Health: Alcoholic Liver Disease

Some persons consider drinking as only a means of enjoyment. Each evening is festive for them, when they sit with their bottles, oblivious to the world. Little do these confirmed alcohol lovers realize that they are injuring their liver, a vital organ of the body, on a regular basis. Three forms of liver disease occur due to damage caused by alcohol, through its metabolism in the liver. Although, ingestion of about 160g/day of alcohol for more than 5 to 10 years is said to cause chronic liver disease, individuals vary in their susceptibility. Women are more susceptible than men and can develop chronic liver disease by consumption of lesser quantity and in a smaller duration of time. In fact the 3 types of liver disease are different manifestations of the same disease that is caused due to damage to the liver by alcohol. Manifestations vary according to the degree of damage and ongoing consumption of alcohol. Fatty infiltration of liver cells, so called fatty liver is the first stage. This is the time when damage to liver cells has already begun to manifest. There may be no symptoms. At times, there may be pain on the right hand side of the stomach, some nausea, vomiting and loss of appetite. This is the stage when changes are totally irreversible. If one stops drinking alcohol at this stage, one can regain good health. But if he continues to enjoy drinking, further damage to liver cells will occur thus damaging the liver more. This will result in the stage clinically known as, “alcoholic hepatitis.” There is nausea, vomiting, loss of appetite, jaundice and enlargement of liver. This stage is not irreversible totally. But still if the person affected stops drinking, some beneficial results will be seen. At least part of the liver can be salvaged, so that it continues to carry out its vital functions to the body. Otherwise the damaged liver tissue will shrink and collapse leading to cirrhosis of the liver, which is the third and final stage of liver damage by alcohol. This then becomes the point of no return. As liver gets badly damaged, so are its functions deranged. This causes deficiency of proteins, particularly albumin in the body, because it is produced in the liver. This and other factors cause salt and water to accumulate in the body leading to swelling of legs and abdomen and then the whole body. The affected person gets breathless on walking even short distances and also finds it difficult to lie down and sleep. Ability of the body to clot following some injury is impaired as manufacture of clotting factors is affected. This leads to excess bleeding from any site in the body like the nose, mouth, e.t.c. There is also disturbance of hormones which are produced or metabolized in life. This can cause enlargement of breasts in men (Gynecomazia). There is also altered metabolism of drugs taken since most of it is done in the liver. Accumulation of drugs in the system may lead to toxic levels while sometimes drug levels may remain too low to have their desired effect. This becomes more important in case of drugs taken for chronic diseases like T.B. or heart problems, because then it becomes difficult to obtain a cure with the drugs. Liver damage caused by alcohol is further compounded by any infection of the liver like hepatitis. Drugs like paracetamol, erythromycin, e.t.c. can also cause liver damage and aggravate the injury caused by alcohol to liver cells. Once the liver function gets deranged, it continues going downhill. Gradually the kidney function also gets disturbed. A person may go into coma due to accumulation of toxic metabolic products in the body which affect the brain. Death is the final end point. But when it will come, remains unpredictable. Some people pass months to years in that state. They suffer physically, while the families suffer mentally and financially. Because, it becomes an endless cycle of hospital visits, tests, treatment, home and again hospital for the sick persons. There is no treatment available to cure alcoholic liver disease, once it develops. What is used is only for palliation, i.e. to provide relief in symptoms. Liver transplant is done in some highly specialized centres in the world. But that is a very complicated matter. With great difficulty a suitable donor can be found. Also putting in another liver taken from another person, most likely who has recently died entails many complications requiring life long vigilance and medication. Therefore, for the majority of the people it is not practical and is still a faraway dream. Is it not better to guard and keep our liver healthy and save it from being damaged by alcohol? All that is needed is a strong will to stop drinking alcohol, before it starts damaging your liver. Avoid alcohol now, so that you have no regrets later. The author is a specialist in Internal MedicineE-mail – rachna212002@yahoo.co.uk