6.0 alcoholism and liver disease

alcoholism/ alcohol use disorder

condition where a person is unable to control their drinking despite negative consequences

excessive alcohol consumption over time can cause serious damage to the liver leading to alcohol related liver disease ARLD

the liver plays a key role in filtering toxins, including alcohol from the blood

chronic alcohol use can overwhelm and damage the liver leading to conditions like

• fatty liver

• alcoholic hepatitis

• cirrhosis

in early stages liver damage may be reversible if alcohol intake is reduced or stopped

prolonged alcohol abuse can lead to irreversible damage causing liver failure and increasing the risk of liver cancer

when alcohol is consumed

the liver breaks it down using enzymes, primarily:

• alcohol dehydrogenase ADH

• cytochrome P450 CYP2E1

these enzymes convert alcohol → acetaldehyde (toxic)

a toxic substance which is further broken down → acetate + water + CO₂

chronic alcohol consumption overwhelms these metabolic pathways

leading to a build up of acetaldehyde and oxidative stress which damages the liver cells

key stages of liver disease from alcoholism

1. fatty liver steatosis

2. alcoholic hepatitis

3. cirrhosis

4. complications+ liver failure

1. fatty liver steatosis, appears in the early stages of alcoholism

fat begins to accumulate in liver cells because the liver prioritises alcohol metabolism over fat metabolism

fatty liver is reversible

if alcohol consumption is stopped

2. alcoholic hepatitis, continued alcohol use

causes inflammation and damage to liver cells

alcoholic hepatitis involves the immune responses and oxidative stress that worse liver injury

symptoms may include:

• jaundice

• fever

• and liver pain

• though it can also be asymptomatic

3. cirrhosis

chronic inflammation causes fibrosis, scarring of the liver tissue

in cirrhosis healthy liver tissue is replaced with scar tissue which impairs liver function

the liver becomes less able to filter toxins/ produce important proteins and manage blood clotting

cirrhosis is often irriversible

and can lead to liver failure

4. complications and liver failure, liver function declines significantly to complication like

• portal hypertension, increases blood pressure in the livers blood vessels

• ascites, fluid build up in the abdomen

• hepatic encephalopathy, confusion caused by toxin build up in the brain

• increased risk of liver cancer

alcohols affects on liver function

• detoxification

• fat metabolism

• protein production 

detoxification

the livers main role is detoxing the blood but with chronic alcohol consumption it struggles to clear toxins leading to systematic effects

fat metabolism

alcohol inhibits the livers ability to break down fats resulting in fat accumulation, steatosis

protein production

damage from alcoholism reduces the livers ability to produce essential proteins like those involved in blood clotting leading to easy bruising and albumin leading ascites