Why Does My Liver Hurt After Drinking Alcohol?

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The liver is an organ that handles a variety of tasks in the body, including processing fats and proteins, storing glycogen, and facilitating the removal of toxins from the body. This includes alcohol.

Liver inside human body

The stomach and intestines absorb alcohol before traveling to the liver. In the liver it is metabolized and broken into various chemicals before being flushed from the body via the lungs and urinary tract. 

Most people’s livers can handle a moderate amount of alcohol, but if you consume too much it puts a heavy load on the organ and creates harmful enzymes. Do this often enough and it will cause liver damage. Liver damage from drinking too much alcohol is one of the most common causes of liver pain. 

Potential Causes of Sore Liver After Drinking

There are several reasons your liver might hurt after drinking alcohol. For example:

1. Excessive Alcohol Consumption

Binge drinking strains the liver. Over time, alcohol abuse leads to damage and makes it painful for the liver to process alcohol.

2. Hepatitis

Hepatitis is a condition that causes liver inflammation. Most people develop hepatitis from a viral infection, but it is also caused by autoimmune problems and exposure to certain medications or toxins, including alcohol.

There are five strains of hepatitis (A, B, C, D, and E), each caused by a different virus. Hepatitis A and E are acute and hepatitis B, hepatitis C, and hepatitis D are all chronic.

3. Liver Damage

Liver damage is a term that includes a variety of issues that might arise with the liver. Damaged livers are unable to perform their designated functions. In most cases, early symptoms of mild liver damage is unnoticeable, but when the liver is more than 75 percent damaged there will be a decrease in function.

4. Alcohol Liver Disease (AKA Alcohol-related Liver Disease, Alcohol Hepatitis, Alcoholic Cirrhosis, or Alcoholic Fibrosis)

Many cases of liver damage are linked to alcohol consumption. Estimates show about 10 to 15 percent of Americans who drink heavily will develop alcohol liver disease. It is a progressive condition that arises after years of heavy drinking and eventually leads to cirrhosis of the liver.

Woman staring at glass of alcohol

5. Fatty Liver Disease

Fatty Liver Disease is one of the earliest stages of alcohol-related liver disease. It occurs when fat builds up in liver cells. In its earliest stages, it causes only mild to moderate pain.

6. Non-alcoholic Fatty Liver Disease

Excessive alcohol consumption isn’t the only cause of fatty liver disease. Non-alcoholic fatty liver disease (NAFLD) is a term that covers a range of problems with fat in the liver that is not linked to drinking alcohol. The disease affects about 30 percent of adults in developed countries and most of those affected are diabetic and/or obese.

In its earliest stages, NAFLD is reversible. Left untreated, it will eventually lead to liver inflammation or steatohepatitis. Over time, this causes cirrhosis (liver scarring) and negatively affects liver function.

NAFLD symptoms are mild and usually include fatigue and pain or discomfort in the upper right abdomen. As it progresses, symptoms include:

  • Abdominal swelling
  • Enlarged spleen
  • Enlarged blood vessels near the skin’s surface
  • Jaundice
  • Red palms

Nobody is sure exactly what causes NAFLD, but medical experts believe it is linked to a combination of:

  • Obesity
  • Insulin resistance
  • High blood sugar
  • High levels of fat in the blood

7. Reye’s Syndrome

This is a rare but serious condition that causes liver and brain swelling. It most often affects children and teens recovering from chickenpox or the flu. People with a metabolic disorder are most at risk, especially if they take aspirin. Reye’s syndrome is potentially fatal if not treated quickly.

8. Cirrhosis

Cirrhosis is the final stage of liver disease and occurs when scar tissue replaces healthy liver tissue. This negatively impacts liver function. Studies show that approximately 10 percent of heavy drinkers are at risk for cirrhosis. Pain tends to be moderate to severe at this stage and increases after someone consumes alcohol.

Cirrhosis can also cause bleeding of the esophagus, ascites (buildup of fluid in the abdomen) kidney failure.

9. Hemochromatosis

Hemochromatosis when the body absorbs too much iron from food. It can be life-threatening.

10. Liver Cancer

Long-term alcohol use is linked to an elevated risk of liver cancer. An excessive amount of alcohol damages the liver. Over time, the liver becomes inflamed and eventually there is scarring. The more damaged someone’s liver, the greater risk there is of cancer developing.

There is also evidence that long-term use of excessive amounts of alcohol also increases a person’s risk of colon and rectal cancer: 

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Liver Pain and Alcoholic Liver Disease

Excessive alcohol consumption contributes to three types of liver disease that occur in stages:

  1. The first is fatty liver disease, which develops when fat buildup occurs in liver cells.
  2. This progresses to Alcoholic Hepatitis, which is inflammation of the liver.
  3. Eventually, inflammation leads to permanent scarring of the liver or alcohol-related cirrhosis, which causes liver function to break down.

Symptoms of Alcohol-Related Liver Disease

Alcohol Liver Disease occurs in stages, beginning with fatty liver, progressing to mild and then acute alcoholic hepatitis, and eventually developing into cirrhosis. Pain occurs at all stages, though it’s typically mild and occasional at the earliest stages of fatty liver disease.

liver pain

As damage progresses, you’ll likely experience symptoms including:

  • Nausea
  • Vomiting
  • Intensifying pain
  • Jaundice

At the point of cirrhosis, you can experience:

  • High blood pressure (portal hypertension)
  • Liver scarring
  • Kidney failure
  • Esophageal bleeding
  • Cancer

When to See a Doctor for Liver Pain

Liver damage can lead to serious complications, including death. However, most liver diseases can be treated effectively with medical care and lifestyle changes.

