Alcoholic liver disease: the harmful effects of lockdown drinking

Most people think that alcohol is fairly harmless and just something to enjoy with no harm except a hangover the next day or putting on a little bit of weight. However, excess alcohol could be damaging to the liver. In the UK, over 250,000 people are admitted to the hospital solely because of alcohol-related illnesses. 

During the coronavirus lockdown, there have been reports of a spike in alcohol sales, suggesting that many people are turning to drink as a way of handling the very surreal situation 

Here, leading consultant gastroenterologist and hepatologist Professor Laith Al-Rubaiy explains how excessive drinking can damage the liver and why we should be careful with how much we consume, especially during the pandemic.

How can excess drinking damage the liver?

When people drink more than the recommended allowance they will put the liver under pressure. In addition to the behavioural effect, the liver suffers the most from excessive alcohol consumption.

The liver can only process a certain amount of alcohol at any given time. Drinking too much means that the liver cells will have to work overtime to process that excess alcohol. This will make the liver inflamed, swollen and tender, a condition we call alcoholic hepatitis. 

Over time, this inflammation will result in fibrosis and ultimately scarring of the liver, what we call cirrhosis. Cirrhosis is the final and irreversible stage of alcohol-related liver disease. It is important to increase public awareness of the risks of excess alcohol. You can read one of my previous articles on this here.
 

Who is at risk of excessive alcohol consumption during the pandemic?

A lot of dangerous misinformation and myths were spread over the last few months that consuming high-strength alcohol can kill the COVID-19 virus. No, it does not. Excess alcohol can cause serious health problems, including death. 

Unfortunately, alcohol consumption may be associated with a range of other diseases and mental health disorders, which can make a person more vulnerable to COVID-19 infection. 

Chronic liver disease negatively affects the body’s immune system and increases the risk of infections. Therefore, people should be aware of how much alcohol they are consuming during COVID-19 pandemic.
 

Alcohol sales have soared, might we see more people with alcohol-related liver damage after this?

The Lancet Liver Commission identified late diagnosis of liver disease as perhaps the most important clinical issue and estimated that around 75% of patients with fatal cirrhosis were unaware of their disease until presenting as an emergency with acute-on-chronic liver failure or visceral bleeding.

With the increasing consumption of alcohol, we have seen an increase in hospital admission related to alcohol excess. We are doing our best to increase public awareness of this critical issue. 
 

What signs indicate that you might need to reduce alcohol consumption?

The liver is just as vital an organ as the heart, but people often fail to appreciate the importance of keeping it healthy. 

Seven in ten people with liver disease are undiagnosed and unaware that they already have some degree of liver damage. There are also lots of myths, for example, people believe that you need to be an ‘alcoholic’ to develop liver disease.

However, one in five of us in the capital are currently drinking at a level that puts our liver at risk and many people don’t realise that being overweight is also a big risk factor. 

Around 90% of all liver disease in the UK is attributable to alcohol, obesity and viral hepatitis and is therefore preventable. There are several screening tools that help with determining whether someone is at risk of alcoholism.

One tool is known as CAGE, which is a questionnaire that measures the severity of a drinking problem. If a patient answers “yes” to two or more CAGE questions, they should seek professional medical assistance. The four CAGE screening questions are:
 

• Have you ever felt you should cut down on your drinking?
• Have people annoyed you by criticising your drinking?
• Have you ever felt bad or guilty about your drinking?
• Have you ever had a drink first thing in the morning to steady your nerves or get over a hangover?
   

Is alcoholic liver damage reversible?

Unfortunately, advanced liver disease is irreversible. Around 75% of liver disease cases are currently diagnosed at a late stage when treatment options are limited, costly and unlikely to reverse the effects. Therefore, it is imperative to address alcohol excess at an early stage and change lifestyle.
 

What are the first signs of alcoholic liver disease?

There is no specific sign of early alcohol-related liver disease but one should be aware of early symptoms related to alcohol excesses such as temporary blackouts or short-term memory loss, irritability and extreme mood swings, making excuses for drinking such as to relax, deal with stress or feel normal, or having a hangover when not drinking.  

If you would like to discuss your liver health with Professor Laith Al-Rubaiy, you can book an appointment via his Top Doctor’s profile here.