Alcohol is the people’s No. 1 drug, with every German consuming an average of 138.4 liters of alcoholic beverages each year. This damages the body in many ways, but the liver, as the central organ of alcohol breakdown, is particularly affected. How alcohol affects the liver, we explain here.
Definition: alcohol abuse and alcohol dependence
One speaks of alcohol abuse when very large amounts of alcohol are drunk regularly, but there is no dependence on the substance. In alcohol dependence, one is physically and/or emotionally dependent on the substance alcohol. Alcoholism is a disease. It never occurs suddenly; rather, the development to it is usually a longer process.
Alcohol abuse and dependence in Germany
An estimated 1.3 to 1.9 million people in Germany are addicted to alcohol, and another eight million at least abuse alcohol. As many as 74,000 people die annually from the direct and indirect consequences of this abuse.
Alcohol is a cell poison
Alcohol, ethanol or C
2
H
5
OH is the main toxic substance in fermented beverages. Regular alcohol consumption causes both physical and psychological damage. In this context, the liver is the central organ of alcohol breakdown and is therefore highly affected by excessive alcohol consumption. Liver damage is the most common result of continued alcohol consumption. However, not all alcohol-related diseases and deaths are related to the liver.
What happens in the liver?
Only about ten percent of ingested alcohol is excreted unchanged by the kidneys and lungs; about 90 percent is broken down in the liver. A variety of biochemical processes take place here. One important process, for example, is the conversion of alcohol into acetaldehyde. However, acetaldehyde in large quantities damages the cell function of the liver and is incidentally also responsible for the hangover the morning after. Furthermore, there is a restriction in the breakdown of fatty acids and a simultaneous increase in the synthesis of new fatty acids. These fatty acids are deposited in the cells of the liver – it becomes fatty, so to speak. Later, fatty liver hepatitis occurs and subsequently liver cirrhosis due to destruction of the lobular structure of the liver.
What are the alcohol-related diseases of the liver?
The following liver diseases can occur in association with alcohol:
- Fatty liver: alcohol-related fatty liver represents the early stage of alcohol-related liver disease. The fat that is not broken down (see above) accumulates in the liver and gradually leads to the alcohol fatty liver. When abstaining from alcohol, however, the changes form back again.
- Alcoholic hepatitis develops when an already existing fatty liver is further severely stressed by massive alcohol consumption. In the course of the disease, it comes to pain, flu-like symptoms, digestive disorders and jaundice.
- Cirrhosis of the liver: alcohol-related cirrhosis of the liver can be symptom-free, especially in the early stages, but leads to irreversible changes in liver tissue by transformation into connective tissue. This disease is incurable.
A glass of wine for women – two for men
The most important measure to prevent alcohol-related liver disease is a sensible approach to alcohol. According to the World Health Organization (WHO), moderate alcohol consumption is considered to be up to ten grams of alcohol per day for women and up to 20 grams for men. Ten grams of alcohol correspond to about 0.1 liter of wine or 0.25 liter of beer. Anyone who exceeds these amounts is at significantly increased risk of alcohol-related liver diseases. The WHO also recommends taking at least one to three alcohol-free days per week. The way in which alcohol is handled also plays a decisive role in therapy. People suffering from fatty liver, alcoholic hepatitis or cirrhosis should live abstinent lives. While fatty liver and alcoholic hepatitis can be cured by abstinence, the changes in the liver are irreversible in the case of cirrhosis. Therefore, one should not let it get that far in the first place.
The hangover afterwards
Because the feeling after copious amounts of alcohol is similarly unpleasant to catarrh, students in the 19th century referred to the alcoholic after-intoxication as a “hangover.” A hangover is accompanied by a massive need for fluids. This is because alcohol deprives our bodies of water.Some drinks also contain fusel oils, which the liver can convert into toxic substances. Thus, the skull often still hums even if you are already sober.
History of alcohol
Alcoholic beverages are not an “invention” of modern times, on the contrary – as a food, stimulant and intoxicant, alcoholic beverages have a tradition dating back thousands of years. The oldest records can be found among the Sumerians (approx. 5000 BC). The first brewery was then established in Egypt around 3700 BC. Beer was considered a staple food and was also used as a means of payment. For example, civil servants and slaves were paid part of their salary in beer. Wine was also apparently known to the ancient Egyptians. Only recently have scientists been able to detect remnants of wine in Tutankhamen’s burial chamber. The first distillation, i.e. the separation of liquid substances by evaporation and re-liquefaction, took place in the Arab region around 700 AD. This made it possible to produce higher-proof alcoholic beverages. It was not until the 11th century that this method reached Europe. Thus, monasteries were then important places for beer and wine production in the Middle Ages.