Doctor Consultation

You should seek medical treatment if:

  • Your stool and urine appear darker
  • Your eyes or skin are changing color
  • Your appetite is reduced or you feel full after only a few bites
  • You feel pain in the upper right side of your abdomen
  • Your right shoulder hurts

Treatment For Liver Pain 

The best way to treat liver pain after drinking is to avoid alcohol. Early-stage alcohol-related liver disease reverses when you abstain.

Even if you stop drinking alcohol, it’s still important to seek a medical evaluation if you’ve experienced liver pain. Your doctor will assess your liver health, possibly via a liver function test (blood test) or liver biopsy, and rule out non-alcohol-related causes of the pain.

Treatments options vary based on the cause of liver pain and include:

Lifestyle and Diet Changes

Incorporating exercise and adding healthy foods such as fruits and vegetables into your diet improves liver pain. The addition of high fiber foods and the reduction of sugar, salt, refined carbohydrates, and trans fats also helps. And of course, curbing alcohol consumption is the best lifestyle change to make.

Home Remedies

Some home remedies for treating liver pain include:

  • Papaya juice
  • Bland foods
  • Buttermilk
  • Dark chocolate
  • Carrot juice

Medications

Your doctor might prescribe medication to help with liver pain after drinking. The most common medication offered is an antibiotic used to treat abdominal infections called Flagyl or Metronidazole.

Liver Transplant or Surgery

Liver transplants and liver surgery are used only in extreme cases of liver disease and cancer and for those experiencing complete liver failure.

Alcohol & Liver Disease Statistics

20

Percent

Of heavy drinkers will develop steatosis (fatty liver).

10-15

Percent

Of alcoholics will develop cirrhosis (advanced liver disease).

90

Percent

Of people survive cirrhosis if they quit drinking. Only 70 percent of those that don't quit survive.

Liver Pain FAQs

What are the first signs of liver damage from alcohol?

Early symptoms of liver damage from alcohol include abdominal pain, nausea, vomiting, fever, and jaundice (yellowing of the skin).

What are signs that your liver is not functioning properly?

Symptoms of liver failure include fatigue, nausea, blood in thee stool, loss of appetite, abdominal pain, fluid buildup in the abdomen, arms and legs, disorientation, jaundice, and vomiting blood.

What helps liver pain after drinking?

If you wake up with liver pain after a night of drinking, drink plenty of water as soon as you can. Avoid heavy, fatty foods for a few days and sit up straight to alleviate pressure on the liver. If the problem persists for a full day, contact a healthcare professional.

Why does my right side hurt after drinking alcohol?

If your right side hurts after a night of drinking it could be a sign of liver damage. If the pain doesn't go away after a few hours, you should contact your doctor.

Will liver pain go away?

Sometimes liver pain will go away if you make certain lifestyle changes such as change of diet, abstinence from alcohol, and weight loss. Other liver problems could require medication or surgery.

What does pain in the liver feel like?

Pain in the liver can manifest as pain in the right side of your abdomen. It also can occur in the front center of your belly, back, or shoulders. It can sometimes be confused with stomach pain.

Do I Have a Drinking Problem?

If you're wondering if you have a drinking problem, this self-assessment can help you. These questions are used by doctors and are taken from the DSM-V. However, self-assessments are not an adequate substitute for professional assessment.

  1. In the last year have you continued to drink more than you meant to? (Larger amounts of alcohol or over a longer period of time?)
  2. In the last year have you found it difficult to limit your excessive drinking?
  3. In the last year have you spent a lot of time obtaining, drinking, or recovering from alcohol?
  4. In the last year have you felt cravings or strong urges to drink?
  5. In the last year have you found yourself letting obligations and responsibilities like work, school, and relationships with friends and family fall to the wayside?
  6. In the last year have you continued to consume alcohol despite alcohol-induced social or interpersonal issues caused by alcohol?
  7. In the last year have you stopped or slowed down attending important social, work, or recreational activities due to alcohol use?
  8. In the last year have you continued to use alcohol in situations that can cause you physical harm?
  9. In the last year have you continued to use alcohol despite knowing it is harming you physically, psychologically, or socially?
  10. In the last year have you developed a high tolerance for alcohol that requires you to drink more and more to achieve the same effect?
  11. In the last year have you experienced any alcohol withdrawal symptoms, such as nausea, irritability, or tremors (delirium tremens)?

According to the DSM-5, alcohol use disorders are classified as mild, moderate, and severe. If you answered "yes" to

  • 2 to 3 questions, you may have a mild alcohol use disorder
  • 4 to 5 questions, you may have a moderate alcohol use disorder
  • 6 or more questions, you may have a severe alcohol use disorder

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Resources +

Harvard Health Publishing. “Is Your Liver at Risk?” Harvard Health, www.health.harvard.edu/diseases-and-conditions/is-your-liver-at-risk. Accessed 17 Aug. 2020.

Harvard Health Publishing. “Abundance of Fructose Not Good for the Liver, Heart - Harvard Health.” Harvard Health, Harvard Health, Sept. 2011, www.health.harvard.edu/heart-health/abundance-of-fructose-not-good-for-the-liver-heart.

“Alcohol Related Liver Disease And Alcohol Damage - ALF.” American Liver Foundation, 2019, liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/alcohol-related-liver-disease/.

“Hemochromatosis - Symptoms and Causes.” Mayo Clinic, 2018, www.mayoclinic.org/diseases-conditions/hemochromatosis/symptoms-causes/syc-20351443.

Mann, Robert E., et al. “The Epidemiology of Alcoholic Liver Disease.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 2003, pubs.niaaa.nih.gov/publications/arh27-3/209-219.htm.

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