Liver Foundation of WA | Alcohol Liver Disease
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Alcohol Liver Disease

Alcohol Liver Disease or ALD is the result of severe alcohol abuse. The liver is a very resilient organ and liver damage does not take place as the result of a few drinks once in a while. It happens over a period of years after prolonged heavy drinking. However, not everyone who drinks will develop the disease because it depends on a number of factors like gender, genes, body weight and your body’s capacity for handling alcohol.

What happens when I drink alcohol?

When you are sipping that cool pint of beer or that nice glass of wine the alcohol is absorbed into the bloodstream via the stomach and intestines. Since the blood must pass through the liver before circulating through the rest of the body, it means that the liver is taking the maximum concentration of alcohol first. Certain enzymes in the liver will then metabolise the alcohol so that it can be broken down into water and carbon dioxide. The carbon dioxide and water will eventually be excreted through the lungs and urine. Alcohol Liver Disease can lead to fatty liver, hepatitis and cirrhosis.

So how does the alcohol harm my liver?

The problem arises when you drink faster than your liver can process the alcohol. This makes the blood alcohol level rise in the blood stream. Acetaldehyde is a toxic substance which is produced when the liver metabolises alcohol. This destroys the liver cells. The liver metabolises the alcohol with the help of two enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). ADH metabolises alcohol to acetaldehyde which is a highly toxic substance and is also a known carcinogen. Then this acetaldehyde is further metabolised down to another less active by-product called acetate which in turn is broken down into water and carbon dioxide.

What are the risk factors for Alcohol Liver Disease?

  • Alcohol Consumption
  • Gender
  • Malnutrition
  • Viral infection
  • Genetics
  • Drugs

Alcohol Consumption:

Alcohol consumption has its roots in antiquity. The history of almost all regions of the world show that alcohol was consumed by men as part of their daily lives or had some health or religious significance. Alcohol in moderation is said to be cardioprotective (i.e.good for your heart) while in excess it can be hepatotoxic( poisonous for the liver).Alcoholic cirrhosis has plagued the serious imbiber through much of recorded history. So although, not everyone will develop Alcoholic Liver Disease, if you drink hazardous amounts of alcohol it can lead to alcoholic hepatitis or cirrhosis. (scarring of the liver)

Gender:

Females appear to be especially susceptible to alcohol-induced liver injury. Studies have shown that it may take as little as 20- 40gms of daily alcohol ingestion over an extended period of time for women to develop Alcoholic Liver Disease. Women with cirrhosis due to alcohol have a shorter life expectancy than men with the same cause.

Malnutrition/Diet:

Nutrition plays a very important part in your liver care. While poor nutrition is not going to result in liver disease, studies have suggested that the type of diet consumed in association with excess alcohol may have a marked effect on the pattern and severity of the liver injury. In order to remain healthy, your diet has to be balanced with your body’s needs. A balanced diet is one in which all the nutrients are present in the correct proportion to keep your body at optimum health.

Virus Infection:

Vaccination for Hepatitis A and B are the single most important methods of prevention from these two viruses, thus preventing liver injury. There is no vaccination available yet for Hepatitis C and the only cure is prevention. Hepatitis C is a liver disease caused by the Hepatitis C virus (HCV). People usually get infected through exchange of bodily fluids via sexual contact, infected needles or blood transfusions. Alcohol consumption by a person infected with Hepatitis C can accelerate the patient’s progress from chronic HCV to cirrhosis and liver cancer.

Genetics:

It is not yet clear why one man can consume alcohol on a regular basis for years and not develop Alcohol Liver Disease while another can succumb after a few years of drinking. Consumption of alcohol can increase your iron absorption. Hence people with Haemochromatosis must have a moderate alcohol intake.

Drugs:

When alcohol is ingested in combination with other medication, it can have adverse effects on the body. For instance, it can cause excessive sedation when taken with anti-anxiety drugs like Xanax. Antibiotics like Cefaclor can induce nausea, vomiting and stomach cramping. Alcohol and cocaine can prove to be a lethal combination in high doses. It can damage your kidneys, muscles and in extreme cases can even lead to death. In people with chronic Hepatitis C, consumption of even minimal quantities of alcohol can accelerate the progression of liver disease.

So how is Alcohol Liver Disease Diagnosed?

Alcohol Liver disease is diagnosed on the basis of laboratory test results, history of alcohol intake and physical signs of liver disease which can include ascites, splenomegaly, jaundice etc. Ultrasound scans can show the extent of damage of the liver , blood tests revealing abnormal liver function tests ( Hepascore) and liver biopsies and are also done to ascertain the extent of liver damage.

What is the treatment for Alcohol Liver Disease?

Continuous long-term management is the most important aspect of treatment of patients with ALD. All authorities are unanimous in agreeing that abstinence from alcohol improves survival. Nutritional therapy also goes a long way in the management of patients with ALD. An optimum diet may actually encourage hepatic regeneration.