Alcohol is a drug and large amounts of it are poisonous (toxic) to the liver. The liver protects your body from the damaging effects of alcohol by breaking it down into less harmful substances. People with any liver condition should be very cautious about drinking alcohol, as there is strong evidence that it will make their condition worse. Drinking advice will vary from person to person, even with the same condition. Many people find they can no longer tolerate alcohol; others drink a little on special occasions. If your liver disease has been caused by alcohol, then you should not drink. If you are unsure whether you should drink, talk to your doctor.
Alcohol is a toxin (or poison) that is usually dealt with by the liver. Drinking too much alcohol over a long period harms the liver and makes it very fatty, with the liver cells becoming bloated and unable to work properly. This results in swelling and inflammation of the liver – known as alcoholic hepatitis or alcoholic steatohepatitis – and can lead to scarring, known as fibrosis. Extensive scarring, combined with hardening of the liver, is known as cirrhosis and can ultimately lead to liver cancer. It can also cause bleeding from the stomach which requires emergency hospitalisation.
Everyone reacts to alcohol in a different way, but the government recommends that adult men
should drink no more than 21 units of alcohol in a week and adult women, no more than 14. These units should be spread over the week:
- men should not drink more than 3 to 4 units a day
- women should not drink more than 2 to 3 units a day
- everyone should have at least two alcohol free days every week.
Units have been used for 25 years in the UK to describe amounts of alcohol. In the past, a unit could be identified as a drink – one unit (8 grams of pure alcohol) was a measure of spirits, half a pint of beer or a glass of wine.
However, both the alcohol content (abv) of drinks and the standard measures of drinks served have increased over time. Spirits used to be served in 25ml quantities – now it is often 35ml; wine used to be served in 125ml quantities – today it is usually 175ml or 250ml glasses; the strength of lager used to be 3.5% abv – now it is commonly 5% abv. The abv (shown on the bottle, box or can) tells you how many units there are in a litre, i.e. 6% abv means there are 6 units in a litre. If you drink half a litre (500ml) – just under a pint – of beer of this strength then you have had 3 units.
An accurate way of calculating how many units you are drinking is to multiply the abv figure by the size of your drink. For example, a typical can of beer these days is 440ml, at 5% abv strength. Therefore: 440 x 5 = 2,200; divide this by 1,000 = 2.2 units. You can use this formula to work out other drinks:
- a standard glass of wine (175ml) at 12% abv is 2.1 units and a large 250ml glass is 3 units
- one measure 35ml of spirits (40% abv) is 1.4 units
- a pint of low strength (3.5 - 4% abv) beer or lager is 2.3 units
- a pint of regular cider (alcohol 5% abv) is 3.4 units
- a standard measure of port or sherry (50ml) is 1 unit.