Alcohol and the Liver
Heavy drinking has been on the rise for years and as we enter the festive period it’s one of the most popular times of the year where people drink too much. A few too many to you, might just resonate with yourself as a niggling hangover that lasts a day or two, but as a Gastroenterologist and Hepatologist I can’t ignore the unwanted effects that drinking can have on the body and in particular the liver.
The Drinkaware guidelines suggest that the weekly recommendation is no more than 14 units and anything above this can be considered as a risk to health. Unfortunately many people aren’t actually aware of what they are drinking. This limit has been calculated based on the health risks that alcohol gives you, including liver disease, but also risks if various cancers.
There seems to be a general lack of awareness in the general population to recognise and accept the damage that alcohol can have on the liver, and health in general. However, the facts are that alcohol is essentially a poison, and so it comes as no surprise that it can have some pretty unwanted and damaging effects on our organs, particularly our liver.
The liver is the organ that metabolises alcohol that is consumed. As the liver is breaking down the alcohol it can lead to toxic metabolites which in turn can damage the liver. If you exceed the capability of your liver to metabolise alcohol safely, that is when problems can arise.
The first sign of damage is the accumulation of excess fat in the liver. This can then go on to cause inflammation, which in turn can lead to scarring. When the liver is completely taken over by scar tissue, Cirrhosis is said to be present, and Cirrhosis can be due to a variety of issues that damage the liver, not just alcohol. The whole of this process can take many years, during which time there may be no symptoms, although abnormalities may show up on blood tests or Ultrasound scans, being done for other reasons. The first sign of trouble can be when the scarring gets even worse and the liver’s capacity seriously declines. At that stage you can become jaundiced (yellow), swell up or start bleeding internally. These are very serious complications from which there may be no recovery.
Interestingly, different people can be more or less susceptible to liver injury e.g. women have a lower amount of a certain enzyme used to breakdown the alcohol in the liver, so damage may occur with less consumption. Other risk factors that play a role in the development of liver disease include obesity and family history. The livers of two people who drink exactly the amounts at the same frequency could react completely differently because of such factors. In addition, the carriage of viral Hepatitis (B or C), which can be undetected and asymptomatic for many years, will leave the liver more susceptible to the effects of alcohol.
We don’t want this blog to put you off your festivities, but being aware of what can happen is half the battle. The liver does have great powers of recovery and repair, if allowed to do so, and if no scarring has yet occurred. Just remember, long term damage may have no symptoms, and might not be reversible. If Cirrhosis is already present the forgotten effects of drinking suddenly become very real. If you are concerned about your drinking, talk to your GP, ask for simple liver tests (blood and Ultrasound scan), and if necessary seek help with trying to cut down or be completely abstinent.