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What happens to your liver when you
quit alcohol
Published: January 16, 2024 5.48pm GMT
Ashwin Dhanda
Associate Professor of Hepatology, University of Plymouth
According to Greek mythology, Zeus punished Prometheus for
giving fire to humans. He chained Prometheus up and set an eagle
to feast on his liver. Each night, the liver grew back and each day,
the eagle returned for his feast. In reality, can a liver really grow
back?
The liver is the largest internal organ in the human body. It is
needed for hundreds of bodily processes, including breaking down
toxins such as alcohol. As it is the first organ to “see” alcohol that
has been drunk, it is not surprising that it is the most susceptible to
alcohol’s effects. However, other organs, including the brain and
heart, can also be damaged by long-term heavy alcohol use.
As a liver specialist, I meet people with alcohol-related liver disease
every day. It is a spectrum of disease ranging from laying down of
fat in the liver (fatty liver) to scar formation (cirrhosis) and it
usually doesn’t cause any symptoms until the very late stages of
damage.
At first, alcohol makes the liver fatty. This fat causes the liver to
become inflamed. In response, it tries to heal itself, producing scar
tissue. If this carries on unchecked, the whole liver can become a
mesh of scars with small islands of “good” liver in between –
cirrhosis.
In the late stages of cirrhosis, when the liver fails, people can turn
yellow (jaundice), swell with fluid and become sleepy and
confused. This is serious and can be fatal.
Most people who regularly drink more than the recommended
limit of 14 units of alcohol per week (about six pints of normal
strength beer [4% ABV] or about six average [175ml] glasses of
wine [14% ABV]) will have a fatty liver. Long-term and heavy
alcohol use increases the risk of developing scarring and cirrhosis.
A man with jaundice pulls down one
eyelid.
Yellow skin and eyes are signs of a damaged liver. Creative Cat
Studio/Shutterstock
Good news
Fortunately, there is good news. In people with fatty liver, after
only two to three weeks of giving up alcohol, the liver can heal and
looks and functions as good as new.
In people with liver inflammation or mild scarring, even within
seven days of giving up alcohol, there are noticeable reductions in
liver fat, inflammation and scarring. Stopping alcohol use for
several months lets the liver heal and return to normal.
In heavy drinkers with more severe scarring or liver failure, giving
up alcohol for several years reduces their chance of worsening
liver failure and death. However, people who drink heavily can be
physically dependent on alcohol and stopping suddenly can cause
alcohol withdrawal.
In its mild form, it causes shaking and sweating. But if severe, it
can cause hallucinations, fits and even death. Going “cold turkey” is
never recommended for heavy drinkers, who should seek medical
advice about how to safely give up alcohol.
Other benefits
Giving up drinking also has positive effects on sleep, brain function
and blood pressure.
Avoiding alcohol for long periods also reduces the risk of several
types of cancer (including liver, pancreas and colon) and the risk of
heart disease and stroke.
However, alcohol is not the only cause of ill health. Giving it up has
many health benefits, but it is not a panacea. It should be seen as
part of a healthy lifestyle, including a balanced diet and regular
physical exercise.
So, to answer the question posed by the myth of Prometheus, the
liver has an amazing power to repair itself after it has been
damaged. But it cannot grow back as new if it was already severely
scarred.
If you stop drinking and only have a fatty liver, it can quickly turn
back to normal. If you had a scarred liver (cirrhosis) to start with,
stopping alcohol will allow some healing and improved function
but can’t undo all the damage that has already been done.
If you want to look after your liver, drink in moderation and have
two to three alcohol-free days each week. That way, you won’t have
to rely on the liver’s magical self-healing power to stay healthy.
