Alcohol and Liver: Myths and Facts

Q1- Why alcohol is bad for liver?

The liver is one of the most complex organs in the human body, with over 500 functions. Some of its salient functions include filtering out blood toxins, storing energy, synthesizing hormones and proteins, and regulating cholesterol and blood sugar. As alcohol is broken down in the liver, several potentially dangerous by-products are generated, such as acetaldehyde and highly reactive molecules called free radicals. Perhaps more so than alcohol itself, these products contribute to alcohol-induced liver damage. Each time the liver filters alcohol, some of the liver cells die. Although the liver is capable of regenerating itself, prolonged alcohol abuse over years can reduce its ability to regenerate.

Q2- Does stopping alcohol help in improving your liver health?

if you have been a heavy drinker for many years, reducing or stopping your alcohol intake will have important short- and long term benefits for your liver and overall health.

Q3- Is there a safe drinking limit for alcohol?

Although safe limits of alcohol drinking have been described, the best way is not to consume alcohol at all. The most effective way to prevent alcohol induced liver damage is to stop drinking or stick to the recommended limits of alcohol consumption: Women with a healthy liver should not drink more than 1 alcoholic beverage a day (or 7 drinks in 1 week). Men with a healthy liver should not drink more than 2 drinks a day (or 14 drinks in 1 week).

Q4-Is consuming alcohol while taking other medications safe?

Mixing alcohol with other medications can be very dangerous for your liver. Never take alcohol and medication simultaneously. When combined, certain medications, such as acetaminophen, can lead to severe damage to your liver. Other medications that are dangerous to combine with alcohol include antibiotics, blood thinners, antidepressants, sedatives, pain medications, and muscle relaxants.

Q5- Is there a genetic predisposition for alcoholic liver disease?

Yes. There is a genetic predisposition toward alcoholism, and certain HLA phenotypes and female gender may have increased overall risk of alcohol induced liver damage.

Q6- What spectrum of liver disease is caused by alcohol?

There are 3 main stages of alcohol related liver damage, although there is often an overlap between these stages. These stages are:

• Alcoholic fatty liver disease- Drinking a large amount of alcohol, even for just a few days, can lead to a build-up of fats in the liver. This is called alcoholic fatty liver disease and is the first stage of ALD. Fatty liver disease generally does not cause any symptoms, but it's an important warning sign that you're drinking at a harmful level. Fatty liver disease is reversible if you stop drinking alcohol.
• Alcoholic hepatitis- It is a potentially serious condition that can be caused by alcohol misuse over a longer period. Patients usually develop jaundice when this develops. The liver damage associated with mild alcoholic hepatitis is usually reversible if you stop drinking alcohol. Severe alcoholic hepatitis, however, is a life-threatening, and needs hospitalization and ICU treatment.
• Cirrhosis- It is the stage where the liver develops scarring. It's generally not reversible but stopping alcohol can prevent further damage and significantly increase your life expectancy. A person who has alcohol-related cirrhosis and does not stop drinking has a less than 50% chance of survival for at least 5 more years.

Q7- Does type of alcohol matter in liver disease?

No. The amount of alcohol you drink is important, not the kind of alcohol you drink.

Q8- Do people with other liver disease along with alcohol intake are more prone to liver injury?

Alcohol is a direct hepatotoxic agent and those who have pre-existing liver diseases are more prone to the toxic effects of alcohol. A person who consumes alcohol regularly and has had any type of hepatitis faces a higher chance of developing further liver problems.

Myths:

• It is safe to consume alcohol if you are taking a healthy diet.
• Liver protective drugs can protect you from liver damage while you are consuming alcohol.
• Drinking a specific kind or brand of alcohol is less injurious to the liver.

Facts:

• Alcohol is among the top three cause of liver damage in India.
• You can prevent or reduce liver injury if you stop alcohol intake.
• Ongoing alcohol consumption leads to life threatening alcoholic hepatitis and cirrhosis, wherein liver transplantation may be the only definitive treatment.