Coronavirus has affected everyone in some way, whether that be contracting the virus, death from the virus, or struggles as a result of lockdown restrictions. Figures show that alcohol sales were up by 67 percent before the UK went into lockdown, with many drinking at home in isolation.
It was also predicted the number of people with alcohol-related liver disease will rise because of the coronavirus crisis.
Could your alcohol consumption lead to liver damage, what are signs of liver damage to look out for, and can the damage be reversed?
Dr William Alazawi, Consultant Hepatologist at the London Digestive Centre and The Princess Grace Hospital, part of HCA Healthcare UK, offered his advice to Express Health.
How much would you have to drink a day to develop liver damage?
When we drink a small amount of alcohol, the liver processes it and breaks it down into harmless substances. But drinking too much alcohol can overwhelm these processes, leading to a build up of fat in the liver, causing damage and eventually preventing the liver from carrying out vital functions in the body.
Dr Alazawi said: “The question is: how much alcohol is too much? It isn’t possible to know what each person’s risk is because damage from alcohol is repaired differently in different people. This depends on lots of things, including our genes, what we eat, our behaviour, and our environment. The official NHS guidance is that we should keep our alcohol intake below 14 units per week and spread our drinking over at least three days in the week, with several alcohol-free days.
“But what is a unit? We don’t normally refer to ‘units’ when we talk about drinking, but units are a handy way of working out how much alcohol there is in a drink. One unit is the same as half a pint of weak bitter, a small glass of low strength wine or a single measure of a spirit in a pub or bar. If you’re drinking a drink with a higher percentage of alcohol in it: a stronger lager, cider or a fuller bodied wine, then it will have more units.”
What are the signs of liver damage to look out for?
Symptoms such as yellowing of the skin and eyes (jaundice), abdominal swelling, itchy skin, dark urine, pale stools and a tendency to bruise easily can indicate that the liver has reached the late stages of disease and is not working properly. If you notice these, you should seek urgent medical attention.
But Dr Alazawi warned: “We see many patients who do not have these symptoms. Some patients have non-specific symptoms of fatigue, nausea, or abdominal pain, but we also see many patients who do not have any symptoms at all but can have quite advanced liver disease.”
How long does it take to develop liver damage?
Damage and scarring in the liver can develop into a condition called cirrhosis, which in turn can lead to liver failure and liver cancer.
Although it can take many years to develop advanced scarring of the liver or cirrhosis, this varies a lot between people and we see patients of all ages with advanced stages of liver disease.
Dr Alazawi added: “Sadly, we even see people in their early 20s with liver failure due to alcohol.
“The NHS recommends that if you are worried about the amount of alcohol you drink, then you should seek advice, firstly from your GP who may recommend that you see a liver specialist for further tests and scans.”
Can drinking at home increase your liver disease risk in any way?
Whether you drink alcohol at home or in the pub, it gets broken down in the liver and can damage the liver in the same way.
But drinking at home might mean you drink more because you serve yourself more generous amounts, because you have lots of cans or bottles in the house or because you don’t have to get home at the end of the evening.
It might also be easier to drink at home at times of the day when you wouldn’t normally drink if you were out of the house.
But Dr Alazawi advised: “Drinking excess alcohol doesn’t just damage your liver, it can affect the body and mind in lots of different ways.
“Some people can become depressed if they drink and more so if they drink alone. Especially in these times of lockdown, we need to be aware of our own mood and mental health as well as that of those around us. If you’re feeling low, it can be helpful to talk about your mood with family, friends or even seek help. Whether you’re concerned about yourself or a loved one, these helplines and support groups can offer expert advice.
“Drinking at home, particularly in lockdown, might also mean your diet is less healthy – and don’t forget there are lots of calories and sugars in alcoholic drinks. You may be more tired because you sleep less well, drink less water and may not feel like doing as much exercise. This might lead to you putting on weight, which can lead to a build up of fat in the liver just like alcohol can, making the liver damage worse.”
Can you reverse liver damage?
The liver has a reputation for being able to regenerate itself and this means that many of us assume it is a forgiving organ. But, if the liver is damaged repeatedly or over a long period of time, then it can reach the limits of this regeneration, leading to liver scarring.
Dr Alazawi said: “Even if there is significant scarring, the liver can recover at least to some degree by reducing the amount you drink to within the recommended limits and in some cases stopping drinking alcohol altogether. This, together with a healthy diet and taking regular exercise, can improve your liver health and have a positive impact on your overall heath in general.”
How can you prevent liver damage?
Focussing on lifestyle – cutting down your alcohol take, following a healthy diet and taking regular exercise – will have a positive impact on your liver health. Dr Alazawi recommended the following:
Follow a healthy diet
Many of us lead sedentary lifestyles and one of the effects of this is that more and more people in the UK are now overweight or obese, which is a common cause of chronic liver disease. In fact, a build-up of fat in the liver can lead to liver damage and cirrhosis in the same way as alcohol.
Eating sensible portion sizes and eating a healthy balanced diet which is high in vegetables, pulses, and lean meats and low in certain fats and carbohydrates, will help you to maintain a healthy weight and minimise your risk of non-alcoholic fatty liver disease.
Increase your exercise
When combined with a healthy diet, regular exercise can also help you to look after your liver. Exercise can help to reduce fat build up in the liver and has wider health benefits including reducing the risks of obesity, diabetes, and heart disease.
It is recommended that you aim for a total of 150 minutes of exercise each week, combining aerobic with anaerobic exercise. If you have any health concerns or haven’t exercised for a while, it is important to discuss your exercise plans with a clinician or trainer to reduce the risk of harm or injury.
Know the risk factors – and get tested if you need to
Alcohol isn’t the only thing that can harm the liver. Lots of other conditions, including a build up of fat in the liver, infection with hepatitis viruses, and your own immune system can all damage the liver. These can eventually lead to cirrhosis and liver failure and are often more serious in people who drink large amounts of alcohol as well.
Many of these conditions can be treated – such as hepatitis B and C infections – and can be detected with simple blood tests or scans. Find out more about the risks of liver diseases, including who should have a hepatitis test, at the British Liver Trust.
Seek medical support
If you are worried about your liver or about your general physical or mental health – please do seek medical advice.