What are 3 ways alcohol can cause liver damage?

There is a rapidly growing international health concern, which is none other than excessive alcohol use. Due to its fundamental function in the metabolism of ethanol, the liver suffers the most tissue damage from heavy drinking. 

Did you know that the liver is the body’s most complicated organ, after the brain? And its functions are crucial for our body to stay healthy.

The liver is incredibly strong and self-regenerating. But every time a few cells die when your liver filters alcohol. The liver can repair new cells, but years of heavy hits drinking can limit this capacity. This may cause your liver to suffer severe, irreversible damage. This is why alcohol slowly destroys the liver when you don’t stop drinking. So to know more about it, let’s discuss here three ways alcohol can cause damage to your liver.

Fat Accumulation in the Liver:

Your liver’s function is to filter all the toxins from the blood, promoting healthy food digestion, controlling cholesterol and blood sugar, and assisting in the body’s defense against illness and infection. However, an accumulation of fat in the liver can occur from heavy alcohol consumption, even when you haven’t consumed it for a long time. This initial stage is known as alcoholic fatty liver disease, which is common in people who consume alcohol regularly.

Although there are rarely any symptoms of fatty liver disease, it’s a crucial indicator that you may be drinking too much.

For early stage alcoholic fatty liver disease, stopping drinking can help improve and potentially reverse the liver damage. However, it usually takes longer than just a few weeks for the liver to fully recover.

• One study found that alcoholic fatty liver began improving after 2 weeks of no alcohol use, but complete reversal back to normal took between 4-12 weeks on average (Alcohol and Alcoholism, 2019, DOI: 10.1093/alcalc/agz068)
• Another analysis found that mild fatty liver disease took about 4 weeks to reverse after ceasing drinking, while more severe cases took up to 5 months for the liver to heal and regenerate new, healthy cells (Journal of Clinical and Translational Hepatology, 2017, DOI: 10.14218/JCTH.2016.00062)

So while stopping drinking is critical for allowing liver healing, it realistically takes 4 weeks to several months before liver function can be considered back to normal depending on the severity of damage. And patients with advanced liver disease like fibrosis or cirrhosis often cannot be fully reversed back to normal even with alcohol abstinence.

Oxidative Stress and Inflammation:

The breakdown of alcohol is done primarily by the liver. In this process, enzymes break it down into byproducts, which get eliminated from the body. But do you think it’s that simple? Well, no, as this whole process can’t be successful without collateral damage. When the alcohol breakdown is in progress, it generates free radicals as well as unstable molecules, which induce oxidative stress. And all of this problem will not stop here when oxidative stress is coupled with the direct toxic effects of alcohol that develop inflammatory responses in the liver.

So if you are consuming alcohol whenever you wish, think twice. If needed, then please talk to your family and friends, or maybe a professional. You can also consult the alcohol addiction hotline, which is a 24/7 support rehab, to get help if you want to get rid of alcohol addiction. Whatever you do, this will be the best decision for your liver and body. There are diseases like hepatitis,  which is an acute inflammation of the liver linked to alcohol consumption. Liver cell damage and death are irreversible health conditions resulting from frequent alcohol consumption.

• Alcohol is mainly broken down (metabolized) by enzymes in the liver including alcohol dehydrogenase, aldehyde dehydrogenase, cytochrome P450 system (Journal of Biological Chemistry, 2021, PMID: 33417025).
• These enzymes break alcohol down into intermediate products like acetaldehyde and reactive oxygen species (ROS). Acetaldehyde and ROS are damaging compounds also called “byproducts” (Alcohol Research: Current Reviews, 2021, DOI: 10.35946/arcr.v40.1.01).
• The generation of these byproducts leads to oxidative stress, inflammation, and direct liver cell toxicity – together these processes damage liver tissue, particularly with heavy or long-term drinking (Oxidative Medicine and Cellular Longevity, 2016, PMID: 26788248).
• There is extensive evidence confirming that alcohol metabolism related oxidative stress, inflammation, and cell death play central roles in alcoholic liver disease progression over time (World Journal of Gastroenterology, 2014, PMCID: PMC4204131).

Final Damage

Now both of the previous stages can be cured but this is a  critical stage of the disease where the liver has severe scarring, which is called cirrhosis. There might not even be any noticeable symptoms at this point. Healthy liver tissue is replaced by scar tissue, which impairs normal liver function. 

This will result in liver failure as your cirrhosis worsens. This is the outcome of chronic, long-term hepatitis. There are numerous causes of hepatitis, which is an inflammation of the liver. When inflammation persists, your liver tries to heal itself by creating scars. However, an excess of scar tissue impairs liver function. Prolonged liver failure is the final stage. Although it’s usually irreversible, giving off alcohol right away will greatly prolong your life and stop additional criminal damage. 

• Cirrhosis represents an advanced stage of liver disease characterized by widespread scarring of liver tissue from chronic injury and inflammation (Journal of Hepatology, 2022, PMID: 36701455)
• Liver cirrhosis is often clinically silent in early stages, but extensive scarring replaces functional liver cells over time leading to impaired liver function (Clinics in Liver Disease, 2021, PMID: 34407732)
• Alcoholic liver disease is a common cause of cirrhosis, arising from repeated cycles of alcohol-induced liver inflammation and healing attempts that result in excessive fibrotic scarring (JAMA, 2015, PMID: 26240238)
• As cirrhosis advances, the buildup of scar tissue blocks normal blood flow in the liver, disrupts essential functions like protein package and bilirubin processing, and can set the stage for liver failure (Nature Reviews Disease Primers, 2021, PMID: 34323772)
• While early cirrhosis can sometimes be reversed if the underlying trigger (alcohol) is removed, decompensated cirrhosis often continues worsening despite alcohol abstinence at this late stage (Alcohol Research: Current Reviews, 2022, PMID: 36691033)

Conclusion 

Well, all of these issues can be reversed or prevented if you give off alcohol, ideally permanently. This offers your liver the best opportunity for healing and lowers the possibility of additional harm. It might be quite tough to stop drinking if one is addicted to alcohol. However, assistance, guidance, and medical care might be beneficial for the person who is suffering. In extreme situations where the liver has ceased working and does not get better, you might need a liver transplant. But even after a liver transplant, you have to leave alcohol behind to stay healthy. To live a happy life, you have to stay healthy and if you want to protect your body and your liver, then choose to stay away from alcohol. 

More References:

• Wiley, 2015, 10.1002/hep.27990 – Reference showing that heavy alcohol use is a leading cause of liver disease globally. Provides epidemiology on the impact of alcohol on liver health.
• Nature Reviews Gastroenterology & Hepatology, 2010, 10.1038/nrgastro.2010.117 – Review on the mechanisms and pathways by which alcohol causes liver damage, including oxidative stress, inflammation, and cell death.
• Journal of Hepatology, 2012, 10.1016/j.jhep.2011.12.003 – Study demonstrating the progression of alcoholic liver disease from fatty liver to fibrosis/cirrhosis with continued heavy drinking.
• Alcohol Research: Current Reviews, 2021, 10.35946/arcr.v40.1.01 – Overview of alcohol metabolism pathways in the liver and how this process leads to tissue injury over time.
• Alcohol and Alcoholism, 2019, 10.1093/alcalc/agz068 – Research supporting that stopping drinking can allow reversal/healing of early stage alcoholic liver disease like fatty liver.
• Nature Reviews Gastroenterology & Hepatology, 2014, 10.1038/nrgastro.2014.60 – Review discussing treatments for end-stage liver disease, including consideration of liver transplantation when liver failure occurs.