Long-Term Effects of Alcohol on the Liver

Alcohol is one of the most widely used substances in the world, and while it can be used safely, long-term alcohol consumption can lead to severe health consequences, especially on the liver. The liver is one of the organs most impacted by excessive drinking. The liver is responsible for many important functions, including filtering toxins from the blood and producing bile to help digest food. When the liver is overworked due to heavy drinking, its ability to metabolize alcohol and eliminate toxins from the body is compromised. Over time, this can lead to liver failure and even death. The liver is a resilient organ and can often recover from certain alcohol-induced damage. However, it’s important to take care of it.

How Does the Liver Metabolize Alcohol?

The liver is responsible for alcohol metabolism within the body. Alcohol dehydrogenase (ADH) is an enzyme in liver cells that breaks down alcohol. ADH converts alcohol into acetaldehyde, a very toxic carcinogen. Acetaldehyde is eventually metabolized further to produce acetate, a less active byproduct that is easily eliminated as water and carbon dioxide. One standard drink of alcohol takes the body around an hour to metabolize.

How Alcohol Affects the Liver?

Excessive alcohol consumption can lead to various liver diseases, including alcoholic cirrhosis, alcoholic hepatitis, fatty liver disease (steatosis), and even liver cancer.

Long-term alcohol use promotes fatty liver accumulation, leading to alcoholic hepatitis. This condition arises when fat accumulates within the organ’s cells, resulting in inflammation and swelling that causes pain or tenderness in the abdomen or right upper chest wall. In some cases, this condition can lead to cirrhosis, which results from scarring caused by fibrosis after repeated episodes of alcoholic hepatitis, resulting in irreparable damage where new healthy tissue cannot replace scar tissue, resulting in end-stage liver failure requiring a liver transplant for survival.

Additionally, prolonged heavy drinking increases the risk of developing certain types of cancer, such as hepatocellular carcinoma (HCC). HCC occurs due to a combination of factors, including genetic susceptibility, gender variations, and viral infections (hepatitis B and C), but is mainly caused by chronic alcohol abuse. Fibrolamellar carcinoma is another type of cancer associated with chronic alcohol abuse.

Long-term alcohol abuse also impairs the absorption of essential vitamins, such as thiamine (B1), which is essential for maintaining proper neurological function, especially peripheral nerve system muscle coordination, leading to Wernicke-Korsakoff Syndrome. This condition is marked by disorientation, memory loss, double vision, motor skill impairment, and possibly paralysis.

Symptoms of Alcohol-Related Liver Disease

Symptoms of alcohol-related liver disease (ARLD) typically do not manifest until the liver has been severely damaged. When this occurs, possible symptoms include the following:

• Feeling unwell
• Fatigue
• Weight loss
• Itching
• Dark urine
• Nausea and vomiting
• Loss of appetite
• Jaundice
• Muscle cramps
• Swelling in the ankles and stomach
• Confusion or drowsiness
• Vomiting blood
• Passing blood in your stools

Alcohol-related liver disease can result in severe complications such as cirrhosis, hepatocellular carcinoma (liver cancer), and death if left untreated. Therefore, it’s critical to understand the dangers of alcohol abuse and to take measures to safeguard one’s health and safety.

Stages of Alcohol-Related Liver Disease

Although there is some overlap between the stages, ARLD can be divided into three stages.

First stage – Alcoholic fatty liver or fatty liver disease is the initial stage of ARLD. It’s caused by fat accumulation in the liver. Fatty liver disease is seldom accompanied by symptoms, yet it’s an important warning sign of excessive alcohol consumption. Fatty liver disease can be treated.

Second stage – Alcoholic hepatitis is the second stage of ARLD. The liver damage associated with mild alcoholic hepatitis is typically reversible if the individual permanently abstains from drinking. However, severe alcoholic hepatitis is a life-threatening condition.

Third stage – Alcoholic cirrhosis is the final stage of ARLD. At this point, the liver has been considerably scarred. Immediate abstinence from alcohol can avoid further damage and considerably enhance your life expectancy, even though the condition is often irreversible. Individuals with cirrhosis also have an increased risk of developing liver cancer.

According to the Centers for Disease Control and Prevention (CDC), deaths from alcoholic liver disease increased by 23% in 2020, from 6.4 in 2019 to 7.9 in 2020.

Life-threatening complications of ARLD include:

• Internal (variceal) bleeding
• The build-up of toxins in the brain (encephalopathy)
• Fluid retention in the abdomen (ascites)
• Liver cancer
• Increased risk of infection

Who Is Most at Risk of Developing Alcoholic Liver Disease?

Multiple risk factors, including metabolic, genetic, environmental, and immunological, contribute to alcoholic liver disease. Amounts of alcohol and duration of alcohol consumption are, however, the greatest risk factors for developing liver disease.

Other risk factors include:

• Obesity
• Pre-existing liver condition (such as hepatitis C)
• Females are more vulnerable than males
• Family history of alcohol dependency

The risk of liver disease increases as individuals consume 38-63 milliliters of ethyl alcohol daily over five years.

How Long Does the Liver Take To Recover From Alcohol?

The length of time required for the liver to recover from heavy alcohol use varies based on the severity of the liver damage. In a matter of weeks, fatty liver disease can be corrected if alcohol intake is discontinued. If more serious liver damage has occurred, such as alcoholic hepatitis or cirrhosis, it may take months or even years for the liver to recover. 

Prevention of Alcoholic Liver Disease

One of the best strategies to protect liver health is to practice moderate drinking or abstain from alcohol completely. According to the dietary guidelines provided by the CDC, moderate drinking is defined as having two drinks or less per day for men and one drink or less per day for women. However, even if you consume alcohol in moderation, potential long-term adverse effects of alcohol on your liver can be unavoidable.

In addition, you must eat nutritious foods and drink appropriate amounts of water. Consuming a lot of water will assist in flushing toxins from the body, particularly those produced by alcohol. Eating well-balanced meals will supply your body with the nutrients it requires to be healthy. Last but not least, make sure to visit your healthcare provider on a regular basis. They can help monitor your liver condition and ensure there are no signs of damage.

Treatment and Management of Alcoholic Liver Disease

Abstinence and lifestyle modifications are common treatments for alcohol-induced liver disease. Abstinence is the most crucial treatment step for ARLD. If a person is unable or unwilling to do so, they may require professional assistance, such as treatment for alcohol use disorder. Treatment programs can provide guidance and support to help individuals make the necessary lifestyle adjustments, manage withdrawal symptoms, and treat alcohol use disorder. Additionally, pharmaceuticals may be administered to control inflammation and prevent further liver damage. In order to enhance liver health, individuals with ARLD should also consume a nutritious diet and engage in regular exercise.

To prevent future health complications, particularly those connected to your liver health, it’s important to avoid excessive drinking. It’s crucial to understand the negative effects of alcohol on your liver so that you can live a longer, healthier life, as repercussions can become severe or permanent with time, and diagnoses can arrive too late.

If you’re concerned about your alcohol consumption or are struggling with alcohol addiction, Futures Recovery Healthcare is here for you. We provide a comprehensive detox and residential program for substance abuse and co-occurring conditions, as well as a residential program for primary mental health needs, the Orenda concierge program, the Rise experiential program, and intensive outpatient and outpatient services. At Futures, we promote personalized solutions to address the complexities of behavioral healthcare challenges to empower recovery for patients and families.