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Congratulation on quitting drinking! You've taken a tremendous step in improving your overall health both physically and mentally.

Now that last call has come and gone it's time to take a close look at the damage that's been done - especially scary liver damage.

So here’s what you do:

1. Read this article for a brief overview of the three stages of liver disease, the symptoms of liver disease and how a doctor will test for liver disease

2. Go see a doctor to make sure you’re OK.

3. If you have any disease, take it seriously and comply with medical advice (since liver disease is asymptomatic until severe, you may have some degree of disease and not know about it).

4. If you don’t have any disease, celebrate your good fortune, and then commit to making up for the past with lifestyle choices that reduce your risk of future liver problems - you’ll find 8 great ways to love your liver at the end of this article.

By the way, if you still drink and you worry about liver damage, you probably have cause for concern. People who drink in real moderation don't tend to have these worries.

The Three Stages of Alcoholic Liver Disease

There are 3 stages to alcoholic liver disease. These stages are usually progressive.

Stage 1 - Alcoholic Fatty Liver

  • Excess fat deposits in the liver build-up after prolonged excessive alcohol consumption (or in some cases, after a single binge session)
  • Fatty liver rarely causes noticeable symptoms, except in quite severe cases
  • For most people, 2 weeks of abstinence reverses the condition

Stage 2 - Alcoholic Hepatitis

This second stage is far more serious, in fact, it can be lethal.

  • When you drink heavily over a period of many years, or in some more rare cases, when you have a really excessive binge, you can damage your liver to a point where it gets inflamed
  • For reasons that remain poorly understood, some people can drink very heavily for decades without developing alcoholic hepatitis, while others who drink far more moderately, may develop the condition more quickly.
  • The condition is potentially reversible, but it won’t go away unless a person quits drinking completely for a period of many months or years.

Alcoholic hepatitis won’t go away unless you commit to complete abstinence, and since 1 in 3 drinkers presenting with symptomatic alcoholic hepatitis die within 6 months, quitting is your only good option.1

Stage 3 - Cirrhosis

  • In this third stage, scar tissue build-up from prolonged liver inflammation compromises liver function
  • Cirrhosis is not reversible, though it can be managed or the progression slowed through treatment and complete abstinence from alcohol

Ex-Heavy Drinker? You Have/Had Fatty Liver

Nearly all heavy drinkers, defined as people who regularly/chronically exceed recommended drinking guidelines, have fatty liver (90% to 100%, according to the National Health Service in the UK.)

Frighteningly:

  • Roughly 25% of people with alcoholic fatty liver will progress to alcoholic hepatitis
  • Roughly 20% of people with alcoholic fatty liver will progress to cirrhosis

My Liver Feels Fine - Does That Mean I’m OK?

Maybe…or maybe not.

If you’ve been drinking enough to be worried about your liver you should probably get checked out, especially considering:

  • Your liver can withstand considerable assault before its functioning becomes so compromised that you’d know there was something wrong.
  • The liver has few nerve endings, so even a ‘hurting’ liver won’t create pain, as most of the rest of your body will
  • Some people with irreversible cirrhosis may feel no symptoms of their condition

So here’s the deal:

  1. If you’ve stopped drinking after a long period of heavy use, you should probably get your liver functioning checked out
  2. Even if you feel OK, you almost certainly have or had fatty liver, and you may even have hepatitis or cirrhosis
  3. If you have hepatitis or cirrhosis, it’s important that you know - so you’ll know that you can’t relapse - and so you can get started on a treatment program to slow disease progression.

Seeing a Doctor - Testing Your Liver

If your doctor suspects liver damage, she will likely recommend one or more of the following tests:

  • Blood tests - Liver function tests check for markers in the blood that indicate liver malfunction.
  • Liver scans - Taking a visual look at your liver using ultrasound, a CAT scan machine or an MRI machine.
  • A liver biopsy - You’ll usually get some local anesthesia for this procedure in which a doctor pushes a long hollow needle into the organ to extract a small sample for examination under a microscope.2
  • An endoscopy - In this procedure, doctors thread a small camera into your stomach to look for varisces (swollen veins) that would indicate cirrhosis.

So see a doctor and get your liver checked - hopefully you'll find nothing wrong and earn peace of mind for your efforts

But if test results indicate a treatable problem (one that might have worsened without treatment) you’ll never regret having invested a few hours on checking yourself out.

Alcoholic Liver Disease Symptoms

So don’t wait for symptoms before quitting drinking or seeing a doctor, but definitely see a doctor - with urgency - should you notice any of the following liver disease symptoms:

Initial symptoms

  • Fatigue and feelings of general bad health
  • Nausea and diarrhea, especially in the morning
  • Loss of appetite
  • Vague pain in the liver area (the area below your ribs on your right side)

More serious symptoms

  • Vomiting blood
  • Dark tarry stools
  • Yellowing eyes or skin
  • Confusion and memory problems
  • Dramatic weight loss
  • Itching
  • Bruising very easily
  • Swelling of the legs, ankles or abdomen
  • The development of male breasts
  • Muscle weakness and wasting3

Lifestyle Choices That Minimize Disease Risk

So if your doctor diagnoses serious disease - then get expert medical advice, follow instructions and do everything you can to stop drinking and get healthy. It's not always easy, but it’s not complicated either.

