Liver Disease And Alcohol 

What is liver disease?

Liver disease refers to any condition affecting the liver. The liver is a vital organ that regulates and performs more than 500 functions. Some of the main functions include producing bile and cholesterol, converting glucose into glycogen, and processing alcohol. 

Liver disease affects the ability of the liver to perform its function. It is a significant health challenge worldwide and includes fatty liver, liver fibrosis, cirrhosis, non-alcoholic liver disease, alcoholic liver disease, viral hepatitis, and hepatocellular carcinoma. 

Some of these conditions are reversible, like fatty liver, but can increase the likelihood of developing into fibrosis of the liver which can develop into irreversible fibrosis of the liver (cirrhosis). 

Over time these conditions can lead to liver cancers or liver failure (loss of liver function). Furthermore, some conditions like non-alcoholic liver disease and alcoholic liver disease are a spectrum of disorders with fatty liver at one end and cirrhosis at the other. 

What are the symptoms of liver disease?

Most liver diseases are asymptomatic, but the most common sign is jaundice, which is the yellowing of the whites of the eyes and skin. This happens because of the decreased ability of the liver to remove bilirubin (a compound produced from the breakdown of red blood cells). Other symptoms include abdominal pain, nausea or vomiting, bruising easily, fatigue, and swelling of limbs. 

Alcohol is the main risk factor for liver disease

Many factors influence the prevalence of alcoholic liver disease, including genetic and environmental factors, making this disease difficult to define. However, the risk of liver disease increases with the amount and duration of alcohol consumed. Excessive alcohol consumption alone is not enough to promote alcoholic liver disease. Only one in every five heavy drinkers develop alcoholic hepatitis, and one in every four develops cirrhosis.

Because the liver is the centre of alcohol metabolism, liver function is directly impacted by excess alcohol consumption. Excess alcohol is directly converted to fat, which can build up in the liver, causing fatty liver. 

Product of the first step of alcohol metabolism is toxic to liver cells

Acetaldehyde, a major toxic metabolite, is one of the principal culprits mediating fibrosis and causes changes in DHA structure or material. It is a known carcinogen which damages liver cells. Acetaldehyde binds to the DHA, leading to functional impairments of key proteins, including enzymes, and DNA damage, promoting mutagenesis.

Continuous presence of alcohol leads to irreversible liver damage

With continued drinking, alcoholic liver disease can proceed to liver inflammation, fibrosis, cirrhosis, and even hepatocellular carcinoma.

Types of alcoholic liver disease

Alcoholic fatty liver disease is a spectrum of conditions ranging from simple steatosis to acute alcoholic hepatitis and cirrhosis.

Alcoholic hepatitis occurs when active alcohol abuse-induced liver injury results in inflammation. It causes liver cells to die, which is frequently followed by permanent scarring.

 Alcoholic cirrhosis is liver scarring (fibrosis) caused by long-term liver damage.

If you’re worried about your or your loved one’s alcohol intake

Signs to look for

Here are some warning signs to look for:

  • A lack of interest in regular activities, preferring to drink on any occasion
  • Appearing drunker more frequently, or the need to drink more to achieve the same effect
  • Feeling tired, ill, or irritable
  • Unable to say no to alcohol or limit consumption to one or two drinks
  • Feeling anxious, depressed, or having difficulty sleeping
  • Being secretive or dishonest about their alcohol consumption

What to do

A primary care physician is a good place to start. Try to be as accurate and honest as possible about how much you drink and any problems it may cause you.

The national alcohol helpline is called Drinkline. You are welcome to phone this free helpline in complete confidentiality if you have concerns about your own or another person's drinking. Call 0300 123 1110 (weekdays 9 am to 8 pm, weekends 11 am to 4 pm) (weekdays 9 am to 8 pm, weekends 11 am to 4 pm).


The best strategy to avoid alcoholic liver disease is to quit drinking alcohol or consume it within advised limits:

If you drink up to 14 units a week and wish to cut back, attempt to have a few drink-free days each week. Men and women are advised not to consume more than 14 units of alcohol each week habitually.

A pub measure (25ml) of spirits or almost half a pint of regular-strength beer constitutes one unit of alcohol.

Even if you've been a heavy drinker for a long time, cutting back on or quitting alcohol will have significant short- and long-term advantages for your liver and general health.


Not all heavy drinkers develop alcoholic liver damage. The more alcohol you drink and the longer you drink, the greater your risk of developing liver damage.


  1. Rasineni K, Casey CA. Molecular mechanism of alcoholic fatty liver. Indian J Pharmacol. 2012;44(3):299-303. doi:10.4103/0253-7613.96297
  2. Setshedi, M., Wands, J. R., & Monte, S. M. (2010). Acetaldehyde adducts in alcoholic liver disease. Oxidative medicine and cellular longevity, 3(3), 178–185.

Misha Siddiqui

Master's degree, Integrated immunology, University of Oxford, England

2nd year PhD candidate at institute of cancer research and AstraZeneca applying deep learning to understanding immunometabolism using multi-omics. I have a masters in integrated immunology from the university of oxford and undergraduate in applied medical sciences from UCL. presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
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