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Alcohol Effects on the Liver

By: S. Rennie, LPN

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The liver is an organ that takes the most abuse from alcohol consumption and is probably the most commonly thought of when discussing the harming effects of alcohol on your body. It's also the subject of which the most information is available.1

Alcoholic Liver Disease (ALD) is a blanket term in which conditions related specifically to the liver and alcohol use fall under. The most prevalent types of Alcoholic Liver Disease, or ALD, are fatty liver, alcoholic hepatitis, and cirrhosis.1 Often, as people continue to drink heavily, they progress from fatty liver to hepatitis to cirrhosis. All three of the disorders can occur together.1 ALD – and particularly cirrhosis – has long been one of the most prevalent and devastation conditions caused by alcohol consumption and is one of the leading causes of alcohol-related death.2

Fatty Liver, which occurs after acute alcohol ingestion, is generally reversible with abstinence and is not thought to predispose to any chronic form of liver disease if abstinence and/or moderation are maintained.3 It is estimated by the National Institutes of Health that about 20 percent of alcoholics and heavy drinkers develop fatty liver, or steatosis.1 Other sources estimate that 90-100 percent of patients with heavy drinking will develop this disease.4 The condition can lead to death if alcohol consumption is not reduced or stopped.1 

Alcoholic Hepatitis is inflammation of the liver caused by alcohol.1,5 This is usually diagnosed through a liver biopsy after common clinical signs including swollen liver, nausea, vomiting, fever, jaundice and abdominal pain, among others, are observed.1 Only a small percentage of heavy drinkers develop alcoholic hepatitis, yet the disease can occur in people who drink only moderately or binge just once. And though damage from alcoholic hepatitis often can be reversed in people who stop drinking, the disease is likely to progress to cirrhosis and liver failure in people who continue to drink. It is estimated that in severe cases, the mortality rate is 50 percent.1 If heavy drinking continues, 40 percent of those with alcoholic hepatitis will further develop into cirrhosis.1 Researchers are learning more about how and why alcoholic hepatitis occurs, but less is known about how to treat alcoholic hepatitis effectively. When damage is severe enough that the liver no longer functions, a transplant may be an option.5

Cirrhosis of the liver is the most serious and final form of ALD and a cause of many deaths and serious illnesses.1 Cirrhosis occurs when the cells of the liver are damaged and can't repair themselves. As live cells die, scar tissue forms. When this scar tissue builds up, blood can't flow through the liver properly.6 The primary job of the liver is to filter and clean the blood supply. When this tissue is scarred, it keeps blood from flowing normally causing a build up of poisons and wastes in the body.6 Prolonged periods of this poisoning and malnutrition lead to a condition known as hepatic encephalopathy, a condition in the brain with a bevy of problems that will be addressed separately. Women are at a greater risk then men in developing alcohol cirrhosis.6 Drunkenness is not essential for the development of this disease.7 About 10 percent to 15 percent of people with alcoholism develop cirrhosis, but many survive it. The 5-year survival rate for people with cirrhosis who stop drinking is about 90 percent, compared with 70 percent in those who do not stop drinking.1 Signs and symptoms of this disease may not be present until the disease is relatively advanced.7 The signs and symptoms include but are not limited to loss of appetite, nausea, jaundice, abdominal pain, fever, ascites (abdominal fluid buildup), confusion, thirst and fatigue.7 Once liver cells have been damaged, nothing can be done to repair the liver or cure cirrhosis.6 Treatment is aimed at avoiding further damage to the liver, and preventing and treating complication such as bleeding from broken blood vessels.6 Also stopping offending medications and alcohol is vital to the management cirrhosis.8

Alcohol can be a factor in several other forms of liver disease not specifically attributed to it, and may interact with risk factors for other forms of liver disease.1 An example of this is people with alcohol-related cirrhosis are at a higher risk of developing liver cancer. Those with Hepatitis B or C accompanied with heavy drinking are at a much higher risk of cirrhosis than with heavy drinking alone.1

Interestingly enough, mortality rates from cirrhosis have declined in the United States as well as some other countries since the 1970's. Some of the factors that have contributed to this decline are increased participation in treatment for alcohol problems and Alcoholics Anonymous membership, less consumption of alcohol and changes in the types of alcoholic beverages consumed.1


  1. Robert E. Mann, Ph.D., Reginald G. Smart, Ph.D., and Richard Govoni, Ph.D. The Epidemiology of Alcoholic Liver Disease. National Institute on Alcohol Abuse and Alcoholism Publication. September 29, 2004.
  2. In this Issue. National Institute on Alcohol Abuse and Alcoholism Publication. September 29, 2004.
  3. Kyrsten Fairbanks, MD. Alcoholic Liver Disease. Disease Management Project. The Cleveland Clinic, December 13, 2004.
  4. Mohammad K. Ismail, MD, Caroline Riely, MD. Alcoholic Fatty Liver. emedicine from WebMD. October 31, 2006.
  5. Mayo Clinic Staff. Digestive System: Alcoholic hepatitis. Tools for healthier lives. August 15, 2006.
  6. American Academy of Family Physicians (Source). Cirrhosis and Portal Hypertension.
  7. Alcoholic liver disease. Medical Encyclopedia. MedlinePlus. A service of the U.S. National Library of Medicine and the National Institutes of Health.
  8. Cirrhosis. Medical Encyclopedia. MedlinePlus. A service of the U.S. National Library of Medicine and the National Institutes of Health.

This page was last modified on : 10/28/2013

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