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Dr Varuna Aluvihare

Drinkaware Trustee and leading Hepatology Specialist

You may only notice symptoms of alcohol-related liver damage when you are on the path to liver failure. Taking stock of your drinking can prevent serious self-inflicted harm.


We don’t think enough about liver health, insists Dr Varuna Aluvihare, leading Hepatology Specialist. Yet we should because when a person’s liver fails, their whole body starts to shut down.

“The liver is a workhorse,” explains Dr Aluvihare, pointing out that it’s an organ with many different and vital functions, which include converting food into energy, filtering toxins from the blood and fighting infection and disease, and produces many important proteins. “It’s only when it stops functioning properly that patients suddenly understand just how vital it is.”

What many of us don’t realise is that we are doing irreparable damage to our livers through too much consumption of alcohol. In fact, alcohol-related liver disease is on the rise, accounting for over a third of liver disease deaths. Unfortunately, because of increased drinking in the lockdown, Dr Aluvihare — who is a Trustee of independent alcohol education charity Drinkaware — is concerned that could lead to more alcohol-related harm materialising over the next few years..

How you can be damaging your liver and not realise it

Too much alcohol may cause cell damage which can lead to inflammation and scarring of the liver, reducing its function and increasing risk of cancer. Symptoms of alcohol-related liver damage can include jaundice, swelling of the belly, legs or ankles, easy bruising, fatigue, weakness, loss of appetite, and bleeding; yet these may not appear until the later stages of liver disease. “You can abuse your liver for a long time without noticing the damage it’s sustaining,” notes Dr Aluvihare.

Perhaps this is why many of us don’t feel the need to cut back on drinking and give our livers a break. Or perhaps some of us think that if we simply stop drinking (one day, we promise, we’ll get around to it) we can reverse any alcohol-induced liver damage. “The liver has a well-known ability to regenerate, so it’s true that if you intervene early enough it can recover completely, or almost completely,” confirms Dr Aluvihare. “The trouble is, by the time you see a liver specialist, your liver might be working at only 10% or 15% of its normal function and may have reached the point of no return.”

How you consume alcohol is important. It’s not healthy to have six alcohol-free days and then binge drink 14 units in one go. Your liver has a saturation point.

While it’s unlikely that damage can be reversed at this stage, it may be possible to prevent the liver failing entirely by giving up alcohol, eating healthily and exercising. “A person with cirrhosis can still lead a pretty good life with specialist medical care,” says Dr Aluvihare. “But if they carry on harming themselves with alcohol, the likelihood is that they will progress to liver failure stage — and then they run the risk of serious harm.”

Why sensible alcohol consumption is so important

Dr Aluvihare has simple advice for anyone worried about the effect that alcohol is having on their liver: follow the low risk drinking guidelines set by the UK Chief Medical Officers’ — i.e. no more than 14 units per week, for both men and women. “Also, how you consume alcohol is important,” he says. “It’s not healthy to have six alcohol-free days and then binge drink 14 units in one go. Your liver has a saturation point.”

Your GP can give you a simple blood test to identify if your liver is laying down fat, which is one of the first signs of alcohol damage. “Fat is increasingly prevalent in our population,” says Dr Aluvihare. “Fat-induced liver disease mimics alcohol-induced liver disease, so if you are overweight and you drink harmfully, then you more than double the health risk to your liver. So, keep physically active, eat well — and stop harming yourself with alcohol.”

Speak to your GP for help and advice on whether you should make any changes in your drinking. Other support tools are available through the Drinkaware website.

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