The liver is a very important organ of the body and is very necessary for life. It is the largest gland in the body and the second largest organ. The liver receives almost all the blood flow from the digestive tract. Thus when a person drinks alcohol, it is absorbed directly into the bloodstream and the liver receives most of it to break it down and to rid the body of this poison. The normal blood flow into the liver is approximately 1.5 litters per minute.

The liver breaks down toxins absorbed from the intestine or manufactured in the body and modifies them so they are no longer harmful; then it excretes them into bile or blood. It stores vitamins, especially fat-soluble vitamins and synthesizes cholesterol, metabolizes or stores sugars, and processes fats. It assembles amino acids into various proteins and controls blood fluidity and regulates blood-clotting mechanisms. It converts the products of protein metabolism into urea for excretion by the kidneys, which will leave your body as urine. It stores minerals such as iron for red blood cell production.

The connection between heavy alcohol consumption and liver disease has been recognized for more than hundreds of years. Because our liver is so large and has the capacity to regenerate, people can function with only 10-20% of their liver. The symptoms of liver disease will not be prevalent until we have progressed substantially into the disease. Liver disorder symptoms may remain latent until damage is really detrimental. Many of heavy drinkers develop alcoholic hepatitis and cirrhosis. There are other risk factors which also play a role in the development of alcohol-related liver complications. These risk factors are related to gender, heredity, diet, etc.

Three conditions of the liver disorder are often associated with alcohol abuse. Liver disease in alcoholics usually progresses through the three conditions chronologically starting with fatty liver and proceeding to alcoholic hepatitis which can eventually lead to cirrhosis.

Fatty Liver relates to fat deposits in the liver. To some extent, fat deposits will happen in almost all heavy drinkers. It can also happen in non-alcoholics after just one incidence of drinking. People with fatty liver may have no symptoms and have just an abnormal enlargement of the liver that is smooth and non-tender with minimal or no functional changes. However, alcoholics may have abdominal pain, severe jaundice syndrome, acute liver failure, ascites (abnormal accumulation of fluid causing an abnormal swelling in the abdomen). Chances of recovery are better at this stage than with cirrhosis. Damage is reversible and does not necessarily lead to more serious damage.

Alcoholic Hepatitis leads to widespread inflammation and destruction of liver tissue. Patients may develop fibrosis, where scar tissue begins to replace healthy liver tissue. Patients might start having fever, jaundice, and abdominal pain. The outcome of alcoholic hepatitis may be fatal but also may be reversed by abstaining from alcohol and with proper treatment.

Alcoholic cirrhosis is the most advanced form of liver disease. The early symptoms are general weakness, weight loss and the later symptoms are loss of appetite, indigestion, nausea, vomiting, abdominal swelling. Due to alcoholic cirrhosis functions of the liver may be impaired which may lead to malfunction of other organs such as the brain and kidneys. The outcome of alcoholic cirrhosis is usually fatal due to complications such as kidney failure, and hypertension (high blood pressure) in the vein carrying blood to the liver. This disease is usually fatal if chronic alcohol exposure continues; however, if the patient quits drinking, and undergoes proper treatment their condition may become stable. The alcoholic will progress from fatty liver to alcoholic hepatitis, to cirrhosis.

Sometimes heavy drinkers may develop alcoholic cirrhosis without first developing alcoholic hepatitis, and it could also happen that an alcoholic may have a sudden onset and rapid course of alcoholic hepatitis; then die before cirrhosis develops.

Not all liver disease in alcoholics is caused by alcohol. Also, alcohol induced liver disease may be accompanied by other conditions not related to alcohol but which can cause liver failure, such as non-alcoholic hepatitis and exposure to drugs and occupational chemicals. Furthermore, it is important to remember that fatty liver and alcoholic hepatitis may be reversed if we stop drinking alcohol, and cirrhosis can be stabilized if we stop drinking alcohol.

Metabolism of Alcohol in the Liver
Most of alcohol that people drink is metabolized in the liver. Alcohol DeHydrogenase (ADH) is the enzyme that converts alcohol to acetaldehyde through a chemical process called oxidation. The chemical, acetaldehyde, which is generated, is more toxic than alcohol itself. ADH converts acetaldehyde to acetate, which can be used as fuel by the cell. Acetate travels through the bloodstream to other parts of the body where it can enter other metabolic cycles that produce energy or useful molecules. The usual biological role of both ADH and ALDH is to metabolize vitamin A. Studies have shown that women, Asians, Native Americans, and older people have less of the enzyme alcohol dehydrogenase; thus they are not able to metabolize alcohol as efficiently as those who have more of this enzyme possibly making them get drunk faster and experience liver complications sooner. In people who engage in heavier and more chronic alcohol consumption, a second pathway is utilized with the enzyme called microsomal ethanol-oxidizing system (MEOS). MEOS helps get rid of toxic compound in the body by using an enzyme called cytochrome P450. This enzyme converts alcohol to acetaldehyde. Cytochrome P450 is thought to help eliminate alcohol at high blood alcohol concentrations that prevail in heavy drinkers. Cytochrome P450 also generates reactive oxygen radicals that damage cellular components. Chronic alcohol consumption can substantially increase iron levels in the body. In fact almost one third of alcoholics have excessive iron levels in their livers much of which is free iron; thus these elevated levels may damage liver. Some acetaldehyde may combine with liver proteins to form harmful compounds that can impair the function of various cellular components and enzymes. Also alcohol can combine with other molecules in the cell to form potentially dangerous compounds such as fatty acid ethyl esters and phosphatidylethanol.

• ← Taraxacum officinale – A herb effective in the treatment of cirrhosis, jaundice and other liver disorders
• World Hepatitis Day 2013: This is hepatitis. Know it. Confront it. →