When you drink large amounts of alcohol, even for just a few days, it can damage your liver. Fortunately, the liver is an incredible organ as it’s the only one that can regrow healthy liver cells and repair itself. This means if you seek help for your alcohol addiction you may find your liver damage is not long-lasting and can actually be reversed.
However, as liver damage is often symptomless, many people don’t realise the destruction their alcohol intake is causing until it’s too late. Here we explain what alcohol does to the liver, how to identify liver damage and how you can help it heal itself.
What Does the Liver Do?
The liver, which sits inside the ribcage, on the right side of the body, plays an essential part in helping the body to function properly.
Everything we eat and drink, and most of the medications we take, are absorbed into the blood, which then passes through the liver. The liver operates like a sorting centre, converting the nutrients we ingest into substances we need and breaking down the stuff we don’t need so our body can expel it.
The liver has many other roles including:
- Breaking down fats so we can use them for energy
- Removing toxins so we get rid of them in our urine and faeces
- Storing sugar, maintaining a constant level and turning it into glycogen when we need it
- Producing bile, which helps break down fats
- Producing most of the proteins in the blood
- Regulating blood clotting
- Fighting infection by removing bacteria in the bloodstream
The liver also helps with immunity and keeps our digestion system stable. Basically, it keeps everything inside working as it should be. We can’t maintain a healthy body without a healthy liver.
How Does Alcohol Affect the Liver?
The liver breaks down the fluids we drink, including alcohol. However, if it is faced with more booze than it can cope with, it can no longer do its function properly. Heavy drinking, especially for a prolonged amount of time, causes alcohol-related liver disease (ARLD) and this happens in the following three stages.
Fatty Liver Disease (Steatosis)
Alcohol is full of sugar, and excess alcohol in the liver means a build-up of sugar and fat. If the liver can’t break down the fat as efficiently as it should to keep the body healthy, it starts accumulating in the liver until the organ becomes enlarged and stops working properly.
Fatty liver disease is the earliest response to excessive alcohol consumption. However, symptoms do not often appear and by the time they do the damage to the liver can already be severe.
Symptoms of fatty liver disease include:
- Nausea and feeling sick
- Unexplained weight loss
- Lack of appetite
- Dark urine
The great news is this stage of liver disease can be completely reversed. The treatment is simple: stop drinking. To do this, it is best to seek professional help to manage alcohol withdrawal symptoms and see if medication can help you taper off your alcohol addiction.
Inflammation of the Liver (Alcoholic Hepatitis)
Around 40% of people with fatty liver disease, who continue to drink, will go on to develop alcoholic hepatitis. This means the liver is inflamed. Symptoms, if they are present, are similar to those of fatty liver disease. However, as alcoholic hepatitis is a more advanced stage of liver disease, it can be fatal in around 50% of cases.
Symptoms of alcoholic hepatitis include those above and:
- Swollen stomach and ankles
- Tenderness in the stomach and liver area
- Blood in vomit or faeces
- Feeling confused and disoriented
- Yellow eyes and skin (jaundice)
Again, the treatment of alcoholic hepatitis is to stop drinking for good. A liver transplant is an extreme remedy but people are asked to abstain from drinking for six months prior to transplantation and as most people with advanced alcoholic hepatitis will die in two months, a liver transplant is rarely achievable.
Scarring of the Liver (Cirrhosis)
Alcohol can alter chemicals in the liver that break down and remove scar tissue, which means heavy drinking can result in a build-up of scarring inside the liver. The scar tissue (also called fibrosis) replaces healthy liver cells and the reduction of healthy cells affects the organ’s functionality.
Around 10 to 20% of heavy drinkers will progress from alcoholic hepatitis to cirrhosis and women are more at risk than men, even if they drink less alcohol. This is because they have less body water than men and absorb more alcohol. Cirrhosis usually develops after around 10 years of sustained drinking.
That might sound like a lot but if you think about how you ‘caned it’ in your twenties, or laugh about how much of that decade felt ‘like a blur’ and then realise you’re still having regular after-work drinks or opening a bottle of wine with dinner, it’s probably time to change your drinking behaviour.
Cirrhosis is the most serious form of alcohol-related liver disease as severe scarring is irreversible. Half the people who develop cirrhosis from excessive alcohol consumption will die.
Although there are no ‘safe’ alcoholic drinks that will prevent you from developing liver disease, drinking spirits in particular is linked with a higher rate of death from cirrhosis.
Again, cirrhosis is often symptomless until liver damage is very advanced. Many people only seek treatment because of the effects ARLD is having on their body. They are then diagnosed with cirrhosis in hospital, or in the mortuary.
Symptoms of alcoholic cirrhosis include those above and:
- Generally feeling unwell
- Vomiting blood
- Itchy skin
- Muscle cramps
In the case of alcoholic cirrhosis, as in all alcohol-related liver diseases, the treatment is to stop drinking for good.
Medications can’t help your liver recover although you may be prescribed medication to deal with other conditions your liver disease has caused, such as dangerously swollen or bleeding veins in your food pipe (oesophagus).
