Alcohol Abuse and Its Effects on the Liver

Last Updated: August 7, 2019

Everyone knows that abusing alcohol is bad for our health. But how much is too much? And what exactly happens after heavy drinking? Learn why the liver is a crucial organ, how alcohol affects it and what can we do about it.

Why Is The Liver So Important?

The liver is one of our principal organs that works non-stop on hundreds of different tasks. Its main role is to break down food to convert it to nutrients and energy. Another important task is to clean the body of waste and protect us against infections.

Alcohol abuse increases the risk of harming the liver. When the liver is damaged, we often don’t realize it until it is in a critical state. Overall, over one-third of deaths due to liver diseases were alcohol-related.

How Alcohol Affects Liver

The liver is a sturdy organ and can manage occasional small amounts of alcohol. It will break it down to remove alcohol toxins from your body. But if you drink too much or too quickly, you are sabotaging its detoxifying work. Your liver has trouble to keep up with the toxins and gets injured in the process.

Dehydration. Liver cells need to water to function properly. Alcohol is a diuretic, which means that lots of water leave your body. Long-term alcohol effects on body, including the liver, are largely caused by dehydration, and organs work less efficiently.

Scarring. Alcohol promotes the formation of an enzyme (acetaldehyde) that destroys liver cells. They also harm neurons which results in brain damage and cells forming the stomach lining.

Too much alcohol in your systems strains your organs. As a result, the liver metabolizes it less efficiently. And that can lead to various liver diseases as one of the most severe harmful effects of alcohol.

What Is Scarring The Liver Cells?

We know about two main mechanisms that cause scarring and inflammation in the liver:

  • Gut toxins. When toxins from our gut bacteria get into our liver, they can harm the organ.
  • Oxidative stress. The chemical reaction needed in the process of breaking down alcohol molecules can damage liver cells.

What is alcoholic cirrhosis?

Alcoholic cirrhosis is an advanced liver disease caused by heavy drinking of alcohol for at least a decade. The healthy liver structure is replaced with scars, causing the cells of the liver to die. This condition is irreversible, and the symptoms are similar to those of alcoholic hepatitis.

What Are The Main Liver Diseases Caused by Alcohol Abuse?

There are a few primary alcohol-related liver diseases:

  • Alcoholic fatty liver disease.

Alcoholic shakes are not the worst outcomes of drinking too much. Regular heavy drinking until the emergence of signs of alcohol poisoning promotes at first building up of fat in liver cells. The swollen liver can sometimes make you feel fatigue and discomfort in the right abdomen areas. Tests can show elevated liver enzymes, but this stage is usually not dangerous. The fatty liver disease is often not severe nor dangerous. Especially because it is reversible.

If you reduce or stop your alcohol consumption, the liver will return to normal size. You can achieve that in as soon as two weeks of abstinence.

But it you continue drinking, the fatty liver can turn into a much more critical condition.
  • Alcoholic hepatitis (a viral disease).

The next stage after fat deposition is inflammation or mild scarring of liver cells – hepatitis. More than one-third of heavy drinkers develop it.

The mild stage is not yet dangerous. You usually need blood tests to show elevated enzymes to know about your condition. You still can reverse it by abstinence.

But chronic alcoholic hepatitis may be risky. It can occur suddenly and cause severe complications, such as liver failure or even death. Here are typical symptoms of chronical hepatitis:

  • Nausea, a general unwell feeling, and confusion
  • Pain in the liver
  • Yellowing of the skin and the eyes (jaundice)
  • Blood clotting issues and gut bleeding
  • Coma and not uncommonly death

At this point, only medical intervention can help. It involves a steroid treatment and feeding through a tube in the stomach.

  • Alcoholic cirrhosis.

The most advanced liver injury is when it comes to tissue disruption. Scars gradually replace the healthy liver structure (fibrosis), and liver cells die off. Symptoms are similar to those of alcoholic hepatitis.

Cirrhosis usually happens to 10-20 percent of heavy drinkers after at least a decade of alcohol abuse.

The bad news is that this condition is not reversible with abstinence or medication. However, stopping drinking can decrease the symptoms and prevent further progress of liver disintegration.

It is important to know, that every person can get to this stage differently. Some people never experience hepatitis. They may be ignorant of their fatty liver problem and suddenly develop cirrhosis.


