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Causes
By Mayo Clinic staff
The liver is your body's workhorse. It performs hundreds of vital functions, including processing most nutrients, producing bile and substances that help your blood clot, and removing drugs, alcohol and other harmful substances from your bloodstream. Although the liver has a great capacity for regeneration, constant exposure to toxins can cause serious — and sometimes irreversible — damage.
Just how alcohol damages the liver — and why it does so only in a minority of heavy drinkers — isn't entirely clear, although a number of hypotheses exist. What is known is that the process of breaking down ethanol — the alcohol in beer, wine and liquor — produces highly toxic chemicals such as acetaldehyde. These chemicals trigger inflammation that destroys liver cells. In time, web-like scars and small knots of tissue replace healthy liver tissue, interfering with the liver's ability to function. This irreversible scarring, called cirrhosis, is the final stage of alcoholic liver disease.
Risk increases with time, amount consumed
Heavy alcohol use can lead to liver disease, and the risk increases with the length of time and amount of alcohol you drink. But because many people who drink heavily or binge drink never develop alcoholic hepatitis or cirrhosis, it's likely that factors other than alcohol play a role:
- Genetic factors. Having mutations in certain genes that affect alcohol metabolism may increase your risk of alcoholic liver disease as well as of alcohol-associated cancers.
- Other types of hepatitis. Long-term alcohol abuse worsens the liver damage caused by other types of hepatitis, especially hepatitis C. If you have hepatitis C and also drink — even moderately — you're more likely to develop cirrhosis than if you don't drink.
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Other diseases. People who drink alcohol are more likely to develop alcoholic hepatitis if they also have another disease that affects the liver, such as iron overload (hemochromatosis) — a disorder in which the body stores too much iron.
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Malnutrition. Many people who drink heavily are malnourished, either because they eat poorly — often substituting alcohol for food — or because alcohol and its toxic byproducts prevent the body from properly absorbing and metabolizing nutrients, especially protein, certain vitamins and fats. In both cases, the lack of nutrients contributes to liver cell damage.
It was once thought that malnutrition, rather than alcohol, caused alcoholic liver disease. Now, the relationship between the two appears more complicated. Some research has found that even in the presence of good nutrition, alcoholic hepatitis can still develop, yet other studies have found that nutritional supplementation can improve outcomes in people with alcoholic hepatitis.