But hopefully your doctor finds nothing seriously wrong.

If so, that’s fantastic news! You dodged a bullet and you’ve got a great opportunity to live a long, full and healthy life - and though you’ve been hard on your liver until now, there’s a lot you can do, starting from today, to maintain liver health and make up for all that past trauma.

8 Ways to Mend Your  Liver after You Stop Drinking

1. Stop Drinking (Don’t Cut Down)

This one bears repeating…

You may feel that you achieve a lot by cutting-down, but if you’ve got alcoholic liver disease, it’s not enough. If you have alcoholic hepatitis or cirrhosis, cutting down will only slow the rate of damage - but your liver function will continue to slowly worsen. 

2. Stop Smoking

Cigarettes contain toxic additives. When you inhale these additives you send them for processing in the liver. Studies show that for people with alcoholic liver disease, smoking accelerates liver scarring.4

3. If Obese - Lose Weight

Excess alcohol consumption and obesity are the two leading causes of liver disease, and research shows that the combination of obesity and alcohol abuse is uniquely harmful - being overweight and abusing alcohol isn’t twice as bad...it’s four times as harmful.

Researchers in the UK found that:

  1. Overweight women are twice as likely as healthy-weight non alcohol abusers to develop serious liver disease
  2. Healthy-weight alcohol-abusing women are twice as likely to develop serious liver disease as healthy-weight non alcohol-abusing women
  3. Overweight alcohol-abusing women are 4 times more likely than healthy-weight non alcohol-abusing women to develop serious liver disease.5

4. Eat Well (Veggies, Fiber and Antioxidants)

A healthy diet promotes liver health.

  1. Minimize your intake of processed foods, sugars and saturated fats
  2. Maximize your intake of fruits and vegetables and high-fiber foods

Your liver produces free radicals when metabolizing alcohol. Free radical caused oxidization is a major source of the damage that leads to liver diseases. There is some evidence to support an increased intake of antioxidants as way to protect your liver from alcohol related damage - and plant foods high in antioxidants are just good for you period, so there is little risk and lots of likely benefit to incorporating such foods into your daily diet.

5. Avoid Exposing Yourself to Toxins

Whether you breathe them, or they come in through your skin, toxins eventually pass through the liver.

  • Avoid over-exposure to aerosol sprays, spray paints, spray insecticides, spray fungicides and the other sprayed chemicals. If spraying inside, wear a mask and try for as much ventilation as you can.
  • Likewise, avoid over-exposure to chemicals on your skin, such as insecticides. Wear gloves or cover up.6

6. Exercise

Getting regular exercise helps your liver in a number of ways. Such as by:

  • Reducing your risk of liver cancer - Research suggests that people at high risk of liver cancer (such as people with a history of heavy drinking) can reduce their risk through regular exercise7
  • Boosting immune function
  • Helping you to maintain a healthy weight (obesity is hard on the liver)

7. Avoid Hepatitis B and C

You really don’t need hepatitis B, or C, especially with a history of heavy drinking. Hepatitis B and C are transmitted through infection via blood or sexual fluids. To protect yourself from these diseases:

  • Get vaccinated
  • Use condoms
  • Avoid beauty treatments such as manicures or pedicures unless you know all instruments are sterile
  • Likewise avoid tattoos and piercings unless you feel confident of sanitation practices8

8. Watch Your Medications

Overdosing on certain over the counter medications can do your liver a lot of harm. Talk to your doctor about all the medications you take to avoid interaction effects (don’t forget to mention herbal supplements, which can also affect liver functioning).

Be especially careful with acetaminophen. When feeling sick you could easily conceive of taking a couple of Tylenol, an all-purpose cough and cold medication and some Nyquil, all within a couple of hours - and since all of these meds contain acetaminophen, you could easily climb into the toxic range.

Factors That Increase the Risk of Liver Diseases

Why can some people drink hard for a lifetime without succumbing to liver disease, and for others, a decade or two is all it takes. Why the difference?

Not surprisingly, the greatest risk factor for alcoholic liver disease is alcohol - lots of it.

  • Men who have more than 35 drinks per week for more than 10 years and women who have more than 28 drinks per week for more than 10 years have a substantially increased likelihood of developing alcoholic liver diseases.9 And in general, greater quantities over longer periods equate to higher likelihoods.

But even among alcoholics who consume large quantities over long periods, only about half of those in this highest risk category will develop serious liver disease, so it’s not only the alcohol that’s at work here, other factors also clearly influence your odds of getting these diseases.

Other risk factors known to increase a person’s likelihood of alcohol liver diseases include:

  • Being a woman - If 100 women and 100 men consume the same amount of alcohol (based on body weight) for the same period of time, more women than men will develop liver diseases. And the bad news doesn’t stop there - compared to men who contract liver diseases, women who contract these same conditions will experience a faster disease progression.
  • Hepatitis - Drinking while infected with hepatitis B or C will result in greater liver aggravation.
  • Genetic factors - Scientists know some people seem to have a genetic predisposition to liver diseases, though they haven’t yet mapped out exactly how this is passed on.
  • Obesity - Being obese puts extra strain on the liver.
  • Eating a diet that is very high in dietary fat.
References
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Page last updated Aug 28, 2014

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