Alcohol has many ill effects on our body and one of the organs is the liver. Those who drink excessive alcohol, have more chances of damage to the liver.
We attend to many patients who consume only beer but do not consume whisky. I would like to clarify that Beer, whisky, vodka, rum, champagne, or wine, all have alcohol in them. If taken in excess, they can damage the liver.
The next question is what quantity of alcohol can damage the liver.
It is observed that the qty of alcohol varies in males & females.
Males, who drink about 40-50 gm of alcohol every day, are at a greater risk of liver damage. Females, who consume about 20-30 gm of alcohol every day, are at a greater risk of liver damage.
A big beer bottle contains up to 50g of alcohol. A small peg of Whisky contains 12g & large peg of whisky contains 24g of alcohol.
It is observed that not all persons, who consume alcohol, have a liver problem.
Drinking alcohol or alcohol affects many organs of our body. One of these organs is the liver. People who drink alcohol in excess risk of liver failure.
We have many patients who drink beer but do not drink alcohol. Here I would like to clarify. Beer, whiskey, vodka, rum, champagne or wine.
All these contain alcohol. Drinking alcohol in excess can lead to liver failure. The next question is how much alcohol can lead to liver failure.
It has been seen that this ratio is different between men and women. Men who drink more than 40-50 grams of alcohol daily risk of liver failure. On the other hand, women who consume more than 20-30 grams of alcohol daily risk of liver failure.
If we look at a large bottle of beer, it contains up to 50 grams of alcohol. A small peg of whiskey contains 12 grams of alcohol and a large peg of whiskey contains 24 grams of alcohol. It has been seen that all people who drink alcohol do not have a bad liver.
There are some factors that decide whether the liver will be bad or not. It has been seen that people who are fat and weigh more risk of liver disease. And if these people drink alcohol, the risk of liver disease increases many times.
Similarly, people who smoke alcohol also have a higher risk of liver failure. And if someone has hepatitis B or C infection, which is a virus, if such people consume more alcohol, they also have a risk of liver failure. And it has been seen that if you do not take a good diet with alcohol, if there are less vitamins and minerals in the diet or protein is less or there are more bad fats, such people also have a risk of liver failure.
Now let’s know what difference does alcohol make on our liver? What kind of diseases can occur in the liver by consuming alcohol or alcohol? The first is the fatty liver. If the fatty liver is not controlled, such patients have alcoholic hepatitis, which later converts to cirrhosis. Some patients may also have a risk of liver cancer.
So first of all, people who drink alcohol have more fat in their liver. When we get an ultrasound, the liver turns white. This condition is called fatty liver.
After having a fatty liver, patients may have pain in the upper part of the stomach or the right side. Some patients may feel tired and sometimes it can be totally silent. When we get an ultrasound of the patient, the liver appears to have more fat.
And when we get a blood test done, in some patients, the liver enzymes have a higher amount of SGOT or SGPT. In patients with alcoholic fatty liver, the amount of SGOT can be higher than SGPT. And if we do not treat the fatty liver, such patients have alcoholic hepatitis.
In alcoholic hepatitis, the size of the liver increases and the liver becomes a little hard. Such patients have yellowish eyes and yellow urine. When we get a patient tested, the amount of bilirubin in the blood increases.
And if alcoholic hepatitis is not controlled, such patients may also have cirrhosis. Cirrhosis means that the liver has become very hard. After cirrhosis, swelling occurs in the patient’s feet and water fills in the stomach.
The liver makes an important protein albumin. Albumin is a protein that binds our blood. When the albumin in the body decreases, water starts coming out of our blood vessels.
It gathers in the legs or stomach. In patients with cirrhosis, the vessels of the digestive tract swell, which we call varic. Many times these varic burst, which makes the patients vomit blood.
Along with that, motion or thinking can also become black. Hemoglobin in these patients decreases and they need to be given blood. And we have to do endoscopy to control bleeding.
