Alcohol Liaison Service
Alcohol
How It Affects Your Liver
Information
Introduction
Many people think that alcohol is fairly harmless - other
than a few ill-effects the next day and perhaps some
weight-gain, alcohol doesn’t seem to have any long
lasting effects. But alcohol can cause harm.
Each year in the UK 150,000 people are admitted to
hospital and 22,000 people die prematurely from alcohol
related causes. That works out at 400 people dying
every day. The cost to society has been estimated at
over £20 billion.
You don’t have to be a heavy drinker to run into
problems. Drinking just a bit more than you should over
time can seriously harm your liver.
Not feeling any side effects from drinking doesn’t mean
that you are not risking chronic ill-health or lasting liver
damage from alcohol-related liver disease.
The liver is your largest internal organ. Dealing with the
alcohol you drink is just one of its many jobs. If you are
drinking too much, your liver has to literally soak up the
excess and with few nerve endings to signal pain, you
won’t know anything is wrong.
2
If you’re drinking on a regular basis, the chances are
that you won’t feel anything happening until the damage
to your liver is so severe that it could even be fatal.
It is easy to underestimate how much alcohol you are
drinking and often difficult to stop after a certain number
of drinks.
A little more knowledge about alcohol itself will help and
taking a few minutes to read this leaflet will help you
understand the effect alcohol has on you and your liver.
If you keep track of how much you drink, you should
stay in better shape and be around for longer to enjoy it!
What is alcohol?
Alcohol is a drug produced by the fermentation of sugar
in yeast.
The main psychoactive ingredient in alcoholic drinks is
ethanol or ethyl alcohol. Ethanol dissolves quickly in
water and is absorbed into the bloodstream.
In the short term, in small doses, it acts on receptors in
the brain to make people feel uninhibited and provides a
general sense of well-being.
3
Drinking more alcohol starts to affect the balance and
speech centre of the brain.
If you drink regularly, the brain’s receptors adapt to the
alcohol and higher doses are needed to cause the same
effect.
Alcohol is a depressant. Rather than acting as a
stimulant, alcohol is likely to have the opposite effect on
people who drink heavily.
What happens when you drink alcohol?
Alcohol is quickly soaked up through the lining of the
stomach and the upper part of the intestine (gut) and
into your blood stream. The higher the concentration of
alcohol, the faster it will be absorbed (e.g. whisky will be
absorbed faster than beer).
From the intestine, the alcohol is carried to your liver as
well as other organs and body tissues. Your brain will
be affected by the flow of alcohol which acts on the
central nervous system to alter your physical coordination and mental judgement.
Your liver cannot store alcohol. It processes about 90
per cent of the alcohol you drink to eliminate it from your
body and it breaks down the alcohol into water, gas
(carbon dioxide) and fat.
4
What happens to the liver if you drink too
much?
Along with the central nervous system, the liver suffers
the most from alcohol consumption. Your liver can only
handle a certain amount of alcohol in any given time (1
unit per hour).
If you’re drinking quickly, your liver cells will have to
work overtime to process the alcohol. When this is
more than the liver can deal with, the excess is
transported to the rest of your organs.
Your liver needs water to do its job. As alcohol acts as
a diuretic (makes you pass urine), it dehydrates you and
forces the liver to divert water from elsewhere.
When the liver is processing alcohol it produces a
substance called acetaldehyde. This has a toxic effect
on the liver itself as well as the brain and stomach lining
and this is what causes hangovers.
Acetaldehyde is then broken down into a chemical
called acetate which is broken down further into carbon
dioxide and water, outside the liver. Regular and heavy
drinking over time can strain or disrupt this process
leading to alcoholic liver disease.
5
The first stage of disease may not seem all that
significant but must be acted upon. The later stages are
very serious and can threaten your life.
Fatty liver
When the liver breaks down alcohol, it stores the fat in
your liver. There should be little or no fat in a healthy
liver. Too much of this fat can build up if you drink more
than the liver can cope with, leading to fatty liver
disease.
You can get a fatty liver without drinking. This is called,
perhaps unoriginally, ‘non-alcoholic fatty liver disease’
(NAFLD).
It is thought that if you are overweight and drink too
much, you increase the chances of damaging your liver
as it receives fat from both food and alcohol.
Fatty livers return to normal if you drink within sensible
limits. If you carry on drinking above that limit, you run
the risk of more serious damage.
