How Alcoholism Causes Liver Disease?

Alcoholism

Alcoholism is a chronic and progressive condition that includes an individual’s inability to control his/her drinking, continuing to use alcohol (even if it causes problems), and being preoccupied with alcohol. An addict drinks more to get the same effect of physical dependence or a situation of withdrawal symptoms that emerge if drinking is stopped rapidly. When an individual is having a problem with alcoholism, it becomes hard to predict how long he/she will indulge in drinking or the consequences that will occur after drinking (Mayo Clinic 1). The rationale for this research paper is to provide a persuasive discussion on the relationship between alcoholism and liver disease.

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The Liver

The liver is the heaviest and largest organ in the human body. The organ is located in the right upper part of the body under the ribs. The liver is responsible for vital functions, including removing toxins in the body system, processing nutrients, making bile, and building protein. The liver conditions such as inflammation and hepatitis interfere with those processes, thus leading to poor health. However, the liver is extremely resilient and has the ability to repair itself. In fact, conditions such as inflammation may occur without causing any medical attention, but in extreme conditions; for instance, hepatitis and cirrhosis, there can be an interruption of vital liver functions. Our bodies cannot survive without the liver because nutrients cannot be processed amid toxins in the blood. The absence of liver functions will result in serious illnesses such as brain damage and coma (Abdel-Misih, Sherif, and Bloomston 646).

Alcohol Problem and Liver Disease

Individuals may have a problem with alcohol, even if their behaviors have not progressed to the situation of alcoholism. Therefore, a drinking problem is a state where individual drinks too much, a situation that causes repeated problems in a person’s life. However, the point of alcoholism is not yet reached. Binge drinking is another drinking pattern where a person may drink five or more drinks in a row, a habit that can cause social problems and health risks associated with alcoholism. When an individual exhibits the problem of alcoholism, it might not be possible to reduce the intake or quit the drinking habit without seeking assistance. Those individuals who deny they have a problem are likely to be experiencing alcoholism and other forms of excessive drinking.

Heavy drinkers develop serious liver diseases after prolonged alcohol abuse. Alcohol cirrhosis and hepatitis are also influenced by factors such as diet, gender, heredity, and co-occurring liver illness. In fact, more liver damage is attributed to alcohol metabolism while liver injuries are caused by direct toxicity because of metabolic by-products of the alcohol and the inflammation induced by those by-products. When liver cells are exposed to bacterial toxins, liver disease is likely to emerge. The continued liver injury will lead to fibrosis and, eventually, fatal cirrhosis (Bataller and Brenner 209).

The relationship between heavy alcohol consumption and liver disease was revealed more than 200 years ago. Excessive drinking of alcohol is the most prevalent cause of liver illness and many related liver deaths in the US (Abdel-Misih, Sherif, and Bloomston 645). In fact, the liver is susceptible to injuries from alcoholism because alcohol metabolism takes place in the liver. When the breakdown of alcohol takes place, several by-products are generated, such as reactive molecules, also known as free radicals and acetaldehyde. The by-products from the metabolism process contribute to liver damage more than the alcohol itself.

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The liver is an important and largest organ in the body that can regenerate itself because it has repair reserves (Taub 837). The damages caused by the alcohol do not appear immediately until the damage to the liver is quite extensive. In fact, for a liver injury to take place, a threshold alcohol dose must have been consumed. For men to exhibit liver injury, the intake dose must be higher than the women’s intake. Despite the fact that heavy consumption of alcohol plays a significant role in the development of alcohol-related liver damage, it is only less than half of heavy drinkers will develop cirrhosis and hepatitis. Therefore, other factors, such as heredity and environment, influence liver disease development.

Metabolism of Alcohol by the Liver

The processes of metabolism give insight into understanding alcohol-induced liver damage. Alcohol, when ingested, must pass through the liver to undergo metabolism. In the process, the involved enzyme known as alcohol dehydrogenase (ADH) transforms the alcohol to acetaldehyde through oxidation, which is a chemical process. The acetaldehyde produced is very toxic to the body, regardless of its concentration. Therefore, the enzyme aldehyde dehydrogenase oxidizes the acetaldehyde rapidly to become acetate. The acetate produced is taken to the bloodstream for absorption or into other body parts where other metabolic cycles may take place to produce useful molecules or energy (Cederbaum 667)

The role of ALDH and ADH is to metabolize retinol, also known as vitamin A (Cederbaum 668). In those processes of alcohol metabolism, many of the direct cells are damaged by free radicals. If the free radicals produced are not controlled by the antioxidants, the liver’s vital cells will die. In essence, a high volume of alcohol intake reduces the concentration of Vitamins E and A in the liver, which are the antioxidant vitamins that fight the free radical cells. Therefore, lipid peroxidation increases in the liver, and eventually, the liver develops complications.