Some patients with cirrhosis also become unconscious. One of the functions of the liver is to remove ammonia from the body. Ammonia is a waste product in our body.
Patients with cirrhosis cannot remove ammonia from the blood. This increases their ammonia level. And it affects our brain, which makes the patients unconscious.
Or sometimes the patient can also talk nonsense. In patients with cirrhosis, the muscles begin to break so that other parts of the body can get calories. Therefore, the size of the patient’s muscle mass, such as shoulder muscle, bicep, tricep, decreases.
The blood of the patients with cirrhosis also becomes thin. If there is any injury in the body, it can cause bleeding. This causes red marks on their body many times.
After cirrhosis, the hands also turn red many times. And small red spots form on the skin. When we examine patients with cirrhosis, there is swelling in their legs and stomach.
The liver becomes hard. And we get red spots on the skin. And the hands also turn red.
And many times the hands of such patients also tremble a lot. When we get blood tests done on patients with cirrhosis, the albumin of such patients decreases. And PT and INR increases.
PT, which we also call prothrombin time, also tells us how thick our blood is. Blood in the liver becomes thin, which increases PT or prothrombin time. And INR also increases.
Bilirubin and INR in the blood tell us how serious the liver disease is. In patients with cirrhosis, platelets also decrease. As you have seen, platelet count decreases in dengue patients.
Similarly, platelet count decreases in liver patients. As the pressure increases in the liver, the size of the spleen or spleen increases. The spleen is an organ that destroys the old RBC and old platelets.
In liver patients, the spleen size increases. And more platelets are destroyed. As a result, the platelet count decreases.
When we do an ultrasound of patients with cirrhosis, there is water in the stomach. And the liver vein, which we call portal vein, its size increases. And the size of the spleen also increases.
To diagnose cirrhosis, we do a special test, which we call FibroScan. FibroScan tests how hard the liver is. This is a type of ultrasound test, in which we touch the probe from the outside.
And the result we get is in the number. If the value of FibroScan is less than 5, it means the liver is completely normal. And if this value is more than 13 or 15, it means the liver is hard.
And this is a cirrhotic liver. Drinking alcohol can cause liver cancer in some patients. In such patients, there can be pain in the right side or upper part of the stomach.
When we do a blood test, two special markers, alpha-fetoprotein, which we call AFP and PIVCA, their value increases a lot. When we do a CT scan or MRI of such patients, we see a lump in the liver. Now let’s understand how we treat alcoholic liver disease.
First of all, the patient does not have to drink alcohol at all. If the patient stops drinking alcohol, then his liver can improve. Many times, patients have difficulty quitting alcohol.
We give medicines to such patients, so that they can quit alcohol easily. After that, we give good nutrition to the patient. We give such a diet that has more calories and more protein.
If the patient has swelling in the legs, then we reduce the amount of salt in such patients. By quitting alcohol and taking a good diet, many patients improve. And if there is still no improvement, we admit such patients.
And after that, we start special medicines. And if the patient has a cirrhosis complication, such as vomiting blood, we do an endoscopy in such patients and control the vomiting blood. And if the patient is unconscious, then we give medicine to reduce the unconsciousness.
Some patients get an infection. Usually, it is a bacterial infection. Such patients are given antibiotics.
To reduce the effect of alcohol on the liver, some special medicines are also used. If despite all this, there is no improvement, then we give a liver transplant. Usually, we do medical treatment for 7 days.
If there is no improvement in 7 days, then such patients may need a transplant. If the patient has cancer, then it is also treated. The treatment of cancer depends on its stage.
The cancer of the initial stage is either treated with a transplant or local ablative therapy, which we call RFA or TACE. We treat it with that. If the cancer has spread a lot, then such patients are treated with chemotherapy.
One issue is that some people drink alcohol and want to know how bad the liver is. We do some blood tests of such patients, such as liver function test, PTINR, Hepatitis B and C, and some other tests, such as ultrasound and fibroscan, and know how much the liver is working. I hope the information will be useful for you.
