The liver breaks down alcohol so it can be eliminated from your body. Some of the by-products of this process are toxic chemicals that, in high concentrations, can damage the liver. In addition, if you consume more alcohol than the liver can process in a given amount of time, the resulting imbalance can injure the liver by interfering with its normal breakdown of protein, fats and carbohydrates
WHAT ARE THE TYPES OF ALCOHOL-INDUCED LIVER DISEASE?
There are three kinds of liver disease related to alcohol consumption:
Fatty liver is the earliest stage of alcohol-induced liver disease. It is marked by a buildup of fat cells in the liver. Usually there are no symptoms, although the liver may be enlarged and you may experience discomfort in your upper abdomen. Fatty liver occurs fairly soon in almost all people who drink heavily. The condition will usually go away after you stop drinking.
Alcoholic hepatitis is an inflammation of the liver. Up to 35 percent of heavy drinkers develop alcoholic hepatitis, which can be mild or severe. Symptoms may include loss of appetite, nausea, vomiting, abdominal pain and tenderness, fever and jaundice. In its mild form, alcoholic hepatitis can last for years and will cause progressive liver damage, although the damage may be reversible if you stop drinking. In its severe form, the disease may occur suddenly, after binge drinking, and it can lead quickly to life-threatening complications. For most people, moderate drinking will not lead to alcohol-induced liver disease.
Alcoholic cirrhosis is the most serious type of alcohol-induced liver disease. Cirrhosis refers to the replacement of normal liver tissue with nonliving scar tissue. Between 10 and 20 percent of heavy drinkers develop cirrhosis, usually after 10 or more years of drinking. Symptoms of cirrhosis are similar to those of alcoholic hepatitis. The damage from cirrhosis is not reversible, and it is a life-threatening disease. However, if you have alcoholic cirrhosis your condition may stabilize if you stop drinking.
Many heavy drinkers will progress from fatty liver to alcoholic hepatitis and finally to alcoholic cirrhosis over time. However, some alcoholics may have two or all three of the diseases at the same time, and others may develop cirrhosis without first developing alcoholic hepatitis or may never have symptoms from alcoholic hepatitis. The risk of developing cirrhosis is particularly high for people who drink heavily and have another chronic liver disease such as viral hepatitis C.
WHAT ARE THE COMPLICATIONS OF ALCOHOL-INDUCED LIVER DISEASE?
Serious complications from alcohol-induced liver disease typically occur after many years of heavy drinking. Once they do occur, the complications can be serious and life-threatening. They may include:
Accumulation of fluid in the abdomen
Bleeding from veins in the esophagus
Enlarged spleen
High blood pressure in the liver
Brain disorders and coma
Kidney failure
Liver cancer
HOW IS ALCOHOL-INDUCED LIVER DISEASE DIAGNOSED?
Alcohol-induced liver disease may be suspected based on other medical and lifestyle issues related to alcohol abuse. Blood tests may help in diagnosis and to rule out other causes of liver disease. Proof is established best by a liver biopsy. This involves taking a tiny sample of liver tissue with a needle and examining it under a microscope. The biopsy is usually done under local anesthesia.
IS THERE A SAFE LEVEL OF DRINKING?
For most people, moderate drinking will not lead to alcohol-induced liver disease. Moderate drinking means no more than one drink a day for women and two drinks a day for men. (A standard drink is one 12-ounce beer, one 5-ounce glass of wine or one 1.5-ounce shot of distilled spirits). However, for people with chronic liver disease, even small amounts of alcohol can make the liver disease worse. Patients with alcohol-induced liver disease and those with cirrhosis from any cause should stop alcohol completely.
ARE THERE OTHER RISKS TO THE LIVER FROM ALCOHOL USE?
The combination of alcohol and acetaminophen, the active ingredient in many over-the-counter pain relievers, can be very harmful to the liver when either is consumed in large amounts. This is especially true for people who are heavy drinkers.
For people with chronic liver disease, even small amounts of alcohol can make the liver disease worse. Patients with alcohol-induced liver disease and those with cirrhosis from any cause should stop alcohol completely.
HOW IS ALCOHOL-INDUCED LIVER DISEASE TREATED?
First, you must stop drinking. This may require participating in an alcohol recovery program. Your doctor may suggest changes in your diet and certain vitamin supplements to help your liver recover from the alcohol-related damage. Medications may be needed to manage the complications caused by your liver damage. In advanced cases of alcoholic cirrhosis, the only treatment option may be a liver transplant. However, active alcoholics will not usually qualify as suitable organ recipients.
WHAT IS THE OUTLOOK FOR PEOPLE WITH ALCOHOL-INDUCED LIVER DISEASE?
Anyone with alcohol-induced liver disease will improve their health and life expectancy if they stop drinking. People with fatty liver may be able to use alcohol moderately after their liver recovers; people with alcoholic hepatitis or alcoholic cirrhosis should stop drinking completely. For patients who do not stop drinking the outlook is poor: They are likely to suffer a variety of life-threatening health problems caused by alcohol-related liver damage.
WHAT KIND OF SUPPORT IS AVAILABLE FOR PEOPLE WITH ALCOHOL-INDUCED LIVER DISEASE?
The best resource is likely to be an alcoholic support group, because you must stay sober to recover from your liver disease.
