What does your liver do?
Your liver processes everything you consume, aiding the digestion of food and filtering chemicals out of your system. It’s a non-stop job, made harder whenever you add toxins such as alcohol or drugs (including prescription medications, herbal remedies, supplements, or street drugs).
Alcohol and your liver
“Alcohol is an intrinsic part of Australian culture and it plays a central role in most people’s social lives. Heavy drinking is seen as acceptable in almost all social situations, from weddings to sports matches, and even at funerals or baby showers. There are very few occasions where drinking alcohol is not encouraged.”
The constant presence and promotion of alcohol can make it hard to recognise when you’re drinking too much. Heavy drinking seems normal when everyone is doing it.
Exactly how we drink varies considerably. Young Australians are more likely to drink 11 or more drinks on a single occasion (binge drinking). But the age group with the highest percentage of daily drinkers is the over-70s.
When alcohol is constantly advertised as a way to celebrate, relax or reward yourself, it’s hard to acknowledge that it is, essentially, a poison. But it is. Excessive alcohol consumption is linked to over 60 health conditions, including those affecting your liver.
It takes great courage to recognise and admit that you’re drinking too much. Most people agree that alcohol can be a problem but it’s comparatively rare to find someone willing to admit that their own drinking pattern could be harming their health.
Your liver is the ultimate truth-teller. You might think you only had 1 or 2 drinks but your liver has to process the 5 or 6 drinks you really consumed. Each time your liver filters alcohol, some of its cells die. It’s resilient enough to develop new cells if you don’t drink much or drink often. But, when you regularly drink too much, your liver may lose some of its regenerative power and experience serious and permanent damage.
Alcohol-related liver disease (ARLD) has 3 main stages:
- Alcoholic fatty liver disease (steatosis) – a condition that involves too many fat cells in the liver.
- Alcoholic hepatitis – too many liver cells have been destroyed and the liver is inflamed and swollen. Mild cases may be resolved if you stop drinking permanently but severe cases can be life-threatening.
- Cirrhosis – late-stage liver disease where scar tissue replaces healthy tissue and prevents the liver from functioning properly. Symptoms include fluid in the abdomen, bleeding in the oesophagus, an enlarged spleen, behaviour change, confusion and high blood pressure in the liver.
Change your drinking habits.
It won’t necessarily be easy but it is most definitely worth it. And it’s becoming a popular choice. The Alcohol and Drug Foundation reports that 52% of Australians have taken steps to reduce their drinking and 21% of Australian adults don’t drink at all. Sales of alcohol are falling and sales of no- or low-alcohol alternatives are surging. There’s never been a better time to cut back or quit.
If you find you need support to change your drinking habits, talk to your GP, read some ‘quit lit’ or join an online or in-person support group.
Drugs and your liver
Drug-induced liver injuries may come from taking prescription drugs (like statins), over-the-counter medicines, herbal supplements or illegal drugs.
When you think of drugs and liver damage, you probably have an injecting drug user in mind. But something far more ordinary is responsible for most drug-induced liver injuries – good old paracetamol. Paracetamol is the leading cause of acute liver failure in the Western world.
In one study at The Royal Prince Alfred Hospital in Sydney, researchers admitted 115 patients with paracetamol-related liver injuries and 69 with liver injuries from other drugs such as antibiotics or herbal and dietary supplements.
Now, paracetamol is not a problem if you follow the recommended doses. People may accidentally take too much because they’re in pain, they assume it must be safe because it’s so readily available, or they don’t realise that they’re taking several different medications that all contain paracetamol (e.g. cold and flu meds).
Drugs may damage your liver by directly damaging liver cells, by blocking the flow of bile out of the liver (cholestatic), or by doing both.
Symptoms of a drug-induced liver injury may include nausea, itching or loss of appetite. More severe symptoms include jaundice, an enlarged liver, pain in the upper right abdomen, and confusion or disorientation.
If there’s reason to suspect a drug-related liver injury, treatment may include:
- Stopping the drug that’s thought to be the problem
- Administering corticosteroids or an antidote if one is available (N-acetylcysteine can be used as an antidote to paracetamol, for example)
- Monitoring your liver’s response
- A liver transplant.
By being very careful about any medications or herbal supplements you take. If you’re unwell, check every medication to see if it contains paracetamol (call your pharmacist if you’re unsure).
Be wary of herbal supplements. They do not go through the rigorous testing process that applies to prescription medications. Some can and do harm your liver.
How can we help?
At Moonee Valley Specialist Centre, we support many patients with drug or alcohol-induced liver injuries.
Moonee Valley Specialist Centre is the only private practice in Melbourne to conduct liver scans using a state-of-the-art FibroScan® 502 Touch device. Liver scan technology is the key to spotting early health warnings from alcohol or drug use. Please contact us or book an appointment (no referral needed).
If you have other concerns about your liver, then we recommend an appointment with Dr Nathan Connelly, our gastroenterologist, who has a keen interest in helping patients with liver disease.
Please ask your GP for a referral.
All information is general and is not intended to be a substitute for professional medical advice. Moonee Valley Specialist Centre can consult with you to confirm if a particular treatment or procedure is right for you.