Alcoholic hepatitis
If you have a fatty liver and continue to drink, you have
up to a 1 in 3 three chance of developing alcoholic
hepatitis.
6
This is a condition where your liver becomes puffy,
swollen and tender. It can affect you suddenly (after a
weekend of binge drinking, for example) and if your liver
fails, it can kill you.
Alcoholic hepatitis can happen to you at an early stage
or after many years of excessive drinking.
Fibrosis
This is scar tissue that is generated to protect injured
tissue from further damage which would usually
disappear in a healthy liver. When the liver is damaged
through excessive alcohol use, the scarring may keep
building up and lead to fibrosis.
Cirrhosis
The final stage of alcoholic liver disease is cirrhosis
which is usually the result of long-term, continuous
damage to the liver. Irregular bumps, (nodules), replace
the smooth liver tissue and the liver becomes harder.
The effect of this, together with continued scarring from
fibrosis, means that the liver will run out of healthy cells
to support normal functions and can lead to complete
liver failure.
7
By the time you discover you have cirrhosis your quality
of life may be severely damaged as your liver will have
stopped working efficiently. If you carry on drinking at
this stage you will speed up the damage to your liver
and rapidly increase your chances of dying.
The odds are 1 in 10 that you will develop cirrhosis if
you drink too much over a long period of time. In the
UK, the number of people dying from cirrhosis each
year is increasing.
As well as all the problems related to the liver not doing
its job, people with cirrhosis also have a much higher
chance of getting liver cancer and each year, a small
percentage of people with cirrhosis will develop liver
cancer.
Can I avoid liver damage?
Everyone reacts to alcohol in different ways so it’s
difficult to tell in advance who is most likely to suffer
liver damage. However, research shows that three
groups may be more at risk than most:
Women, partly because of their smaller body size
and build
People who are overweight
People who inherit genes that don’t allow proper
metabolism of alcohol
8
How much can I drink?
If you are healthy and eat a balanced diet then sensible
drinking should not give you problems. But what is
sensible drinking? The Department of Health currently
offers the following guidelines for sensible drinking:
Women should not regularly drink more than 2 to
3 units of alcohol in a single day (no more than 14
units in a week)
Men should not regularly drink more than 3 to 4
units of alcohol in a single day (no more than 21
units in a week)
After an episode of heavy drinking it is advisable
to stop drinking for 48 hours to allow your body to
recover.
If you have alcoholic liver damage, cutting
down will only reduce the rate of damage
The symptoms of liver damage may disappear when
you cut down the amount you drink, but this does not
mean that damage is not taking place. Cirrhosis can
develop even after drinking just a little too much over
the years, with possibly no early warning signs of
disease.
Treatments are available that will alleviate the
symptoms of cirrhosis but they cannot reverse it.
9
Stop drinking
The most effective way to treat alcoholic liver disease is
to stop drinking. For most people with fatty liver and
alcoholic hepatitis the liver will recover and heal itself if
they stop drinking.
Even if you have cirrhosis, you will reduce any further
damage to your liver and increase your chances of
survival if you stop drinking. If you cannot stop, try
contacting one of the organisations listed at the end of
this leaflet.
Diet
Drinking alcohol can lead to malnutrition. The
consumption of ‘empty’ calories, a loss of appetite and
poor absorption of food nutrients caused by alcohol’s
toxic effect on the gut can all play a part in this. Eating
well is important in helping your liver recover.
If you have alcoholic liver damage, it is likely that you
lack vitamins, in particular thiamine, a ‘B’ vitamin that
helps the body convert carbohydrates into energy. Your
doctor may prescribe vitamin supplements and it is
important that you take them as prescribed.
10
Contacts
Please see list of contacts for further information, advice
or support
The Alcohol Liaison Nurse Service
 01536 491785
Monday to Friday
9am - 5pm
Help with drinking
All services are free and confidential
Substance 2 Solutions (CRI)
 01604 211304
www.cri.org.uk
Rutland and Leicestershire
Swanswell Charity:  0300 303 5000
Drinkline
the national alcohol helpline
available 24hrs/day  0800 917 8282
Reference:
Information from the British Liver Trust
http://www.britishlivertrust.org.uk
11
If you need this information in another format or language,
please telephone 01536 492510.
Further information about the Trust is available on the
following websites:
KGH - www.kgh.nhs.uk | NHS Choices - www.nhs.uk
Ref: PI.170 April 2014
Review: January 2016