It’s a sobering fact that advanced, alcohol-related liver disease is becoming more common among adults in their 20s and 30s. “In our liver clinics and hospitals, it used to be mostly older people,” says Humberto Gonzalez, M.D., a hepatologist at Henry Ford Health. “But now, younger individuals are requiring an evaluation for a liver transplant, which is the last resort for someone who has advanced liver disease.”
So what accounts for this increase in liver disease among young people? It could be partly due to the socialization of alcohol. Popular culture has normalized the idea that drinking is the way to deal with everyday stressors—and the COVID-19 pandemic emphasized that notion.
In fact, Dr. Gonzalez led a recent study that found increased rates of acute alcoholic hepatitis during 2020 compared with previous years. “Admissions to our hospitals for acute alcohol hepatitis increased by 50%, which we were really surprised to see,” he says.
What Happens To Your Body When You Have Advanced Liver Disease?
The liver has many functions: it aids in digestion (by processing fat, protein and carbohydrates), it creates proteins, it’s the place where medications are metabolized. It helps produce blood clotting factors so you don’t bleed out when you have a small injury or cut. It helps to regulate blood sugar, it metabolizes your food so it can be utilized in the rest of the body. And it helps your body get rid of toxins through the production and excretion of bile.
A healthy liver regenerates itself, but when you drink too much alcohol, your liver becomes damaged with scar tissue. And when you develop too much scar tissue, the liver stops being able to regenerate itself. This stage of liver disease is called cirrhosis. Cirrhosis prevents your liver from being able to perform its functions correctly—or at all.
Symptoms of advanced liver disease include:
- Jaundice, or yellowing of the skin and eyes
- Excess fluid in the abdomen, legs or lungs
- Episodes of confusion
- Bleeding from the gastrointestinal tract (noticed by blood in vomit or stools)
What Are The Treatments For Advanced Liver Disease?
Aside from transplant—which is reserved for the most severe forms of liver disease—abstaining from alcohol is the only way to reverse liver disease. “There are currently no medications to reverse alcoholic liver disease,” says Dr. Gonzalez. “Medications are being tested in clinical trials, but there is no FDA-approved drug to treat alcoholic liver disease. We recommend seeking a therapist and/or participating in an alcohol prevention program to help you abstain from alcohol in the long run.”
You’ll also be advised to maintain a low-sodium, high-protein diet. “The majority of people with alcoholic liver disease lose muscle mass because their liver isn’t producing proteins,” says Dr. Gonzalez. “So a high-protein diet will counterbalance that and a low-sodium diet will help prevent the retention of extra fluids.”
Is There A “Safe” Limit Of Alcohol To Prevent Liver Disease?
In the United States, current guidelines recommend no more than one drink per day for women and two drinks per day for men. “And you can’t save them all up for the weekend and binge drink,” says Dr. Gonzalez. “Binge drinking is very unhealthy for your liver. That said, binge drinking for a week or two, or even a month, wouldn’t put you at risk for severe forms of liver disease. But if you keep it up for several months or a year, this is when you’re in danger of liver disease and cirrhosis.”
Generally speaking, no amount of alcohol is ‘safe.' It is a known carcinogen and raises your risk for some cancers. It may even accelerate genetic aging. “The more infrequent a habit it becomes, the better,” says Dr. Gonzalez.
Humberto Gonzalez, M.D., is a hepatologist at Henry Ford Health. He specializes in non-alcoholic fatty liver disease, alcoholic liver disease, obesity management before and after liver transplant, viral hepatitis, liver cancer, different forms of liver disease and liver transplant. He sees patients at Henry Ford Hospital in Detroit, Henry Ford Medical Center—Columbus, Henry Ford Medical Center—Lakeside and Henry Ford Medical Center—Saginaw.