Know the Facts

Helping you make informed decisions about your drinking

Alcohol and the Liver

The liver is one of the body’s most important organs and plays a major role in metabolism, including filtering toxins out of our bodies. About 90% of the alcohol we drink is processed by the liver, where alcohol is broken down by an enzyme called alcohol dehydrogenase into the chemical acetaldehyde.

Breaking down alcohol is toxic for the liver, making alcohol a major cause of liver damage and disease. This includes inflammation of the liver, cell death, and the build up of fatty deposits. Acetaldehyde, along with other by-products created in the metabolism of alcohol, is poisonous to the cells of our bodies and causes swelling in the liver. Alcohol metabolism also results in increased production of a certain type of fat, called triglycerides, which can build up in the liver, causing ‘fatty liver’.

Alcoholic liver disease

The term ‘alcoholic liver disease’ is used to describe the three main diseases of the liver, which are listed below. These diseases impair the ability of the liver to perform its usual functions, impacting on overall health. Even so, in the early stages, alcoholic liver disease will often show few signs or symptoms until more severe health problems develop, by which time the damage may be too late to reverse.

Fatty liver

This develops in 60-100% of people who drink heavily (6 or more standard drinks a day for men; 2 or more standard drinks a day for women). Fatty liver is caused by a build up of triglycerides in the liver. The only way to reverse this is to stop drinking. If a person continues to drink, they are at risk of developing alcoholic hepatitis or cirrhosis.

Alcoholic hepatitis

This results from inflammation of the liver and develops in 10-30% of people who drink heavily. Alcoholic hepatitis can cause mild abdominal pain or fever, but can also lead to more severe health complications such as jaundice or coma. Alcoholic hepatitis can be reversed if a person stops drinking.

Cirrhosis

This liver disease is caused by scarring and the damage or death of cells in the liver. Blood vessels become stiff and the structure of the liver changes, impairing its function. Cirrhosis occurs in 10-15% of people who drink heavily and is generally irreversible. Risk of liver failure and liver cancer are high.

What to do

Many factors determine a person’s risk for developing alcoholic liver disease, and there is no safe level of alcohol use that will remove all risk. However, drinking no more than two standard drinks on any day reduces the lifetime risk of alcohol-related disease and injury.

If you are at all concerned about your liver, we strongly advise that you discuss this with your doctor. They will be able to assess your health and may send you to get a blood test to check your liver function.

Sources

  • English, D., Holman, C., Milne, E., et. Al. (1995) The quantification of drug caused morbidity and mortality in Australia, Part 1, (pages 1-262). Canberra: Commonwealth Department of Human Services and Health, Australian Government Publishing Service.
  • Forrest, E. & Reed, E. (2011). Alcohol and the liver. Medicine, 39, 532-535.
  • Maher, J.J. (1997). Exploring alcohol’s effect on liver function. Alcohol Health and Research World, 21, 5-12.
  • National Health and Medical Research Council. (2009). Australian guidelines to reduce health risks from drinking alcohol. Commonwealth of Australia: Australian Capital Territory.
  • Naugler, W.E. & Schwartz, J. M. (2008). Hepatocellular carcinoma. Liver Disease, 54, 432–444.
  • Paton, A. (2005). Alcohol in the body. British Medical Journal, 330, 85. doi: 10.1136/bmj.330.7482.85