Alcohol is bad for your liver as much as it is bad for other organs like the brain, heart and even the stomach among other organs.
It is estimated that 8.5% of adults in US have alcohol use disorder. Similar numbers are seen in most countries.
Males as we know it drink more than females in most countries and therefore are more affected than females. The ratio is around 2:1.
There are three main ways in which alcohol damages your liver which will be mentioned here:
- Alcoholic fatty liver disease (also known as Hepatic steatosis)
- Alcoholic hepatitis and
- Liver Cirrhosis
Before diving straight to how alcohol causes the above mentioned diseases, let’s take a look important functions of the liver.
Functions of the liver
Your liver is made up of cell hexagon shaped cells called hepatocytes with some specialized cells in-between them which are responsible for production of bile.
Look at the diagram below to see different types of cells that make up the liver.
The liver is very rich in blood supply from the stomach and intestines. The blood travels from the stomach and intestines to the liver with nutrients and toxins for clean-up of toxins and storage of important nutrients before the blood can go to the rest of the body.
This brings us to the main functions of the liver:
1. Storage function
Your liver serves an important function in storage of glucose and many vitamins.
It stores excess glucose in the form of glycogen for later use when glucose in the blood gets low.
The liver is also stores Vitamin A, B12, D and vitamin E. All these vitamins are important for normal functioning of the body.
2. Production function
The liver is responsible for production of various proteins and immune cells. It produces proteins such as albumin for transport of hormones in the blood.
It also produce vitamin k and other clotting factors like factor fibrinogen protein C and S, factors V, VII, IX, X, XI and factor XII.
Your liver produces bile, an important digestive enzyme that helps in digestion of
3. Metabolism and Detoxifying Function
Most of the toxins that circulate in the blood are filtered out in the liver and some in the kidneys. Without the liver you would die within 3 days.
Drugs are also metabolised in the liver into active forms while the remaining metabolites are excreted in the bile as waste. Old red blood cells are destroyed by the liver together with Spleen.
What alcohol does to the Liver?
Alcohol is absorbed in the stomach and small intestines to the veins which go straight to the liver for initial filtering and cleaning up of toxins that may be ingested with food.
The liver detects alcohol as toxic and begins the breakdown process called catabolism.
The breakdown is done by the enzymes Alcohol Dehydrogenase (ADH), Cytochrome P-450 2E1 (CYP2E1) and Microsomal Enzyme Oxidation System (MEOS). Alcohol catabolism releases harmful reactive oxygen species, increasing oxidative stress and oxygen-free radicals.
Oxygen-free radicals are very harmful chemicals to the body including the liver.
Now, with chronic excessive use of alcohol these harmful by-products increase significantly and damage the liver.
There is also accumulation of fat in the hepatocytes (liver cells) throughout the liver because export of fat from the liver is decreased since hepatic fatty acid oxidation is negatively affected.
The whole process disturbs normal metabolism of fat resulting in hyperlipidaemia and central obesity.
When you continue to consume alcohol in large quantities, oxidative stress damage increases leading to liver tissue inflammation, death of hepatocytes and fibrosis.
Let’s look at each of the main liver diseases that result from excessive alcohol abuse.
Alcoholic Fatty Liver Disease
Alcoholic fatty liver disease is accumulation of excessive fat in the liver, of course due to alcohol abuse. It is sometimes called hepatic steatosis which mean the same thing.
The condition is the first to develop and is potentially reversible. Here the liver enlarges with no symptoms, so the person has smooth hepatomegaly.
It may progress to cirrhosis if you continue drinking.
What is Alcoholic Hepatitis?
Alcoholic hepatitis is a combination of hepatic steatosis and inflammation or damage of the liver tissue due to continued drinking.
It can rapidly progress to Liver cirrhosis, which is an irreversible liver disease if one does not stop drinking.
This condition is worse in people who have Obesity and those with Diabetes Mellitus.
Symptoms of alcoholic hepatitis are: fever, fatigue, nausea, right upper abdominal pain and jaundice (Yellowing of the eyes and skin). History of alcohol use and abnormal Liver function tests in the blood confirms the diagnosis.
Treatment start with stopping alcohol abuse, then the liver recovers on its own. The person is given medication only for symptoms and other drugs which are harmful to the liver are stopped.
Liver Cirrhosis
Liver cirrhosis is characterized by death of liver cell replaced with fibrous tissue. It is not curable and is the 14th leading cause of death worldwide.
The fibrous tissue causes increase in pressure within the veins that supply the liver called portal veins leading to portal hypertension (see below).
There are small nodules that develop on the liver causing it to shrink and become irregular. These nodules cannot function the way a normal liver function and the person will have a wide variety of symptoms.
Read the functions of the liver we mentioned earlier, now imagine when your body cannot perform those functions.
Portal hypertension causes accumulation of fluid in the abdomen called ascites. This is why people with alcohol induced liver disease have chronic ascites.
Alcohol is one of the chemicals that has very few health benefits compared to dangers. What people do not realize about alcohol is that it’s addictive and very difficult to quit once you start drinking regularly.
Share this article to raise awareness about dangers of alcohol and why it is important to stop drinking before you suffer from irreversible damages of the liver.
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