Excessive intake of alcohol increases the risk of Liver diseases in men
Men who drink alcohol in late adolescence are more likely to develop severe liver disease decades later than young people who don’t drink at all, a Swedish study suggests.
Researchers examined data on alcohol consumption for 43,296 men entering military service in 1969 and 1970 when they were 18 to 20 years old. After an average follow-up of almost 38 years, a total of 383 men were diagnosed with severe liver disease, including 208 who died.
Each daily gram of alcohol men typically consumed in their youth was associated with a 2 percent increase in the risk of severe liver disease, even after researchers accounted for other independent risk factors for liver damage like obesity, smoking and cardiovascular disease.
The risk was more pronounced among heavier drinkers. Young men who typically averaged 31 to 40 grams of alcohol (equivalent to roughly 3 to 5 ounces of spirits) daily had twice the risk of liver disease as abstainers, while youth who drank 51 to 60 grams daily had more than quadruple the risk of liver disease.
“We found that most of the study subjects that eventually developed severe liver disease were previously diagnosed with alcohol abuse or dependency,” said lead study author Dr. Hannes Hagstrom of Karolinska University Hospital in Stockholm.
“It is therefore reasonable to believe that drinking alcohol early in life increases the risk that you will continue to drink and might increase your intake,” Hagstrom said by email. “Also, we cannot rule out that a long duration of exposure to alcohol is a contributing cause of this increased liver disease risk.”
In the U.S., one standard drink contains 14 grams (0.6 oz) of alcohol, which is typically the amount in one 12-ounce beer, a 5-ounce glass of wine and 1.5 ounces of spirits, according to the National Institute on Alcohol Abuse and Alcoholism.
The exact amount of alcohol needed to inflict liver damage is unclear and can be influenced by other factors like what people eat, what type of alcohol they consume and how often they binge drink, researchers note in the Journal of Hepatology. But some previous research points to an increased risk of liver disease when men drink more than 30 grams of alcohol daily or when women consume more than 20 grams a day.
Overall, the young men in the current study drank an average of almost 9 grams daily. While roughly 6 percent claimed not to drink at all, almost 5 percent consumed more than 60 grams daily.
During almost four decades of follow up, 2,661 men were diagnosed with alcohol abuse, and roughly one in 10 of these men went on to develop severe liver disease.
In addition, 386 men were diagnosed with viral hepatitis and almost one in four of these men went on to develop liver disease.
The study wasn’t a controlled experiment designed to prove whether or how drinking habits early in life might cause liver disease decades later.
Other limitations include the reliance on men to accurately recall and report on their drinking habits. Heavy drinkers are also more likely than other people to use drugs, increasing their risk of catching viral hepatitis by sharing needles or other drug paraphernalia.
In addition, the researchers lacked data on binge drinking, which might impact the effect of alcohol consumption on the liver, the authors note.
Even so, the results suggest the threshold amount of alcohol linked to liver damage may be lower than previously thought, the researchers conclude.
“It’s quite likely that many of those who reported drinking regularly during their late teens went on to continue or escalate that habit throughout their adult life,” Grucza said by email. “In an ideal world, parents would both try to delay alcohol initiation until the late teens or early twenties and also try teach their kids to drink moderately and responsiby.
Symptoms of liver disease
The liver is in the upper right part of the tummy (abdomen), just below the ribs.
Drinking too much alcohol leads to three main conditions which can seriously threaten your health:
- Fatty liver.
- ‘Scarring’ of the liver (cirrhosis).
Any, or all, of these conditions can occur at the same time in the same person.
If you have early-stage liver disease (fatty liver or mild hepatitis), you may not get any symptoms. As the condition progresses, you may gradually develop symptoms such as:
- Feeling sick (nausea), being sick (vomiting) and feeling generally unwell
- Adominal pain and swelling.
- Swelling of your ankles and lower legs.
- Itchy skin.
- Your urine becoming dark in colour.
- Your stools (faeces) becoming pale or very dark/black because of bleeding into the upper part of your gut (bowel).
A build-up of fat occurs within liver cells in most people who regularly drink heavily. In itself, fatty liver is not usually serious and does not cause symptoms. Fatty liver will usually reverse if you stop drinking heavily. However, in some people the fatty liver progresses and develops into alcoholic hepatitis.
A similar condition can occur in people who don’t drink too much alcohol. Read more about non- alcoholic fatty liver disease.
Hepatitis means inflammation of the liver. The inflammation can range from mild to severe.
Mild hepatitis may not cause any symptoms. The only indication of inflammation may be an abnormal level of liver chemicals (enzymes) in the blood, which can be detected by a blood test. However, in some cases the hepatitis becomes persistent (chronic), which can gradually damage the liver and eventually cause cirrhosis.
A more severe hepatitis tends to cause symptoms such as:
- Feeling sick (nausea).
- Yellowing of your skin or the whites of your eyes (jaundice), caused by a high level of bilirubin – a chemical normally metabolised in the liver.
- Generally feeling unwell.
- Sometimes, pain over the liver.
A very severe bout of alcoholic hepatitis can quickly lead to liver failure.
This can cause deep jaundice, blood clotting problems, confusion, coma and bleeding into the guts. It is often fatal.
The main treatment for alcoholic hepatitis is to provide adequate nutrition (this sometimes involves passing liquid feeds through a tube in the stomach) and steroids.
Cirrhosis is a condition where normal liver tissue is replaced by scar tissue (fibrosis). The scarring tends to be a gradual process. The scar tissue affects the normal structure and regrowth of liver cells. Liver cells become damaged and die as scar tissue gradually develops. So, the liver gradually loses its ability to function well. The scar tissue can also affect the blood flow through the liver which can cause back pressure in the blood vessels which bring blood to the liver.
About 1 in 10 heavy drinkers will eventually develop cirrhosis. It tends to occur after 10 or more years of heavy drinking. Cirrhosis can also develop in people who have never had alcoholic hepatitis.
Cirrhosis can happen from many causes other than alcohol. If you have another persistent liver disease and drink heavily, you are likely to increase your risk of developing cirrhosis.
Cirrhosis can lead to end-stage liver disease. However, in the early stages of the condition, often there are no symptoms. You can get by with a reduced number of working liver cells. But, as more and more liver cells die and more and more scar tissue builds up, symptoms start to appear. The eventual symptoms and complications are similar to a severe episode of hepatitis (listed above). However, unlike a bout of severe hepatitis, the symptoms and complications tend to develop slowly. The scarring and damage of cirrhosis is usually permanent and cannot be reversed.