A lot of people see alcohol as simply something to be enjoyed and as a normal part of life in the UK. Other than a few unwelcome side effects, such as a hangover or putting on a bit of weight, many of us are unaware about the unseen damage alcohol can do to the body.
But every year in the UK, there are more than 300,000 hospital admissions where the main reason for admission is alcohol, and more than one million admissions to hospital where alcohol is partly responsible. Alcohol-related illness accounts for almost three quarters of all admissions to Accident & Emergency departments from midnight until 5am at weekends. Every year, over 6,500 people will die because of an illness directly related to alcohol, and alcohol-related admissions and deaths costs the NHS over £3.5 billion per year. If trends are not reversed, it’s estimated that the cost to the NHS of managing alcohol-related ailments over the next five years will rise to £17 billion.
The liver is your largest internal organ. As well as hundreds of other jobs, it processes the alcohol you drink. If you drink over the recommended daily guidelines (see below), your liver will be unable to process the alcohol you consume quickly enough, which damages the cells in your liver. But because ongoing damage to the liver does not cause pain, you may not have any symptoms of the inflammation, fatty deposits or scarring affecting it until your liver disease is severe, at which point you are at risk of liver failure and death.
You don’t have to be an ‘alcoholic’ to be affected by alcohol-related liver disease. In fact, the term alcoholic is misleading, as alcohol dependency is a spectrum. Currently, one in five people in the UK drink alcohol in a way that could harm their liver. Regularly drinking more than the lower-risk levels of alcohol (defined by the NHS as 14 units a week, spread over several days, with two or three alcohol-free days every week, ideally consecutively) can seriously harm your liver. These guidelines, which are strongly supported by the British Liver Trust, are the same for men and women. It is a lot easier to overdrink than many people realise, putting vast numbers of us in danger of alcohol-related illnesses.
If you are generally healthy, eat a well-balanced diet and take regular exercise, sensible drinking (as outlined above) shouldn’t lead to problems with the liver.
What is a unit of alcohol?
Alcohol-related liver disease can be broken down into stages. Addressing the condition early may prevent it progressing and possibly leading to a liver transplant or death.
Stage 1: Fatty liver
The first stage is a result of a build-up of fat in your liver. When alcohol is metabolised it results in overproduction of fat in the liver. A healthy liver should have little or no fat but if you drink more than your liver can cope with, fat can build up, leading to fatty liver disease.
Stage 2: Alcohol-related hepatitis
If you have a fatty liver, and don’t stop or reduce your intake of alcohol, you are at a high risk of developing alcohol-related hepatitis. This is a condition where your liver becomes inflamed, swollen and tender. Alcohol-related hepatitis can occur at an early stage or after many years of harmful drinking.
Stage 3: Cirrhosis
The final and irreversible stage of alcohol-related liver disease is cirrhosis. This is usually the result of long-term, continuous damage to the liver. Irregular bumps, known as nodules, replace the smooth liver tissue and the liver becomes stiffer due to the accumulation of scar tissue. As a result, the shape of the liver becomes distorted. This can lead to complete liver failure as there are too few cells left to carry out normal liver functions.
About one in 10 people who drink harmful amounts will develop cirrhosis.
For more information, download our publication, below. You can also visit the Support section of our website for help and advice in your area, and see the Useful links section for more organisations that can help.
Download: Alcohol & LD ALD/08/18.pdf
Special thanks to: Dr Stuart Kendrick, consultant hepatologist, Cambridge Liver Unit, Addenbrookes Hospital and Dr Mike Allison, consultant hepatologist, Cambridge Liver Unit, Addenbrookes Hospital.
The Trust has been donated the use of this video discussing the physiology of alcohol on the liver – it is aimed at medical students but after asking for feedback, some patients have also said they find it useful. It can be quite technical, so please discuss any content that you are unsure about with your medical team.
Alcohol and Health in Older People
Online resource providing an overview of the growing relevance of alcohol and how it interacts with the health of older people (defined here as those aged over 55 years).
Leeds Transplant Centre
See the following useful information regarding alcohol related liver disease and transplants:
Leeds Alcohol and the liver workbook