Alcohol and the Liver

Who is the leaflet for?

Patients diagnosed with or worried about developing alcohol related liver disease.

What is its aim?

To provide an overview of alcohol related liver disease and links to more detailed resources.

The functions of your normal liver

The liver is responsible for over 500 functions that are essential to the body, below are a few of the most important. The liver:

1. Produces proteins that circulate in your blood that are vital to the rest of your body.
2. Produces substances that help clot your blood.
3. Acts to clear toxins from your body and break down drugs/medications.
4. Clears the products that are formed when red blood cells die.
5. Produces substances that aid digestion and absorption of nutrients from your diet. It also stores and produces energy for the body.
6. Is vital for a fully functioning immune system.

How does alcohol cause liver damage?

Excess alcohol damages the liver in one of three ways:

1. Fatty Liver: Fatty liver is said to occur in around 90% of heavy drinkers at some point in their drinking life. It occurs when prolonged and excessive alcohol consumption causes accumulation of abnormal amounts of fat within the liver. At this stage, with time away from alcohol, the process is completely reversible.
2. Alcoholic Hepatitis: The term alcoholic hepatitis describes significant inflammation of the liver due excessive alcohol consumption. The symptoms include jaundice (yellowing of eyes and skin), loss of appetite, fatigue and a general feeling of being unwell. In some cases, a patient may need admission to hospital. In severe cases, symptoms include muscle wasting and the build-up of fluid in the abdomen (ascites).
3. Alcohol Related Cirrhosis: Liver damage leads to scarring known as fibrosis. With continued excessive alcohol consumption, this fibrosis will develop into cirrhosis (irreversible scarring). This affects liver function and reduces life expectancy. We have a separate information sheet about cirrhosis and its complications.

How is alcohol-related liver disease diagnosed?

Diagnosis of alcohol-related liver disease involves a combination of blood tests liver, function tests, an ultrasound of your liver, an elastography scan (to assess liver stiffness using a vibration wave - it can give instant results and is non-invasive) and occasionally liver biopsy (taking a sample of the liver. This is an invasive procedure and comes with inherent risks). The details of this will depend on the exact nature of your case.

Treatment of severe alcohol-related liver disease is to stop drinking alcohol lifelong. If this goal is achieved then patients usually respond well, with the probability of scarring reducing and the return of effective liver function.

You may find the following groups helpful in achieving abstinence:

• CGL (Change, Grow, Live). They are the locally commissioned NHS alcohol service. They are based at Mill House, Brookfields Hospital site, Mill Road, Cambridge. Their website Change Grow Live - Drug and Alcohol Service - Cambridgeshire (opens in a new tab) You can also call them on 0300 555 0101. They also have services in Ely, Huntingdon and Wisbech.
• Alcoholics Anonymous (AA, can be complimentary to the NHS service. Their helpline number is 0800 917 7650.
• A local recovery-based cafe which runs groups for those trying to maintain abstinence: The Edge Cafe (opens in a new tab)
• Online options would include SMART recovery and the reddit stop drinking forum: Smart Recovery (opens in a new tab) and /r/stopdrinking: a support group in your pocket! (opens in a new tab)

Prevention

Recommendations for preventing alcohol related liver disease are given by the Department of Health and Royal College of Physicians. They recommend:

• Both men and women should drink no more than 14 units a week. A unit of alcohol is half a pint of ordinary strength beer, a small pub measure (25mls) spirits and a small glass of ordinary strength wine (125mls 12% alcohol).
• It is also important that one should also aim with at least two days a week being alcohol free. Refraining on one day should not mean excess on another.

Further information and other useful contacts

• British Liver Trust (British Liver Trust (opens in a new tab))
• Drinkaware (opens in a new tab)
• IC Finance Guide - Loans and finance guide (opens in a new tab)