Alcoholic Liver Disease (ALD)

ALD is a generic term that is used to refer to those conditions that are related to alcohol use and the liver. The most familiar types of liver diseases are fatty liver, alcoholic hepatitis, and cirrhosis. Individuals who continue to indulge in heavy drinking move from a fatty liver to hepatitis and eventually to cirrhosis. However, all three conditions can occur together according to individual genetic makeup (Fausto, Campbell, and Riehle 46).

Fatty Liver. The condition occurs after acute alcohol ingestion. The condition can be reversed with alcohol abstinence since it does not predispose to any known chronic liver disease if moderation is observed. According to Abdel-Misih, Sherif, and Bloomston, the National Institute of Health estimates that about 20% of heavy alcoholic drinkers will develop a fatty liver or steatosis condition. If the condition is unchecked and alcohol consumption is not reduced or stopped, this condition can lead to death (645).

Alcoholic Hepatitis. The condition is caused by excessive alcohol consumption and brings inflammation of the liver. Development of Alcohol Hepatitis is dangerous and undetectable. However, liver biopsy and other observable signs, including nausea, fever, vomiting, jaundice, swollen liver, and abdominal pain, diagnose it. Only a small number of heavy drinkers will develop alcoholic hepatitis, although the disease can occur in individuals who only drink moderately or binge just a few times. In fact, the damage from this condition can be reversed if the person stops drinking completely. However, the disease will most likely progress to cirrhosis and liver failure for those who continue drinking. In severe cases, the motility rate reaches 50% if the diagnosed individual continues with alcoholism. Those with alcoholic hepatitis will further develop cirrhosis if heavy drinking persists. The only option is a liver transplant if the condition is severe and the liver cannot function or repair itself (Levrero 3835).

Alcoholic Cirrhosis. The Cirrhosis condition proves to be the most severe and final stage of ALD. In fact, it causes many serious illnesses and deaths. When the consumption of alcohol is above the accepted limits, and the liver is damaged and cannot repair itself, then cirrhosis occurs. When the cells die because of alcohol toxins in the liver, the scar tissues form and build up to the extent that there is no proper blood flow through the liver. Therefore, the liver cannot clean and filter the toxins in the blood. If the blood does not gush properly through the liver for cleaning, the wastes and poisons accumulate in the body. Eventually, the prolonged periods of malnutrition and poisoning attract hepatic encephalopathy, which extends to the brain causing severe damage (Schuppan, Nezam, and Israel 838).

The symptoms and signs of cirrhosis are not easily detectable until the condition is in the advanced stages. In fact, the symptoms include nausea, loss of appetite, fever, abdominal pains, confusion, fatigue, thirst, abdominal fluid buildup, and jaundice. After the liver is totally affected by alcohol, the liver cells die, and at this stage, there is nothing that can be done to cure or repair the liver. Therefore, the only available treatment is to avoid additional damage to the liver and prevent complications such as bleeding from broken blood vessels (Schuppan, Nezam, and Israel 838).

In essence, it is evident that long-term consumption of alcohol plays a role in the development of alcoholic liver diseases. Apart from alcohol, there are other predisposing factors that contribute to liver diseases, including diet, gender, and heredity. Liver damage by alcohol occurs during the metabolism and is made worse by the by-product yielded in that process. In addition, direct toxins from the alcohol by-products may cause liver injury and inflammation of the liver. In fact, when liver cells are exposed to bacterial toxins from the metabolic process, then alcoholic liver disease takes place. Finally, the ongoing research should provide additional insights into the mechanism, and a new approach to treating alcohol liver diseases since abstinence from alcohol is hard for many individuals.

 

Works Cited

Abdel-Misih, Sherif R Z, and Mark Bloomston. “Liver Anatomy.” Surgical Clinics of North America 2010: 643-653. Print.

Bataller, Ramón, and David A Brenner. “Liver fibrosis.” The Journal of clinical investigation 115.2 (2005): 209-218. Print.

Bernal, William et al. “Acute liver failure.” Lancet 376.9736 (2010) : 190-201. Print.

Cederbaum, Arthur I. “Alcohol Metabolism.” Clinics in Liver Disease 2012: 667-685. Print.

Fausto, Nelson, Jean S Campbell, and Kimberly J Riehle. “Liver regeneration.”Hepatology (Baltimore, Md.) 43.2 Suppl 1 (2006): S45-S53. Print.

Levrero, Misak. “Viral hepatitis and liver cancer: the case of hepatitis C.” Oncogene25.27 (2006): 3834-3847. Print.

Mayo Clinic. “Disease and Conditions: Alcoholism” Mayo Foundation for Medical Education and Research. Web. 9th Dec, 2014. http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/definition/con-20020866

Schuppan, Detlef, Nezam H Afdhal, and Beth Israel. “Liver cirrhosis.” Lancet371.9615 (2008) : 838-51.

Taub, Rebecca. “Liver regeneration: from myth to mechanism.” Nature reviews. Molecular cell biology 5.10 (2004): 836-847. Print.

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