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Alcohol and Your Liver: Understanding the Risks and Warning Signs

Maybe you have a couple of beers on the weekends with your friends. Or you like a glass of wine with dinner. Or maybe you’re a fan of craft cocktails, and you know you drink more than you probably should.

Whether you’re a casual drinker or you have concerns about your alcohol use, you probably wonder what effect alcohol might have on your liver. After all, your liver is a vital organ that helps keep you healthy. It filters your blood, removes toxins, produces proteins, stores energy and helps with digestion.

Geoffrey Block, MD, a hepatologist with Banner – University Medicine, helped us untangle the relationship between alcohol and your liver’s health.

When you drink alcohol, your liver breaks it down so your body can eliminate it. But over time, too much alcohol can make it hard for your liver to work properly. Your liver can get inflamed and its cells can get damaged. 

Health problems linked with alcohol

“Drinking alcohol can cause liver inflammation, enlarge your liver and cause fat to build up in your liver cells. Those processes make your liver cells die more quickly and leads to scarring (fibrosis). Scarring changes your liver function and makes the blood pressure higher in your liver. Over time, your liver can fail,” Dr. Block said.

Liver issues don’t happen immediately. But eventually, you could develop:

  • Alcoholic fatty liver disease: This condition happens when too much fat builds up in liver cells. If you spot it early enough, you can reverse it. 
  • Alcoholic hepatitis: With this condition, your liver gets inflamed and you may have jaundice (yellow skin and eyes), stomach pain and nausea. It’s a serious condition that needs treatment.
  • Cirrhosis: Cirrhosis is the most advanced stage of liver damage linked with alcohol. With it, scar tissue replaces healthy liver tissue and makes it hard for the liver to work properly. It may lead to liver failure and a higher risk of liver cancer. “You could have cirrhosis with no symptoms until your liver fails,” Dr. Block said.

These conditions may get worse if you keep drinking too much alcohol. Some people may need to stop drinking altogether, but many people can improve their health by cutting back on their alcohol intake and still enjoying a rare drink.

Warning signs of liver damage

In the early stages, you may not have any symptoms of liver damage. As these conditions get worse, you could notice:

  • Fatigue and weakness: Lots of health problems can cause fatigue and weakness. But these symptoms could be a sign that your liver is under stress. You may have trouble sleeping at night and be tired during the day. You may notice that your muscles are wasting away.
  • Abdominal pain and swelling: As liver disease gets worse, inflammation can make your abdomen bigger. You might have pain in the right upper part of your abdomen.
  • Jaundice: Jaundice is a sign that bilirubin — a substance your liver normally processes — is building up. It may mean your liver isn’t filtering waste like it should.
  • Red spots on your chest: These are called spider angiomata.
  • Dark urine, stools or vomit: When your liver isn’t working properly, your urine may be dark. You may have bloody or black stools or vomit blood.
  • Digestive problems: You may have loss of appetite, nausea or vomiting.
  • Confusion or memory problems: You could have symptoms like Alzheimer’s disease or dementia.

If you have any of these symptoms, talk to a health care provider. A provider can test your liver function and recommend treatment options. Your liver damage is likely to get worse and be harder to treat if you don’t get medical care.

How to keep your liver healthy

“A clinical trial in the 1960s proved that alcohol damages the liver even among normal healthy people with good nutrition,” Dr. Block said.

If you choose to drink alcohol, it’s important to keep it to moderate levels. The standard recommendation is up to one drink a day for women and up to two drinks a day for men. And you can’t “save up” your drinks by not drinking on some days and drinking more heavily on others. 

Dr. Block states these are outdated recommendations that are still present on Federal government guidelines intended only for persons with no chronic health problems.

He recommends even lower levels: “There is no ‘safe’ alcohol intake, but if you’re drinking, less is better. You should limit your alcohol to three drinks per week or less.” A drink is considered an ounce of 80 proof liquor, six ounces of wine or 12 ounces of beer. 

It’s also good for your liver to:

  • Choose a diet rich in fruits, vegetables, whole grains and lean proteins that are low in fat. Make sure you control cholesterol, blood sugar and fat in the blood.
  • Get regular physical activity, since it supports a healthy metabolism and may keep fat from building up in the liver. Your liver is likely to be healthier if you’re lean, with a body mass index (BMI) under 25. 
  • Avoid tobacco products.
  • Have regular checkups with your health care provider. Depending on the health of your liver, your provider may want to test your liver function, enzymes and proteins to watch for any problems.

Are you concerned about your drinking?

If you’re having trouble keeping your drinking to a moderate level, talk to your health care provider. They can give you advice and guidance and connect you with resources and organizations that can help. They may also be able to offer medications that help you cut back or stop drinking.

Additionally, you can reach out to Alcoholics Anonymous, SMART Recovery, Moderation Management or other recovery groups. Reach out for support as soon as you see warning signs, since you’re more likely to succeed if you get help right away. However, it’s never too late to make positive changes.

“There aren’t any medications or supplements that can reverse or prevent liver damage from alcohol. The only way you can recover is to stop drinking alcohol. But stopping alcohol for years, or the rest of your life, can often reverse liver damage. Even if you have liver failure or cirrhosis, there may be enough survival time for you to recover,” Dr. Block said. 

“Otherwise, liver transplant may be possible, although this is currently a very limited resource.” It may not be possible for you to get a liver if you need a transplant.

The bottom line

Drinking alcohol can harm your liver, and over time, cause liver failure. If you drink, it’s best to keep it to three drinks a week or less. If you develop liver problems, you can often reverse the damage if you stop drinking.

Reach out to Banner Health if you would like to talk to an expert about ways to keep your liver healthy and strategies for cutting back or quitting drinking.

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