Boost Liver Health: 6 Essential Tips to Reduce Alcohol-Related Liver Disease Risk

The Rising Burden Of Alcohol-Related Liver Diseases

In the current socio-cultural environment, excessive intake of alcohol is a common but preventable cause of steatosis (fatty liver), hepatitis, end-stage liver disease, liver failure and liver cancer. Data suggests that drinking patterns are becoming more harmful, and these harmful drinking behaviors are starting earlier in life in many parts of the world, including India. According to one report, alcohol per capita consumption (APC) in the adult population was seen to increase from 2.4 lt in 2005 to 5.7lt in 2016. Earlier, the age of drinking and heavy drinking patterns lead to higher exposure of the liver to the harmful effects of alcohol.

The dual epidemic of Metabolic Syndrome and harmful alcohol use

There is a general perception that patients who drink less than the prescribed limit are not at an increased risk of liver disease. However, with the epidemic of obesity and metabolic dysfunction associated with fatty liver disease (MASLD), almost a third of the general population in our country (and maybe more) in the urban areas have fatty liver; even lower amounts of alcohol consumption can cause serious liver damage. For example, in healthy individuals, 60-80 gm of alcohol consumed over 5 years can cause cirrhosis or liver failure. But, in obese individuals or individuals with diabetes who also have fatty liver, as little as 20-30 gm of alcohol can significantly damage the liver. This entity of fatty liver, along with moderate alcohol-induced liver damage, is called MET-ALD, which also means "liver damage that occurs as a result of a combination of metabolic risk factor(s) along with alcohol intake". So, there is no safe limit for alcohol intake in the presence of an underlying bad liver.

It is never too late to stop drinking.

Recovery from liver damage is possible at all stages of alcoholic liver disease, provided that drinking is stopped immediately and absolutely. As soon as a person stops drinking, the regenerative mechanisms in the liver begin healing the liver. In the initial stages of liver damage, complete recovery of liver function and structure is possible. Even in advanced stages, such as the stage of cirrhosis, quitting alcohol can halt or at least slow down the progression of the disease and reduce the risk of severe complications to a large extent.

Even low-concentration alcoholic beverages are harmful in the presence of liver disease. 

It is a myth that patients with alcoholic liver damage, who had earlier been drinking whiskey, can now drink beverages like beer or wine since they contain lower concentrations of alcohol. Once the patient has significant liver damage, then any form and amount of alcoholic beverage is harmful.

There is hope even for patients with advanced liver disease and liver failure.

Some forms of liver failure are also reversible just by stopping alcohol exposure and supportive treatment. Even patients who do not respond to abstinence and aggressive treatment can be salvaged by liver transplantation. But, like it is said for all diseases, 'prevention is better than cure", is especially true for alcoholic liver disease. It is even more cost-effective.

Sometimes, the disease is: 'Not being able to give up drinking.'

As I have mentioned in the previous section, recovery from liver damage is possible by quitting alcohol. But unfortunately, after recovery, many patients go back to their harmful drinking patterns. This cycle of 'liver damage > quitting alcohol > recovery > harmful drinking > liver damage' is repeated multiple times in some patients. However, recovery cannot be guaranteed every time. Therefore, it is strongly recommended that such patients should simultaneously seek advice from a psychologist or a psychiatrist, who can guide them through their period of abstinence.

In the end, it should be kept in mind that any amount of alcohol is bad for health, as even  small amounts may be associated with an increased risk of certain cancers. If you do drink socially, and especially if you also have metabolic risk factors such as diabetes, obesity or dyslipidemia, then you are at risk of liver damage. If you want to know about your liver health, meet your hepatologist and get your liver function tests and Fibroscan done.