This is a part of your body that does regular overtime.
The liver is our largest internal organ and it has 500 different roles. One of the liver’s most important functions is to break down food and convert it into energy when you need it. Your liver also helps the body to get rid of waste products and plays a vital role in fighting infections, particularly in the bowel1.
And yet, when your liver is damaged, you generally won’t know about it – until things get serious. Drinking alcohol can increase your risk of developing liver disease and cause irreparable damage to this very important part of your body.
In fact, drinking is a major cause of the 25% increase in deaths from liver disease in England over the last decade (from 9,231 in 2001 to 11,575 in 2009)2. Overall, alcohol-related liver disease accounts for well over a third (37%) of liver disease deaths. And figures show victims are getting younger – more than one in 10 of deaths of people in their 40s are from liver disease, most of them from alcoholic liver disease3.
There are many types of liver disease but the main types are:
- Alcohol-related fatty liver-disease
- Non-alcoholic fatty liver disease
- Viral (Hepatitis)
- Autoimmune (chronic hepatitis)
All of the types of liver disease listed above can cause damage to the liver. The information on this page is specific to alcohol-related liver disease which can be prevented if you understand the impact excessive drinking can have on your liver and take steps to control the amount of alcohol you drink.
Drinking too much alcohol can damage the liver in two main ways
Liver disease is the term used to describe damage to the liver and there are two types. Acute is when liver problems develop over a few months and chronic is damage over a number of years.
There are lots of different causes of liver disease, including drinking alcohol to excess which causes ‘alcoholic liver disease’. Scientists are not sure exactly why drinking too much alcohol can damage your liver but the reasons include:
- Oxidative stress. When our liver tries to break down alcohol, the resulting chemical reaction can damage its cells. This damage can lead to inflammation and scarring as the liver tries to repair itself.
- Toxins in gut bacteria. Alcohol can damage our intestine which lets toxins from our gut bacteria get into the liver. These toxins can also lead to inflammation and scarring.
Drinking alcohol can increase your risk of developing liver disease
Evidence about how much and how often you need to drink to increase your chances of developing liver disease is unclear. But all the research shows that the more alcohol you drink, the more likely you are to develop liver disease.
Evidence suggests that other factors that increase your risk of developing liver disease include:
- Being dependent on alcohol – around seven in 10 people with alcoholic liver disease have an alcohol dependency problem.4
- Being female –this is likely to be connected to how women process alcohol.
- Being overweight –excess weight can exacerbate many of the mechanisms of liver damage caused by excessive drinking5
Excessive drinking can make your liver get fat – reducing your consumption can help it return to its normal size
Drink more than eight units a day (four pints of 4% lager) if you’re a man and over five units a day (a couple of 175ml glasses of wine) if you’re a woman, for two or three weeks and you’re likely to develop something called 'fatty liver’6.
This is when the liver turns glucose into fat, which it sends round the body to store for use when we need it. Alcohol affects the way the liver handles fat so your liver cells get stuffed full of it.
If this happens, you may feel a vague discomfort in your abdomen because your liver is swollen. You might also feel sick and lose your appetite. A blood test may be able to show if you have fatty liver.
The good news: your liver will start shedding the excess fat if you stop drinking for two weeks. To keep risks low you should not exceed the low risk alcohol unit guidelines after that. If you don’t change your drinking pattern, the bad news is that fatty liver is the first stage of liver disease.
Stopping drinking will help reduce damage and the progression of the disease.
People can spend 20 years damaging their liver and not feel any of the effects this is doing to them.
Early symptoms of liver disease can include:
- Abdominal pains
Later stage liver damage symptoms are more serious – and you’ll know about them.
They can include:
- Bleeding in the gut
- Easy bruising
- Jaundice (yellow skin)
- Increased sensitivity to alcohol and drugs, both medical and recreational (because the liver cannot process them
- Liver cancer
- Swelling of the legs ankles, or abdomen
- Vomiting blood
- Weakness, loss of appetite (7)
When you develop cirrhosis, cutting out alcohol is essential to prevent you from dying from liver failure which is when your liver stops working completely. In the most serious cases of cirrhosis, you will only be considered for a liver transplant if you do not drink alcohol for at least three months (8)
Drinking within the government’s low-risk alcohol unit guidelines (drinking no more 14 units a week for both men and women) and spreading those units over three days or more will help keep your risk of developing liver disease low. Reducing the amount you drink can help reverse damage of the earlier stage alcohol-related liver disease.
Once cirrhosis develops, prognosis partly depends on whether or not you continue drinking. Those who continue to drink will feel sicker and die sooner.. Even for those with symptoms, stopping drinking has a beneficial effect – it is never “too late” to stop drinking – even with cirrhosis.
You can keep your risk low by staying within the government’s recommended low risk guidance.. Here are three ways you can cut back:
- Spread your alcohol-intake out over three days or more. . If you want to cut down, a great way is to spread your drinking out over the days a week. Test out having a break for yourself and see what positive results you notice.
- Eat well.A healthy meal before you start drinking, and low-fat, low-salt snacks between drinks can help to slow down the absorption of alcohol. Good nutrition can help to support your liver to function and plays a crucial role in your health (9).
- Keep track of what you’re drinking.Your liver can't tell you if you're drinking too much, but the Drinkaware drink tracking app can. It can even help you cut down
Your GP can help you figure out if you should make any changes in your drinking, and offer help and advice along the way.
If you’re concerned about someone’s drinking, or your own, Drinkline runs a free, confidential helpline. Call 0300 123 1110 (weekdays 9am – 8pm, weekends 11am – 4pm).
The British Liver Trust provides support and information on liver disease and also funds research. Call their free helpline Monday to Friday from 10am to 4.30pm on 0800 652 7330 or visit www.britishlivertrust.org.uk
(1) British Liver Trust website. About The Liver. The Information Standard member organisation. Last reviewed: not known. Accessed: 30/11/15. Available at:
(2) (3) National End of Life Care Intelligence Network website. Deaths from Liver Disease: Implications for end of life care in England. Available at:
(4) NHS Choices website. Alcohol-related liver disease – Treatment. The Information Standard member organisation. Last reviewed: 24/9/15. Available at:
(5) Marchesini G, Moscatiello S, Di Domizio S, Forlani G, 'Obesity-associated liver disease', J Clin Endocrinol Metab, 2008 Nov, vol. 93, no.11, suppl 1, pp. S74-80, Accessed August 2014. Available at:
(6) Drinkaware interview with Professor Chris Day
(7) NHS Choices website. Symptoms of alcohol-related liver disease. The Information Standard member organisation. Last reviewed: 24/09/2015. Available at:
(8) British Liver Trust website. Cirrhosis. The Information Standard member organisation. Last reviewed: March 2011. Available at:
(9) British Liver Trust website. Diet & liver disease. The Information Standard member organisation. Last reviewed: August 2011. Available at: