Alcohol is one of the most popular recreational substances in the United States. An annual survey of adults over age 18 found that 85.6% have drunk alcohol at some point in their lives. Because of alcohol’s widespread use and acceptance in American culture, many Americans develop alcohol-related disorders. About 25% of adults binge drink, and over 14 million have alcohol use disorders.
People with severe alcohol use disorders are at risk of liver disease. Alcoholic hepatitis is a liver disease caused by alcohol consumption. As the disease progresses, it can cause severe liver damage, which is called alcohol cirrhosis.
The liver disease associated with alcoholism is often the beginning of the alcoholism’s end stage. Alcoholism must be recognized and addressed before cirrhosis develops as a result of alcoholic liver disease.
Learn more here about what alcohol-related liver disease is, its stages, and how it is treated.
The Risk Factors of Alcoholic Liver Disease
A chronic alcohol use disorder is one of the most significant risk factors for alcoholic liver disease. Drinking 3.5 ounces of alcohol every day (seven beers) for 20 years is typical for people with alcoholic hepatitis, according to Mayo Clinic. You must take into account other variables, including your size and health condition.
It is possible to damage your liver over a long period if you drink heavily. It is the liver’s job to clean your blood by removing potential toxins. When you drink, your liver filters out alcohol before the organ becomes overwhelmed, and it can reach your brain through the bloodstream. If you drink moderately, your liver usually manages to process it effectively. But if you drink frequently or binge, your liver may not be able to handle it.
Harmful, toxic chemicals are released during the breakdown of alcohol in the liver. The effects of small amounts of alcohol are relatively harmless, but binge drinking over a prolonged period can be extremely damaging. Cells in the liver can be destroyed as a result of inflammation caused by toxic chemicals. Over time, scars appear on the liver. It is possible for these scars to impair liver function. The irreversible final stage of liver disease is cirrhosis, which is widespread scarring of the liver.
Medical conditions can influence the development of alcoholic cirrhosis. The effects of moderate drinking on your liver can be severe if you have hepatitis C. Since the disease affects your liver, you may not be able to process alcohol effectively. Damage to the liver can result from malnutrition and medical and psychological complications. Plus, it’s common for alcohol-dependent people to suffer from malnutrition.
Your sex is another risk factor. Alcoholic liver disease is more common in women. Overweight and obese individuals may also be at greater risk. Your likelihood of falling into alcoholism and liver problems can also be affected by genetic factors.
Signs and Symptoms of Liver Disease
Several uncomfortable symptoms can accompany alcohol liver disease as it progresses. A yellowing of the skin and eyes is a telltale sign that something is wrong with your liver. This yellowing is called jaundice, which is caused by a substance called bilirubin. This substance is the same compound that makes urine and bruises yellow.
For digestion, bilirubin is converted into something called bile by the liver. This compound is released into the bloodstream when the liver is damaged to the point that it cannot process it, causing skin and eye yellowing.
Jaundice is often caused by a liver problem because it indicates that at least one of the liver’s important functions isn’t working properly. Bilirubin is more readily absorbed through the whites of the eyes, so yellowing often starts there.
There may be other less obvious signs of liver disease in addition to jaundice, such as:
- Nausea and vomiting
- Abdominal pain
- Loss of appetite
- Easy bruising
- Dark urine
- Pale stool
- Low-grade fever
The kidneys may also be affected by severe alcohol hepatitis. The organs may struggle to function normally, causing you to have trouble urinating, and you may experience a distended stomach due to fluid accumulation.
Your legs and ankles may also swell. Your cognition may also be affected by toxins building up in your body. Changes in behavior and confusion can result from this.
What Are the Stages of Alcoholic Liver Disease?
When an alcohol use disorder persists for a few years, alcohol liver disease may develop. Damage and impairment of the liver determine each stage of the disease. Here are brief descriptions of each of the stages of alcohol-related liver disease:
In the early stages of alcoholic liver disease, fat builds up in the liver. Consistent alcohol abuse leads to an excessive accumulation of fat in the liver. By accumulating fat in the liver, it becomes difficult for the organ to function normally. In the early stages of an alcohol use disorder, it may not manifest any obvious symptoms. Fat builds up for a few years of an alcohol use problem before advancing to the next stage of alcoholic liver disease.
Alcohol hepatitis can develop from excessive fat in the liver. The process of hepatitis begins with fat in the liver and then progresses to an inflammation that damages liver cells. As a result, liver function will be further inhibited. When you stop drinking, your liver function may improve, but if you continue drinking, your liver function may get worse.
A potentially serious condition caused by alcohol misuse, alcoholic hepatitis is unrelated to infectious hepatitis. This can be the first time someone realizes they’re damaging their liver through alcohol misuse. Binge drinking (drinking large amounts of alcohol in a short time) is less likely to cause alcoholic hepatitis. When you stop drinking permanently, mild alcoholic hepatitis can usually be reversed.
Nonetheless, severe alcoholic hepatitis poses a serious and potentially deadly threat. The condition kills thousands of Americans each year, and some people don’t discover they have liver damage until their condition has reached this stage.
Alcoholic liver disease reaches its final stage when cirrhosis develops. Liver function can be shut down as a result of extensive liver scarring. It is possible that no symptoms are present at this stage. However, you may experience some signs of liver failure.
The damage is generally irreversible, but stopping drinking alcohol immediately can significantly increase your lifespan. A liver transplant is the only treatment for cirrhosis, which is otherwise irreversible. However, you will not be a candidate for a liver transplant unless you stop drinking alcohol.
What Causes Alcoholic Liver Disease?
Alcoholic liver disease is a liver condition that results from excessive alcohol consumption. You are more likely to develop alcohol-related liver disease if you drink more than the recommended amount. Alcohol-related liver disease can be caused by two types of alcohol misuse.
The first is binge drinking or drinking excessive amounts of alcohol in a short period. Fatty liver disease may result from a relatively short but consistent period of severe binge drinking. It’s possible but less common for binge drinking to cause hepatitis.
The second is a long period of frequent alcohol misuse. Drinking too much alcohol over a long period can lead to hepatitis and cirrhosis, which are more serious types of liver disease caused by alcohol.
Drinkers who regularly exceed the recommended amounts of alcohol consumption are most at risk of developing alcoholic liver disease.
Drinking more than one standard drink in an hour is enough to start feeling the effects of alcohol. According to the Centers for Disease Control and Prevention (CDC), blood alcohol concentrations (BAC) above 0.08% are considered binge drinking. For men, this pattern of drinking corresponds to five or more drinks within two hours, while for women, this pattern corresponds to four or more drinks within two hours.
Additional Risk Factors
While the main risk factor for alcoholic liver disease is excessive drinking, there are other contributing factors. Aside from excessive alcohol consumption, other factors can increase your risk of developing alcoholic liver disease.
Other factors include:
- Obesity or being overweight
- The harmful effects of alcohol appear to be more prevalent among women than men
- Hepatitis C or other pre-existing liver diseases
- Taking other drugs
Alcohol use disorder, and other forms of addiction, have significant genetic risk factors. If you have a parent or grandparent with the disorder, you may be more likely to struggle with substance use problems. Genetic factors don’t guarantee that you will develop an addiction, but they can make it more likely. An increased risk of alcoholism means that genetics play a role in alcohol-related medical complications like liver disease.
Mixing alcohol with other drugs can also put more strain on your liver. There are many prescription drugs that should not be mixed with alcohol because the combination can potentially damage your liver.
Alcohol and illicit substances can also be damaging to your liver. For instance, when alcohol is mixed with cocaine, it creates a harmful chemical byproduct called cocaethylene. This chemical is toxic, and it can damage body tissue. Cocaethylene forms in your liver and can cause significant damage, even when you only mix cocaine and alcohol in excess once.
What Are the Complications of Alcoholic Liver Disease?
The liver is a vital organ, so enough liver damage can be fatal on its own. However, it can also cause other complications that can also be dangerous. If you have alcohol-related liver disease, you can develop a number of serious complications.
As a consequence of cirrhosis or alcoholic hepatitis, portal hypertension is a common complication. In this condition, your liver suffers from a potentially serious increase in blood pressure. In severely scarred livers, blood cannot flow through them easily. The blood pressure around the intestines increases as a result.
It is also necessary for the blood to find a new route back to your heart. In order to accomplish this, it uses smaller blood vessels. However, because these vessels cannot carry that much blood, they can become stretched and weakened over time. Varices are weakened blood vessels.
Varices can split and bleed when blood pressure reaches a certain level, which is too high for the varices to handle. Anemia can result from long-term bleeding, which is a condition that occurs when there aren’t enough healthy red blood cells carrying oxygen through your body.
It is also possible for the bleeding to be sudden and extensive, resulting in vomiting blood and passing bloody stools. It is possible to treat split varices with an endoscope that can locate them. The base of the varicose veins can then be sealed with a tiny band.
There may also be a buildup of fluid around the intestines and abdomen in a person with portal hypertension. Ascites is the term used to describe this fluid. Water tablets (diuretics) can be used initially to treat this. It may be necessary to drain many liters of fluid if the problem progresses.
An anesthetic is administered prior to inserting the long, thin tube into the fluid. This procedure is known as paracentesis. Ascites can lead to an infection called spontaneous bacterial peritonitis, which is one of the problems associated with the development of ascites.
The risk of kidney failure and death is increased with this potential complication.
The liver removes toxins from the blood, which is one of its most important functions. Toxins in the blood increase if the liver cannot do this because of hepatitis or cirrhosis.
Hepatic encephalopathy is characterized by high levels of toxins in the blood caused by liver damage. There are several symptoms of hepatic encephalopathy, including:
- Muscle stiffness
- Muscle tremors
- Difficulty speaking
- Coma (in serious cases)
A patient with hepatic encephalopathy may need to go to the hospital. Hospitals use medicine to remove blood toxins from the body.
Liver damage can weaken the immune system. As a result, the body is more susceptible to infection, particularly respiratory infections (such as pneumonia) and urinary tract infections.
It is also possible to develop liver cancer when you have suffered liver damage due to heavy drinking over a period of many years.
In the U.S., liver cancer rates have increased sharply over the past few decades because of alcohol misuse. According to the CDC, around 25,000 men and 11,000 women get liver cancer each year.
How Is Liver Disease Treated?
Preventing alcohol hepatitis is the best option. The progression of liver scarring can be slowed or stopped by moderation or abstinence from alcohol. You should avoid alcohol altogether if you have other health conditions such as hepatitis C or malnutrition issues.
Treatment will begin with addressing your alcoholism if you have a liver problem alcohol abuse caused. For severe alcohol use disorders to be effectively treated, medical assistance is often required.
When someone has been using alcohol chronically for a long time, they may experience withdrawal symptoms, such as tremors, seizures, and a life-threatening condition called delirium tremens (DTs). A doctor and medications may help you get through alcohol withdrawal safely through medical detox and tapering.
The condition of liver cirrhosis cannot be reversed in many cases. The disease can, however, be slowed down with treatment. Medications such as insulin, antioxidant supplements, and SAMe (S-adenosyl-L-methionine) may be used to treat the condition. There is a possibility that you will need a liver transplant if your liver damage is extensive.
Alcohol hepatitis should be treated immediately, as alcoholism could prevent you from being eligible for a liver transplant. You must be abstinent from alcohol for at least six months before you can be considered for a liver transplant.