Different complications can occur from alcohol-induced diseases. Some of them are very dangerous:

  • Fluids built up in the abdomen.
  • Bleeding in the stomach or esophagus can
  • The kidney can fail.
  • It can even lead to liver cancer.
  • Brain disorders can slowly develop.

These are only some examples of possible complications. Often other conditions occur, straining and damaging other organs. Sometimes this can even lead to a coma.

Note, that the stomach pain after drinking alcohol can also be a sign of gastritis.

Can We Treat Alcohol-Related Liver Diseases?

First, you will need to undergo a series of examination. The doctors need to know, if and how badly damaged your liver is.

Are alcohol-related liver diseases treatable?

Not all alcohol-related diseases are treatable. Conditions like alcoholic fatty liver disease and alcoholic hepatitis can be treated with medications and abstinence from alcohol. However, a disease like liver cirrhosis cannot be cured at all. It can only be managed to reduce the discomfort of the sufferer.

How Is An Alcohol-Induced Liver Disease Diagnosed?

  • Examination. During a regular physical check-up, the doctor can recognize a liver disease from your symptoms.
  • An ultrasound of your liver can show the physician if your liver is enlarged or damaged.
  • Blood tests are useful to show abnormal liver function and rule out other diseases.
  • Liver biopsy is often required to confirm the diagnosis. It consists of removing a small piece of the tissue to be studied in a laboratory. The scarred tissue is visible under a microscope.

Is There a Treatment for Liver Diseases?

It all depends on the stage and the type of liver injury. There are some general outlines for any situation:

  • Abstinence is strictly recommended for all kinds of liver issues.
  • A healthy diet is required to put your liver at ease. You might need to work with a dietician to modify your diet. Heavy drinkers often neglect proper eating. They often lack several vital nutrients and can benefit from supplements.
  • Medication is not ideal because it is an additional strain on the liver. But if complications occur, it can be crucial to deal with other health problems medically.
  • A liver transplant can be necessary for some people with a barely functional organ.

Depending on your starting condition, you can expect the following:

If you have a fatty liver or mild alcoholic hepatitis, there is good news. You should fully recover in a couple of weeks, under the condition that you stop drinking.

Severe hepatitis can be life-threatening if it is left untreated. It requires a stay in a hospital and medical care. If you stop drinking, you should get back to a functioning life.

Cirrhosis is the most challenging condition. There is no treatment for cirrhosis, only the option to stop the degeneration of the liver. If it is diagnosed early, you have the opportunity to stop further damage. But in severe cases of cirrhosis with extensive scarring, the liver is not functioning well enough. In this case, your only option could be a liver transplant.

Is alcoholic hepatitis reversible?

Alcoholic hepatitis in its mild stages can be reversed through abstinence from alcohol. However, in the case of chronic alcoholic hepatitis, medical intervention is needed because of its severity. If this condition is not treated promptly, it can cause liver failure or even death.

How Can I Prevent Alcoholic Liver Diseases?

The best way to avoid liver damage is to drink moderately.

  • Men can drink up to 21 alcohol units per week, but no more than four a day. They also should include at least two alcohol-free days per week.
  • Women should have no more than 14 alcohol units per week, but maximum of three units per day. They also should have two days per week without drinking at all.
  • Pregnant women could have one or two units of alcohol per week. But some doctors recommend dropping alcohol altogether during the first trimester for the sake of the fetus. After that, the baby can handle the mother consuming one or two units of alcohol per week.

As a reminder: one unit of alcohol is 8 g or 1 Cl (10 ml) of pure alcohol. Keep track of your drinking and try to spread it out. Healthy nutrition is very liver-friendly as well. In addition to supporting your liver, it helps to slow down alcohol absorption.

Alcohol dependence treatment can help to reverse some of the negative effects of ethanol on the liver. Sober living homes are also useful in relapse prevention. Contact the representatives of any alcohol treatment centers for additional information.

If you have any difficulty with controlling your alcohol intake, don’t leave it at that.
Get help, seek professional assistance or advice.


Marixie Ann Manarang-Obsioma

Content Writer

Marixie Ann Manarang-Obsioma is a licensed Medical Technologist (Medical Laboratory Science) and an undergraduate of Doctor of Medicine (MD). She took her Bachelor’s Degree in Medical Technology at Angeles University Foundation and graduated with flying colors.

The combination of having a good medical background, being a mom, and wanting to help people, especially the elderly has cultivated her passion for working in remote areas with love and compassion.
Marixie likes to travel, read, and watch movies.

Medical review by Brian Obodeze

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