Alcoholic liver disease is a result of overconsuming alcohol that damages the liver, leading to a buildup of fats, inflammation, and scarring. It can be fatal.
The condition is a primary cause of chronic liver disease in Western nations.
The liver is one of the most complex organs in the human body, with over 500 functions. These include filtering out blood toxins, storing energy, making hormones and proteins, and regulating cholesterol and blood sugar.
Liver damage can affect the whole body. Once damage begins, it can take a long time to become noticeable, as the liver is generally highly effective at regenerating and repairing itself. Often, by the time the damage is found, it is irreversible.
According to the Centers for Disease Control and Prevention (CDC), in 2014 the number of deaths from alcoholic liver disease in the United States was 19,388, while all causes of chronic liver disease and cirrhosis are estimated to lead to 12 fatalities per 100,000 people per year.
In 2015, in the United States, nearly 20 percent of all liver transplants occurred as a result of alcoholic liver disease, making it the third most common reason for transplant behind chronic hepatitis C and liver cancer.
Facts about Alcoholic Liver
- Alcoholic liver disease is the main cause of chronic liver disease in Western nations and the third most common cause of liver transplants.
- Abstaining from drinking alcohol is the only way a person has a chance of recovery.
- Jaundice and tremors are symptoms of alcoholic liver disease.
- Treatment options include medication, lifestyle changes, and surgery.
- The recommended daily limits are no more than one drink a day for women and no more than two drinks a day for men.
The early signs of alcoholic liver disease are vague and affect a range of systems in the body.
Along with a general feeling of being unwell, signs can include:
- pain in the abdomen
- nausea and vomiting
- decreased appetite
It can be easy to dismiss the early symptoms as the effects of a stomach bug or general malaise. However, leaving these symptoms undiagnosed and untreated, especially while continuing to consume alcohol, can lead to a faster progression of liver disease over time.
Once alcoholic liver disease progresses, its symptoms become easier to recognize.
The more distinctive signs of later-stage liver disease include the following:
- jaundice, or a yellow tint of the whites of the eyes and the skin
- edema, or swelling of the lower limbs
- a buildup of fluid in the abdomen, known as ascites
- fever and shivering
- extremely itchy skin
- fingernails that curve excessively, known as clubbing
- losing a significant amount of weight
- general weakness and wasting muscles
- blood in vomit and stools
- bleeding and bruising more easily
- more sensitive reactions to alcohol and drugs
Once symptoms are noticeable, the condition has reached an advanced stage, and visiting a doctor is a crucial next step.
Alcoholic liver disease has four main stages.
1. Alcoholic Fatty Liver Disease
Drinking a large volume of alcohol can cause fatty acids to collect in the liver. Sometimes, heavy drinking over a short period, even less than a week, can cause this. There are normally no symptoms, and this stage of the disease is often reversible if the individual abstains from alcohol from this point onward.
2. Alcoholic Hepatitis
Continued alcohol use will lead to ongoing liver inflammation. This can occur after many years of heavy drinking. It can also occur acutely during periods of binge drinking. Hepatitis is a general term swelling and inflammation of the liver from any cause.
If the individual abstains from alcohol on a long-term basis, alcoholic hepatitis is usually reversible.
Fibrosis is a buildup of certain types of protein in the liver, including collagen. It features in most types of chronic liver disease. Mild-to-moderate forms of fibrosis may be reversible. Continuous fibrosis and inflammation can lead to liver cancer.
Cirrhosis occurs when the liver has been inflamed for a long time, leading to scarring and loss of function. This can be a life-threatening condition. Cirrhosis damage is irreversible, but the patient can prevent further damage by continuing to avoid alcohol.
Life-long abstinence can improve liver function, but the permanent and severe damage from cirrhosis might mean that the patient needs a liver transplant to survive.
As the liver no longer processes toxins properly, it will be more sensitive to medications and alcohol. Alcohol use speeds up the destruction of the liver, along with reducing the liver’s ability to compensate for the current damage.
Not all heavy regular drinkers develop liver damage. It is not known why alcoholic liver disease affects some people and not others.
Acetaldehyde is a toxic chemical that is produced by the body’s break down of alcohol. It damages the liver and leads to liver scarring and inflammation.
This chemical appears to affect some people more than others.
To prevent alcoholic liver disease and other conditions linked to the consumption of alcohol, people are advised to follow national guidelines for limits of alcohol consumption.
The guidelines classify moderate drinking as up to one drink a day for women, up to two drinks for men, and only over the age of 21 years. One drink is equivalent to 12 fluid ounces (oz) of beer at 5 percent alcohol, 5 oz of wine at 12 percent alcohol, or 1.5 oz of spirits at 40 percent alcohol.
Binge drinking refers to drinking too much alcohol in a short space of time. It can increase the risk of liver damage. When a man consumes five or more drinks within 2 hours, or a woman consumes four or more drinks in the same amount of time, it is considered binge drinking.
The NIAAA also notes that different people react to alcohol in different ways, and some are more at risk than others from the effects of alcohol. Alcohol use disorder (AUD) often goes along with alcoholic liver disease. It is a form of severe problem drinking. A person has difficulty controlling alcohol intake and feels emotionally low when not using alcohol.
The guidelines identify those at high risk for an alcohol use disorder to be women who drink four or more drinks on any one day, or eight or more drinks in a week, and men who drink five or more drinks on any one day or 15 or more drinks per week.
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