In the UK, alcohol is the leading cause of liver disease. There is a common myth that only ‘alcoholics’ develop alcohol-related liver disease, but even regularly drinking above the guideline amounts can put you at risk. Around 1 in 4 of us drink alcohol in a way that could harm our liver health.
While the liver has the amazing ability to repair itself, just like an elastic band, it can only take so much damage from regularly drinking too much alcohol. In the process of alcohol being broken-down by the liver, harmful chemicals are released that can damage your liver cells. This causes the scarring (fibrosis) which if not treated in time leads to cirrhosis.
In the early stages of alcohol-related liver disease there are often no symptoms, and when they do appear it may not seem immediately concerning, for example, a person may feel more tired or lose their appetite. Unfortunately, this means in many cases, the disease may go undiagnosed until a later stage when significant damage has already been done and treatment is more difficult.
How does alcohol affect the liver?
When you drink, your liver is the first organ to process alcohol and the first to be susceptible to the effects of drinking. There are three stages of alcohol-related liver disease.
Initially, excessive drinking leads to a build of fat in the liver, this is called alcohol-related fatty liver. Your liver works hard to break down alcohol, but some of the by-products are toxic and damaging to the liver. At this stage, the damage is often reversible if you stop drinking alcohol.
The next stage is alcohol-related hepatitis. If the damage caused by drinking continues, the liver becomes inflamed and will start to produce scar tissue as it tries to heal itself. This is called fibrosis, and as it gets worse, it creates knots and tangles (cross-links) in the scar tissue that are more difficult to reverse.
If fibrosis goes unnoticed and untreated for years, it can eventually lead to cirrhosis. This is the most serious stage of liver disease and is often irreversible. The build up of scar tissue makes the liver hard and stops it from working properly. Although it is rare to be able to repair a liver with cirrhosis, it is possible to stop the damage getting worse.
It’s really important that you are referred to a liver specialist if you have one of the more serious forms of liver damage. These conditions are more difficult to treat and need specialist care.
How much should I drink?
The best way to reduce the risk of alcohol-related liver disease is to stop drinking or stick within the low-risk drinking guidelines, by drinking no more than 4 units of alcohol, and taking 3 consecutive days off in a week.
| Wine (all types). Sparkling wine tends to be less strong. | ||
| 750ml bottle | 13% ABV | 10 units |
| 175ml glass | 13% ABV | 2.5 units |
| 125ml glass | 12% ABV | 1.5 units |
| Beer, ale, lager and cider. Watch out for high strength drinks, try a smaller serving – some pubs offer one- and two-third servings as well as pints and halves. | ||
| 1 pint | 4% ABV | 2.5 units |
| 1 pint | 5% ABV | 3 units |
| Half pint | 7% ABV | 2 units |
| 1 pint | 7% ABV | 4 units |
| Spirits (with or without a mixer). In England and Wales, a single is always 25ml. But in Scotland and Northern Ireland it can be 25ml or 35ml. | ||
| 25ml single measure | 40% ABV | 1 unit |
| 35ml single measure | 40% ABV | 1.5 units |
| Alcopops, ready-to-drink and pre-mixed drinks. | ||
| 250ml bottle or can | 4% ABV | 1 unit |
Depending on the strength of the alcohol. Some beer and wine will have more units of alcohol.
If you want to change your drinking and cut down, you’re not alone. Download our handy guide with information and tips to help you make a change and love your liver.
What happens when you give up alcohol?
Because the liver is able to regenerate itself, giving up or cutting down on alcohol can help your liver heal itself and start functioning properly again.
In people with fatty liver, this regeneration can be as quick as two to three weeks after giving up alcohol. For people with liver inflammation or mild scarring, its possible to see significant reductions in liver fat, inflammation and scarring in just seven days of giving up drinking. If you stop drinking for several months, its possible to allow the liver to fully heal its damaged cells.
For heavy drinkers who have more serious scarring or liver failure, abstaining from alcohol for several years can slow down their chances of worsening liver failure and even death. However, people who drink heavily can be physically dependent on alcohol, and should always seek medical advice on how to safely give up alcohol.
Giving up alcohol not only helps your liver but has great benefits for the rest of your body such as your blood pressure, brain function and sleep. It’s important to note that giving up alcohol is not a magic cure and adopting an overall healthy lifestyle, including a balanced diet and regular physical exercise, is the best way to keep your liver and body healthy.
Getting help
It’s very common to find it hard to cut down on drinking alcohol, but it’s a crucial step to keeping your liver and body healthy. There’s no need to feel ashamed or embarrassed about your drinking, if you need support, you could:
Speak to your GP
If you are worried about alcohol and your liver health, please speak to your GP to be assessed thoroughly. Your GP will ask you questions about your alcohol intake and consider if any tests are required, for example a blood test. You can read more about how liver conditions are diagnosed. Finding liver disease early can make a big difference.
Your GP can put you in touch with your local alcohol services who can help you understand your drinking and how to cut down or stop – whichever is best for you. Find out more about what alcohol care teams do in our blog.
Call Drinkline.
A national alcohol helpline. Calls are free and completely confidential. Call 0300 123 1110 (weekdays 9am-8pm and weekends 11am-4pm).
Contact Alcoholics Anonymous.
They offer support to stop drinking throughout the UK. Call free on 0800 9177 650 or visit www.alcoholics-anonymous.org.uk.
Contact Smart Recovery.
A charity that promotes addiction recovery through meetings and online resources, including online meetings. Visit www.smartrecovery.org.uk