If you persist on drinking, no treatment can save you. Medical professionals refer to the ‘law of thirds’. When it comes to alcohol-related liver disease, one third die because they did not stop drinking in time, one third die later from persistent alcohol consumption and one third survive. That means you have a greater chance of dying from alcohol use disorder than you do surviving.
Despite increased education, awareness and understanding of the damage alcohol can do, liver disease is a worsening problem. The number of people dying from liver disease has risen 400% since 1970, and three-quarters of those deaths are related to alcohol abuse. Liver disease is the biggest cause of death in people aged 35 to 90.
How Much Alcohol Can Cause Liver Damage?
Not very much! While heavy drinkers consuming six or seven drinks a day for 10 years can virtually guarantee a diagnosis of alcohol-related liver disease, just over two drinks a day on a regular basis puts you at risk of liver disease.
One alcoholic drink takes around an hour for the liver to process, and with each drink, that time gets longer. So if you’re drinking for hours every day, or even just regularly, the liver doesn’t have time to break down each drink and it becomes overwhelming.
It is sobering news (or it should be). Yet many people who have a couple of drinks with every evening meal would not think they were in danger of developing liver disease. They would be wrong.
And it’s not just quantity that matters. What you drink and when you drink can also have an effect. Drinking outside of mealtimes so the alcohol isn’t absorbed by food, and mixing drinks also increase the likelihood of developing ARLD.
If you don’t feel you can stop you need to seek professional help so you can be supported as you move from addiction to sobriety. Try and reduce your alcohol consumption. Aim for some alcohol-free days a week and drink water or soft drinks between each alcoholic beverage.
These small changes will make a big difference and can give you a better chance of avoiding the worst signs of alcohol-related liver disease.
What Are the Signs of Liver Damage From Alcohol?
Liver disease is a silent killer as it is often symptomless unless too late. It can be easily misdiagnosed as the symptoms you might experience (listed above) can be vague, such as fatigue, feeling generally unwell and having stomach cramps.
ARLD is often diagnosed while being tested for other conditions, which is why it is important to be honest to healthcare professionals about your alcohol consumption. That way, they can test for liver disease before looking for other illnesses and you can receive the right help quicker without going on a wild goose chase to decipher the problem.
Medics are not going to judge you for the amount you drink or your alcohol use disorder. They want to help you, but they can only do that with the right information at hand.
Being honest also means your alcoholic-related liver disease can be diagnosed before it progresses to other very dangerous illnesses, such as cancer of the liver, which is often detected in signs of chronic liver disease.
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Can the Liver Heal Itself After Years of Heavy Alcohol Use?
The great news is yes it can! The liver is unique in that it is the only internal organ that can heal itself by regrowing healthy cells to replace the cell damage caused by drinking.
Even after years of chronic alcohol abuse, the liver has a remarkable ability to recover a significant portion of its mass and function, which means it is never too late to seek help for your addiction.
What is even more incredible is this renewal doesn’t require an operation or medical intervention. All you need to do for the liver to heal itself is to stop drinking.
How Long Does it Take for the Liver to Repair Itself from Alcohol Abuse?
Don’t think you can punish your liver for years and it will bounce back brand new the minute you lay off the bottle.
However, people with a mild to moderate alcohol use disorder can see their liver cells start repairing within days or weeks. If you have fatty liver disease, which is the earliest stage of liver damage, stopping drinking just for two weeks can allow your liver to return to normal.
Think about Dry January. You may think it’s a bit of a gimmick but it has real health benefits. Those 31 days could be all you need to repair the damage of Christmas parties and seasonal excess.
If you have been drinking to excess for many years, you may have to wait months before damaged liver cells start to be replaced and the liver begins its repair. Whether this is resuming partial function or healing completely depends on multiple factors including how much you drink, for how long, whether you take drugs and your general health.
It is important that you don’t start drinking again as relapsing will interrupt the liver’s healing process and undo all your good work. This is why it is essential you receive help with your addiction. Your liver is giving you a second chance. Don’t miss it!
What are the Signs Your Liver is Healing?
Just as liver disease is often symptomless, the signs your liver is healing may only be evident internally and you may not see any physical differences. Additionally, when you stop drinking you may well experience alcohol withdrawal symptoms and these may mask the fact you’re getting better, as they can make you feel worse.
It is essential you seek professional help and treatment when you stop drinking to ensure your withdrawal symptoms can be managed properly and that you have the support to prevent you from relapsing.
Only medical tests can confirm that your liver is healing but rest assured if you start feeling better, more energetic, your weight returns to normal, abdominal swelling reduces, your urine and faeces look a healthy colour and your skin and eyes are no longer yellow, your liver is healing.
Although you might not realise it as the work is happening behind the scenes, when the liver is repairing itself it:
- Enables the blood to clot which prevents excessive bleeding
- Balances glucose levels so your sugars are level and constant
- Regulates amino acids which aids metabolism of nutrients in your body
- Removes bilirubin from your system which means you are no longer yellow
- Reduces the chance of infection by removing bacteria from your system
And that’s just the tip of the iceberg. The liver has around 500 functions in the body and a healthy liver means a healthy body and mind. Think about that next time you reach for a drink or do your liver a favour and don’t.
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