Alcohol consumption has become a normalized aspect of social culture in Nigeria and across Africa. Whether it is at celebratory events, gatherings with friends, or even just a casual drink after a long day, alcohol is a go-to for many people. However, excessive drinking can hurt the liver.
While zero alcohol consumption is ideal for liver health, moderate intake is often considered safe. The National Health Service recommends drinking no more than 14 units of alcohol a week, spread across 3 days or more. That is around 6 medium (175ml) glasses of wine, or 6 pints, that is, 2.8 litres of beer with 4% alcohol by volume (ABV). There is no completely safe level of drinking, but sticking within these guidelines lowers your risk of harming your health. Consuming more than these limits, particularly binge drinking or taking in excess can raise the risk of Alcohol-Related Liver Disease (ARLD).
Alcoholic liver disease (ALD) is a deadly condition affecting millions of people globally and is a growing concern in Nigeria and across Africa.
A new report from the World Health Organization (WHO) reveals that 2.6 million deaths per year were attributable to alcohol consumption, accounting for 4.7% of all deaths, with more than 200 diseases and injuries linked to alcohol use. While Alcohol policy in Nigeria also noted that harmful alcohol use accounts for approximately. 3.3 million deaths annually and it is linked to over 200 non-communicable diseases.
What is alcoholic liver disease
Alcoholic liver disease is a medical condition that occurs when the liver becomes damaged due to excessive and chronic alcohol consumption, leading to impaired liver function.
The liver processes and detoxifies substances in the body and produces essential proteins. Impairment of these functions due to alcoholic disease can have severe consequences, including liver failure and even death.
The stages of Alcoholic liver disease
Alcoholic liver disease progresses through three key stages: fatty liver, alcoholic hepatitis, and cirrhosis. Each of these stages present with different symptoms, allowing for early interventions that can prevent further damage.
- Fatty liver is the first stage, where excessive alcohol consumption leads to fat buildup in the liver. This stage is often reversible with lifestyle changes if caught early.
- Alcoholic hepatitis, the second stage, is marked by liver inflammation. This stage presents with more noticeable symptoms like abdominal pain and jaundice or yellowing of the eyes and mucous membranes.
- Cirrhosis is the final stage, where the liver becomes permanently scarred, leading to severe complications and a higher risk of liver failure.
Early detection during the fatty liver or alcoholic hepatitis stage allows for lifestyle changes and medical treatments, which can stop the disease from progressing to cirrhosis, which is irreversible and life-threatening.
Risk factors of ALD
The risk factors for Alcoholic Liver Disease (ALD) include:
- Excessive alcohol consumption: long-term heavy drinking is the most significant contributor.
- Gender: women are more likely to have alcoholic liver disease than men, even if they drink less alcohol.
- Genetics: those with a parent or relative who has a history of liver disease have a greater risk.
- Obesity: excess body weight can worsen the effects of alcohol on the liver.
- Poor nutrition: alcohol impairs nutrient absorption, and a poor diet can worsen liver damage.
- Co-existing liver conditions: an ongoing liver disease or infections like hepatitis B or C increase the chances of alcoholic liver disease.
- Age – Older adults are at higher risk due to decreased liver regeneration capacity.
Symptoms of Alcoholic Liver Disease
The symptoms of alcoholic liver disease can vary depending on the severity of the condition. In the early stages, there may be no symptoms at all. As the disease progresses, you may experience the following:
- Fatigue
- Loss of appetite
- Nausea and vomiting
- Abdominal pain and swelling
- Jaundice (yellowing of the skin and eyes)
- Confusion
- Dark urine
- Pale-colored stools
- Weight loss
- Easy bruising and bleeding
You should see a doctor immediately if you experience any of these symptoms.
How is alcoholic liver disease diagnosed
For the diagnosis of alcoholic liver disease, your doctor will begin by asking about your medical history and conducting a physical exam. They may also request blood tests to assess how well your liver is functioning. Imaging tests like an ultrasound, CT scan, or MRI can help detect liver damage, such as fat buildup or scarring.
If more clarity is needed, your doctor might recommend a liver biopsy, where a small tissue sample is taken and examined under a microscope to check for damage.
The treatment of alcoholic liver disease
The treatment of Alcoholic Liver Disease (ALD) focuses majorly on halting disease progression, managing symptoms, and promoting liver healing. The main steps in treating include:
- Alcohol cessation: The most critical step in treating ALD is to stop alcohol consumption. Continued drinking will worsen liver damage, while quitting can help stabilize or even reverse early-stage damage.
- Nutritional support: Many individuals with ALD suffer from malnutrition, which can worsen liver health. A balanced diet with vitamins and minerals (like vitamin B, folate, and zinc) helps improve liver function and overall health.
- Medications: In some cases, medications are prescribed to reduce inflammation and improve liver function. These treatments help manage symptoms and prevent complications.
- Liver transplantation: For patients with advanced cirrhosis, a liver transplant may be the only option. However, patients must abstain from alcohol for an extended period to be considered for this procedure.
- Counseling and support: Since ALD is tied to alcohol use disorder, counseling, therapy, and support groups like Alcoholics Anonymous (AA) are vital for long-term recovery.
Alcohol Use Disorder
Alcohol use disorder (AUD) is a common condition that occurs in people with pre-existing alcoholic liver disease. It is a chronic brain disease that affects how a person processes and responds to alcohol.
People with AUD may not experience ALD and can continue to drink despite the negative consequences, such as health problems and relationship issues.
Treatment for AUD may include counseling, support groups, medication-assisted treatment, and other therapies.
Conclusion
Excessive alcohol consumption which is typical in Nigerian and African social cultures, can lead to severe liver damage. The damage is gradual and may take years before it results in full-blown disease. Recognising the symptoms of liver damage early is essential for treatment success; the later stage is irreversible. Thankfully, the condition is manageable.
