Alcohol Consumption and Liver Disease
It is a well studied and established fact that excessive and prolonged consumption of alcohol leads to an increase of liver disease in humans. Liver disease as a result of alcohol consumption is quite common but also very preventable.
Some individual factors put certain groups of individuals at higher risk than others. For example, females are more likely to suffer liver disease as a result of alcohol intake than males.
The types of liver disease common with chronic alcohol consumption fall on a gradient. On one end is the less severe, easier reversible Alcoholic Fatty Liver Disease and on the other end we see the essentially irreversible, life altering Liver Cirrhosis.
Alcoholic Fatty Liver Disease (AFLD)
This is the first step that occurs for alcohol consuming individuals as their liver health and function begins to decline. The liver begins to accumulate and build up fat within its cells after many years of heavy drinking. As fat continues to build up within the liver, it becomes inflamed which continues to progress.
The reason that fat begins to accumulate in the liver with prolonged alcohol exposure is that the liver becomes less adept at breaking down and oxidizing fat. This change occurs as a result of the switching on of processes that store fat and switching off of processes that break down fat. In addition, certain elements that are involved in fat formation in the liver are upregulated. As a result of decreased fat breakdown and increased fat synthesis, we see stores build up in the liver.
There are few symptoms associated at this stage of liver damage but one may begin to notice fatigue or pain in the upper right portion of the abdomen, where the liver is. As the fat stored in the liver begins to increase and inflammation escalates, more symptoms begin to appear as the disease progresses.
The good news is, it is possible to reverse part or all of the liver damage that occurs in this state. Since the damage is still early on, cessation of alcohol consumption will prevent further fat accumulation and inflammation of the liver. There are many great resources for individuals looking to quit drinking. In addition to stopping alcohol consumption, there are certain lifestyle changes that can be made to help reverse any liver damage:
- Consuming a healthy, well-balanced diet.
- Acquiring vaccinations such as those for Hepatitis A and B.
- Exercising regularly to help lose weight and reduce the fat content of the liver.
Alcoholic Hepatitis
As the liver continues to accumulate damage and become further inflamed, the liver disease progresses and takes on a new name; Alcoholic Hepatitis. It occurs if the patient continues on in excessive, prolonged alcohol consumption. The inflammation of the liver eventually leads to the replacement of healthy liver cells with scar tissue further decreasing liver health and consequently, function.
This next step of hepatitis comes with more symptoms and may be more noticeable to the patient. Some of the symptoms that a patient may present with include the following:
- Yellowing of skin and whites of eyes (jaundice)
- Loss of appetite
- Nausea and vomiting
- Increased tenderness of upper right abdomen
Since the disease has significantly progressed by this point, there are also increased risks of various complications. Due to the liver’s increased stiffness, the portal vein carrying blood to the liver may not be able to function as well leading to bleeding within the abdomen. There is also the possibility of fluid accumulation in the abdomen. Since the liver can no longer metabolize toxins as well as a healthy liver can, individuals may see a build up of toxins in other organs and tissues such as the brain. If toxins build up in the brain, a patient may present with drowsiness and confusion. There is also potential for kidney damage as the damage of the liver becomes more pronounced.
At this point in the progression of liver health decline, it is unlikely that reversal of damage is possible. The focus now shifts to treatment of symptoms and prevention of further decline. The number one suggestion is to cease alcohol consumption immediately for prevention purposes. In more severe cases, physicians may prescribe anti-inflammatories to help mitigate the symptoms and decrease the inflammation of the liver.
Alcohol Related Cirrhosis
The final and most serious phase of liver damage associated with alcohol consumption is cirrhosis. This occurs when increased amounts of liver are replaced with scar tissue leading to severe functional impairment as well as a stiff, inflexible liver. At this point, the body can no longer compensate for the loss of function being experienced.
The symptoms of alcohol related cirrhosis are identical to those of alcoholic hepatitis with increasing frequency and severity. There is also the possibility of the patient developing itchiness of the skin as an additional symptom.
Since the disease has progressed so far, there is little that can be done for treatment and reversal is out of the question entirely. Once again, the most important thing to do is to immediately stop consuming alcohol. In addition, physicians have several treatments they may use to treat symptoms:
- Corticosteroids may be prescribed to help mitigate effects of inflammation on liver.
- Nutritional counselling may be suggested as malnutrition is likely.
- Extra protein intake suggested to help reduce risk of brain damage.
- Liver transplant may be suggested to prolong life as well as increase quality.
Liver cancer develops in 10-15% of patients who suffer from alcoholic cirrhosis.