States, following tobacco poor diet, and inactivity. Of these alcohol-related deaths, over 36,000 are directly linked to liver disease, including alcoholic cirrhosis.
Alcoholic liver disease is marked by liver cell damage, inflammation, and eventual scarring, resulting from the body’s response to alcohol. When alcohol is metabolized in the liver, it produces highly toxic byproducts that contribute to these conditions.
These complications can lead to premature death if left untreated. However, understanding the effects of alcohol on the liver can improve the chances of recognizing the problem in yourself or a loved one, potentially reversing the detrimental effects of these diseases.
We often hear that alcohol harms the liver, but what exactly occurs in your body when you consume alcohol, and why does it specifically affect the liver?
Alcohol and Liver Damage
The liver is a vital and complex organ responsible for filtering toxins from the blood, aiding in digestion, regulating blood sugar and cholesterol levels, and supporting the immune system.
The liver is particularly vulnerable to alcohol-related damage because it is the primary site of alcohol metabolism. Although the liver has a remarkable ability to regenerate, this capacity diminishes with prolonged alcohol consumption. Long-term heavy drinking significantly contributes to liver damage. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), consuming 72 ounces of beer, 1 liter of wine, or 8 ounces of liquor daily for 20 years can significantly impact liver health, with women being affected at lower levels.
There are three main types of alcohol-related liver damage:
These stages of liver damage are generally considered to progress sequentially from fatty liver to alcoholic hepatitis, and eventually to cirrhosis. However, it is possible to bypass the hepatitis stage and move directly to cirrhosis.
The Liver’s Reaction to Alcohol
While the liver can handle and process moderate amounts of alcohol, excessive or prolonged drinking can lead to severe health issues.
Most of the alcohol consumed is metabolized in the liver, primarily through an enzyme called alcohol dehydrogenase (ADH). During this metabolic process, ADH oxidizes alcohol into byproducts that can be more harmful than alcohol itself. One such byproduct is acetaldehyde.
Acetaldehyde is a highly toxic compound, even in small quantities, and is known to be a carcinogen that can contribute to alcohol-related cancers. It can cause permanent scarring and damage to liver cells, as well as harm the brain and stomach lining.
Another significant factor in liver damage from alcohol is a group of metabolic byproducts known as free radicals. Free radicals are highly reactive molecules that typically contain oxygen. While they are produced naturally in the body and play a role in destroying disease-causing microorganisms, alcohol consumption can disrupt the body’s natural defense system, leading to increased liver damage. Free radicals can damage liver cells, cause inflammation, and impair essential functions such as energy production.
Inflammation is the body’s response to tissue damage, intended to prevent further injury and activate the immune system. However, chronic alcohol consumption can prolong this inflammatory response, leading to extensive liver damage due to the overproduction of free radicals.
The body also produces proteins called cytokines, which are released by immune cells in response to infection and cell damage. Alcohol consumption raises cytokine levels, which, while protective, also exacerbates inflammation. This creates a cycle of continuous cell damage and inflammation.
Over time, the ongoing inflammation and damage lead to scarring of the liver, known as liver fibrosis. This scarring eventually distorts the liver’s internal structure, a hallmark of cirrhosis. As scar tissue replaces healthy liver tissue, it disrupts the liver’s ability to function properly.
Symptoms of Alcohol-Related Liver Disease
Alcohol-related liver disease often goes unnoticed until the liver is significantly damaged. However, there are some general symptoms to watch for that may indicate the development of liver issues due to excessive alcohol consumption.
Possible symptoms include:
If you or someone you know frequently consumes alcohol in excess, it is important to consult a doctor to check for potential liver damage.
Factors Influencing Vulnerability to Alcohol-Induced Liver Disease
Several factors can affect an individual’s risk of developing alcohol-related liver disease, including genetics, diet, gender, and pre-existing conditions.
Genetics
Genetic factors play a significant role in determining one’s susceptibility to various health conditions, including alcohol-related liver disease. Genetic predispositions can influence how the body processes alcohol and its effects on the liver.
Diet
Dietary factors can impact liver health, especially in relation to alcohol consumption. For example, a ketogenic diet high in fat and low in carbohydrates has been shown to exacerbate liver damage in studies involving alcohol-fed rats. Additionally, a high intake of polyunsaturated fats from sources like nuts, olive oil, and fish may contribute to the development of cirrhosis.
Gender
Women are more susceptible to developing alcohol-related liver diseases than men, often after consuming lower amounts of alcohol over shorter periods. Studies have found that women are more likely to experience alcoholic hepatitis and have higher mortality rates from alcoholic cirrhosis compared to men. The underlying reasons for these differences are still under investigation.
Hepatitis C
The presence of Hepatitis C can increase susceptibility to alcohol-related liver disease and exacerbate the severity of cirrhosis. Managing liver disease in patients with both Hepatitis C and alcohol-related liver damage can be more complex and treatment may be less effective.
Treatment
Alcohol-related liver diseases typically progress through several stages, starting with fatty liver, which affects up to 90% of drinkers. Because symptoms of fatty liver are often subtle, individuals may continue drinking, potentially advancing to alcoholic hepatitis and, ultimately, alcoholic cirrhosis, the most severe form. In some cases, the disease may bypass the hepatitis stage or progress rapidly to cirrhosis.
The primary treatment for alcoholic liver disease is abstinence from alcohol. Abstaining can reverse fatty liver and alcoholic hepatitis, and significantly improve survival rates for those with cirrhosis. For individuals with end-stage liver disease, a liver transplant may be the only effective treatment option.
Statistics from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) show that the five-year survival rate for individuals with cirrhosis is 90%, though it drops to 60% for those with late-stage cirrhosis. Despite this decline, abstinence from alcohol continues to offer substantial benefits, even in the advanced stages of the disease.
During challenging times, such as the holiday season, it can be difficult to abstain from alcohol. To help manage temptations, consider strategies like having a non-alcoholic drink in hand to deter others from offering alcoholic beverages or creating an escape plan for social situations where you might feel pressured.
Prioritizing sobriety is crucial for reducing the risk of developing or managing alcohol-related liver diseases. As George F. Koob, director of the NIAAA, told Self.com, “The biggest benefit is learning where your body is in relation to alcohol and what you want your relationship with it to be.”
Depending on the severity of the condition, a doctor may prescribe anti-inflammatory medications to manage symptoms and slow disease progression. Preventive measures to reduce the risk of Hepatitis C—such as avoiding needle sharing, practicing safe sex, and being cautious with tattoos—can also improve outcomes for those with alcohol-related liver disease.
Future research is exploring the potential of nutritional supplements to protect against liver scarring and the development of medications to moderate the toxic effects of cytokines involved in inflammation. Maintaining an adequate intake of carbohydrates is currently recommended for treating alcoholic liver disease.
What’s Next?
If you suspect that a loved one is struggling with alcohol abuse, achieving abstinence can be challenging. At Sunrise Recovery, we specialize in drug and alcohol rehabilitation and offer a range of programs designed to support individuals on their journey to recovery. In addition to our comprehensive treatment programs, we provide motivational resources, such as alcohol recovery quotes, to inspire and encourage progress. With Sunrise Recovery’s alcohol rehab services, we are committed to helping you or your loved one return to a healthier, more fulfilling life.
