Alcoholic liver disease (ALD) covers a range of diseases such as fatty liver, hepatitis and cirrhosis. All are commonly linked to alcohol abuse or the disease of alcoholism. A January 22 review of studies addressing the effects of binge drinking on the liver underscores the complex interactions among various damages done to the liver by binge drinking.
Results will be published in the April 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available online as an “Early View.” This is the first review that highlights the changes at the molecular level that occur in the liver from excessive alcohol use.
Binge drinking is defined by the U.S. Centers for Disease Control and Prevention (CDC) as four or more drinks in an episode for women, five or more in an episode for men.
Binge drinking is on the rise worldwide, and is particularly common in the U.S. A recent study, reported on examiner.com in early 2012, shows it is a rising – and risky – problem for women, but men are statistically more prone to binge drinking and are also at risk. Teen and young adult binge drinking is also a statistical headache for those in the alcohol abuse prevention profession.
"The liver is the main metabolic site in the body," said Shivendra D. Shukla, Margaret Proctor Mulligan Professor at the University of Missouri, School of Medicine and lead author for the study. "It is involved in the physiological functions of organs such as the heart, kidney, blood vessels and brain. ALD-affected liver chemicals can also influence immunity, cardiovascular health and coagulation. Thus, ALD can have a 'domino effect' on many organs."
The liver is also the major organ for alcohol metabolism, and as such, is the first line of defense against excessive alcohol consumption.
New studies from both experimental animals and humans indicate that binge drinking has profound effects on the liver. This is in addition to the known dangers of acute levels of alcohol. "Chronic alcohol consumption renders the liver highly susceptible to binge-induced liver damage," said Shukla. "Binge-induced liver injury impacts other organs as well, a view rather poorly appreciated by the public."
Shukla said, "This review also sets the stage for additional investigations in this field. The cross-organ implications of binge-induced liver damage must be explored."
Binge drinking can cause changes at the cellular level, in the mitochondria – the power-plant of all living cells. It can result in cell death as a result, and otherwise has a snowball effect in other organs because of the liver’s role in removing toxins from the body. Added Zakhari. "Therefore, people should not binge drink, especially on an empty stomach, and if they are chronic heavy drinkers, binge drinking will exacerbate liver injury, especially if (conditions) such as obesity, Hepatitis C or HIV infection exist."
"We hope this will encourage research and development of newer approaches and tools to control and ameliorate binge-induced health effects,” said the researchers.
The alcohol user is eight times more likely to get cirrhosis, which is irreversible, incurable and fatal. Not all Alcoholics will get it. Only one in 10 develops cirrhosis. However, it is not the only liver disease cause by alcohol. A fatty liver occurs when alcohol consumption disrupts how the body chooses its fuel. Cell mitochondria – our body power plants – normally use fat to produce energy. As acetaldehyde breaks down in the body it releases hydrogen, which mitochondria use before fat as fuel. The unused fat then accumulates around the liver. Even in someone who doesn’t look fat in their extremities or midsection, fat deposits choke the liver.
Alcoholic hepatitis is a third type of liver injury connected to alcohol misuse. It is a condition similar to the other hepatitis diseases, but is not the same as A, B or C hepatitis.
“Lest you think these three liver problems are the realm of only the hard drinker, they can be stimulated by amounts of alcohol between seven and 13 ounces of whiskey – five to nine shots or mixed drinks – in 24 hours,” according to the book, Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety. “There are very few symptoms of liver injury until it becomes chronic because the liver has no pain nerves to tell you when it is hurt. If the liver had nerve endings, you’d never make it to the second drink.”