According to Greek mythology, Zeus punished Prometheus for giving fire to humans. He bound Prometheus and held an eagle feast on his liver. Every night the liver grew again. And every day the eagle returned to the feast. Can a liver actually grow back?
The liver is the largest internal organ in the human body. It is necessary for hundreds of body processes, including breaking down toxins like alcohol. And since it is the first organ that comes into contact with the alcohol we drink, it is not surprising that it is the most vulnerable to its effects. However, we must not forget that other organs such as the brain and heart can also be damaged by long-term excessive alcohol consumption.
As a liver specialist, I treat people with alcohol-related liver disease every day. This is a spectrum of diseases that ranges from the accumulation of fat in the liver (fatty liver) to scarring (cirrhosis) and usually only causes symptoms when the damage is very advanced.
Fat and scars
Alcohol initially makes the liver fat. This fat leads to liver inflammation. It responds by attempting to heal and producing scar tissue. If left unchecked, the entire liver can become a network of scars with little islands of “good” liver in between: cirrhosis.
In the later stages of cirrhosis, when the liver is failing, you may experience yellowing (jaundice), swelling with fluid, and a feeling of sleepiness and confusion. This is serious and can even be fatal.
Most people regularly drink more than the recommended limit of 14 units of alcohol per week (around six pints of regular strength beer). [4 % ABV] or about six glasses of medium proof wine [175 ml] [14 % ABV]) will have a fatty liver. And in the long term they will develop scarring and cirrhosis of the liver.
Luckily we have good news. In people with fatty liver disease, the liver can heal and look and function like new again after just two to three weeks of alcohol withdrawal. People with liver inflammation or mild scarring experience a noticeable reduction in liver fat, inflammation and scarring even seven days after quitting alcohol. Abstaining from alcohol for several months allows the liver to heal and return to normal.
For heavy drinkers with more severe scarring or liver failure, abstaining from alcohol for several years reduces the risk of worsening liver failure and death. However, people who drink excessively can become physically dependent on alcohol, and stopping suddenly can lead to withdrawal symptoms.
In its mild form, it causes tremors and sweating. However, if it is severe, it can cause hallucinations, seizures, and even death. For this reason, heavy drinkers are not recommended to stop drinking alcohol: they should consult a doctor to safely stop smoking.
Quitting drinking also has positive effects on sleep, brain function and blood pressure.
Abstaining from alcohol for a long period of time also reduces the risk of several types of cancer (including liver, pancreatic and colon cancer), as well as the risk of heart disease and stroke.
However, alcohol is not the only cause of poor health. Quitting has many health benefits, but it is not a panacea. It should be considered part of a healthy lifestyle, including a balanced diet and regular physical exercise. So to return to the question raised by the myth of Prometheus: the liver has an amazing ability to repair itself after it has been damaged. But it cannot grow back like new if it was already severely damaged.
If we stop drinking and only have a fatty liver, it can quickly return to normal. If the liver was already scarred (cirrhosis), abstaining from alcohol can lead to healing and improve its function, but without reversing all the damage that has already been suffered.
If you want to protect your liver, don't drink alcohol. But if you do, drink in moderation and allow yourself two to three alcohol-free days a week. This way, you don't have to rely on the liver's magical self-healing power to stay healthy.
Ashwin Dhanda is Associate Professor of Hepatology at the University of Plymouth.
This article was originally published in The conversation.
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