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Alcohol and the Liver: Frequently Asked Questions

Alcohol and Liver Disease

Does alcohol cause liver disease?

Yes, but alcohol is only one of the many known causes of liver disease. The risk of developing liver disease depends on how much you drink and over how long a period.

Other known causes of liver disease include:

  • Viruses
  • Hereditary defects
  • Reactions to drugs and chemicals

Scientists are still investigating the causes for the most serious liver diseases.

How much alcohol can I safely drink?

Because some people are much more sensitive to alcohol than others, there is no single right answer that will fit everyone. Generally, doctors recommend not to have more than two drinks per day.

Are there other dangers from alcohol besides how much I drink?

Yes. Even moderate amounts of alcohol can have toxic effects when taken with over-the-counter drugs containing acetaminophen.

If you're taking over-the-counter drugs, be especially careful about drinking and don't use an alcoholic beverage to take your medication.

Ask your doctor about precautions for prescription drugs.

What kinds of liver diseases are caused by too much alcohol?

  • Alcoholic hepatitis is an inflammation of the liver.
  • Cirrhosis involves permanent damage to the liver cells.
  • "Fatty liver" is the earliest stage of alcoholic liver disease. If you stop drinking at this point, the liver can heal itself.

Alcoholic Hepatitis

What is alcoholic hepatitis?

Alcoholic hepatitis is an inflammation of the liver that lasts one to two weeks.It is believed to lead to alcoholic cirrhosis over a period of years.

Symptoms include of alcoholic hepatitis include:

  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain and tenderness
  • Fever
  • Jaundice
  • Mental confusion

Is alcoholic hepatitis different from "fatty liver?"

Yes. Anyone who drinks alcohol heavily, even for a few days, will develop a condition in which liver cells are swollen with fat globules and water. This condition is called "fatty liver."

It also may result from:

  • Diabetes
  • Obesity
  • Certain drugs
  • Severe protein malnutrition

Fatty liver caused by alcohol is reversible when one stops drinking alcohol.

How can alcoholic hepatitis be diagnosed?

Alcoholic hepatitis is not easy to diagnose. While the disease usually comes on after a period of fairly heavy drinking, it may also be seen in people who are moderate drinkers.

Blood tests may help in diagnosis.

Proof is best established by liver biopsy. This involves taking a tiny specimen of liver tissue with a needle and examining it under a microscope. The biopsy is usually done under local anesthesia.

Is alcoholic hepatitis dangerous?

Yes. It may be fatal, especially if you have had previous liver damage.

Those who have had nutritional deficiencies because of heavy drinking may have other ailments. These medical complications may affect almost every system in the body.

It's important to recognize and treat alcoholic hepatitis early, to help prevent these life-threatening consequences.

Are men or women more likely to get alcoholic hepatitis?

Women appear to be more likely to suffer liver damage from alcohol.

Even when a man and woman have the same weight and drink the same amount, the woman generally has a higher concentration of alcohol in the blood because she has relatively more body fat and less water than the man, and her body handles alcohol differently.

Can "social drinkers" get alcoholic hepatitis?

Yes. Alcoholic hepatitis is frequently discovered in alcoholics, but it also occurs in people who are not alcoholics.

People vary greatly in the way their liver reacts to alcohol.

Do all alcoholics get alcoholic hepatitis and eventually cirrhosis?

No. Some alcoholics may suffer seriously from the many physical and psychological symptoms of alcoholism, but escape serious liver damage.

Alcoholic cirrhosis is found among alcoholics about 10 to 25 percent of the time.

Does alcoholic hepatitis always lead to cirrhosis?

No. It usually takes many years for alcoholic hepatitis to produce enough liver damage to result in cirrhosis.

If alcoholic hepatitis is detected and treated early, cirrhosis can be prevented.

How can prevent alcoholic hepatitis?

The best treatment is to stop drinking.

Treatment also may include:

  • Prescribed medication
  • Good nutrition
  • Rest

Your doctor may instruct you to avoid various drugs and chemicals.

Since the liver has considerable ability to heal and regenerate, the prognosis for alcoholic hepatitis is very hopeful — if you totally abstain from drinking alcohol.


Cirrhosis

What causes cirrhosis?

There are many causes of cirrhosis.

Major causes include:

  • Long-term alcohol abuse
  • Chronic hepatitis
  • Hereditary defects in iron or copper metabolism
  • Prolonged exposure to toxins

In children, the most frequent causes are biliary atresia — a disease that damages the bile ducts — and neonatal hepatitis. Children with these diseases often receive liver transplants.

Many adult patients who require liver transplants suffer from primary biliary cirrhosis. We do not yet know what causes this illness, but it is not in any way related to alcohol consumption.

Is cirrhosis different from alcoholic hepatitis?

Yes.

Hepatitis is an inflammation of the liver.

In cirrhosis, normal liver cells are damaged and replaced by scar tissue. This scarring keeps the liver from performing many of its vital functions.


Source: "What Are the Myths vs. Facts About Alcohol and the Liver" from the American Liver Foundation.

Additional information: Alcohol-Related Liver Disease at the American Liver Foundation