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The liver stands as one of the largest organs in the body, weighing 3.3 pounds. It performs many roles, including:
The liver is also responsible for alcohol metabolism. When an individual consumes alcohol, an enzyme called alcohol dehydrogenase (ADH) begins to convert the ethanol in alcohol into acetaldehyde.
Acetaldehyde can be toxic to the body, even in low concentrations.
However, another enzyme called aldehyde dehydrogenase (ALDH) and an antioxidant called glutathione (GSH) convert the chemical compound into non-toxic acetate. Most of the acetate then circulates through the bloodstream to enter other energy- or molecule-producing metabolic cycles.
When alcohol consumption is high, though, the liver cannot break down the substance quickly enough. This inability can lead to a build-up of acetaldehyde in the body and is one of many reasons that people suffer hangover effects after heavy alcohol intake.
In other terms, drinking alcohol in large quantities, whether periodically or chronically can cause liver damage. Extensive and chronic inflammation of the liver can result in three different types of liver disease:
Fatty liver disease and alcoholic hepatitis are reversible. Alcoholic cirrhosis, however, is permanent and usually fatal.
Alcohol use can also worsen medical conditions like the hepatitis C virus (HCV). When mixed, hepatitis C and alcohol may contribute to liver fibrosis (scarring) and/or other health risks.
Hepatitis C is an inflammation of the liver caused by the hepatitis C virus. Unlike hepatitis A and hepatitis B, there is no current preventative vaccine available for the general population. There is treatment available, though.
There are two types of hepatitis C infection:
In 2018, the CDC reported a total of 3,621 cases of acute hepatitis C in the United States. However, because initial infection does not often present with symptoms, many of those with HCV do not seek medical attention. The CDC estimates that the actual number of cases are underreported and reach approximately 50,300.
While alcohol can worsen a hepatitis C virus infection, it will never cause the medical condition itself. If a doctor diagnoses an individual with HCV, the patient will be advised to stop drinking. Continual drinking despite a doctor’s recommendation can further damage liver cells and interact with HCV treatment.
Alcoholic hepatitis refers to inflammation of the liver due to alcohol consumption. While the disease tends to occur in people who drink heavily over an extended period, there is still a risk for those who consume moderate quantities of the beverage. However, not all heavy drinkers will have alcoholic hepatitis.
Common symptoms of alcoholic hepatitis include:
In more severe cases, symptoms may range include:
Those with hepatitis C are at a higher risk of developing alcoholic hepatitis. When left untreated, HCV places the liver under a great deal of stress, and consuming alcohol can further inflammation of the organ. Alcohol can also impair aspects of the body’s immune system, making it difficult for the viral load to decrease.
The combination of hepatitis C and alcohol increases the risk of cirrhosis and consequently, the accelerated development of hepatocellular carcinoma (primary liver cancer). In one study, more than half of alcoholic patients with HCV developed the cancerous disease.
Apart from alcohol consumption and HCV, other risk factors contribute to alcoholic hepatitis. These examples include:
To treat the liver disease, doctors will prescribe antiviral therapy. Hepatitis C treatment comprises 8 to 12 weeks of oral medication (pills). The treatment program is effective, curing more than 90% of cases with minimal side effects.
If individuals decide to drink during treatment, the alcohol may interact with medication and worsen side effects. It is also important to remember that alcohol consumption can accelerate disease progression of hepatitis C and result in permanent liver scarring.
Healthcare professionals recommend not drinking alcohol after treatment. Even if cured of the disease, there may be liver scarring caused by the viral infection. Alcohol may increase that scarring.
Similarly, alcohol use after hepatitis C treatment has been associated with the risk of liver cancer.
If you believe that you or a loved one are suffering from alcohol use, it is recommended to seek out professional medical help. Your healthcare specialist can provide you with a treatment plan that can guide you in your path to recovery.
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“Alcoholic Hepatitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 30 Nov. 2018, www.mayoclinic.org/diseases-conditions/alcoholic-hepatitis/symptoms-causes/syc-20351388.
“Hepatitis C Questions and Answers for the Public.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 July 2020, www.cdc.gov/hepatitis/hcv/cfaq.htm.
Lieber, Charles S. “Alcohol and Hepatitis C.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, pubs.niaaa.nih.gov/publications/arh25-4/245-254.htm.
Mahler, Jacquelyn J. Exploring Alcohol’s Effects on Liver Function. National Institute on Alcohol Abuse and Alcoholism, 1997, pubs.niaaa.nih.gov/publications/arh21-1/05.pdf.
Rizza, Stacey A. “Drinking after Hepatitis C Cure: Is It Safe? .” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Dec. 2019, www.mayoclinic.org/diseases-conditions/hepatitis-c/expert-answers/drinking-after-hepatitis-c-cure/faq-20121675.