Although it was previously assumed that the total amount of alcohol consumed was the most important factor for determining the risk of alcoholic cirrhosis of the liver, a new study has revealed that daily drinking increases the risk of cirrhosis in comparison to less regular drinking. In the U.S. there are around 16,750 deaths from alcoholic liver disease each year, according to data from 2011, and understanding how patterns of drinking influence risk is essential for keeping this number as low as possible.
Alcohol and Liver Disease
The impact of alcohol on the liver is one of its most well-known health risks. The liver is tasked with processing the alcohol you consume, but filtering the alcohol leads to the death of some liver cells each time. While new cells can develop, prolonged and regular misuse of alcohol reduces the ability of the liver to regenerate and can ultimately lead to the progression of alcoholic liver disease.
First, fats build up in the liver: this is known as alcoholic fatty liver and can develop after just a few days of drinking. The next stage is alcoholic hepatitis, when longer periods of alcohol misuse lead to inflammation of the liver: this stage is still reversible (if you abstain from alcohol long-term), but when it gets severe, the condition can be life-threatening. The final stage is alcoholic cirrhosis, when the liver gradually becomes more scarred and these parts stop functioning: this isn’t reversible, but the development of scarred tissue can be halted by stopping drinking. If you don’t stop drinking, there is only around a 50 percent chance of surviving alcoholic cirrhosis for five years.
Do Drinking Patterns Affect Cirrhosis Risk?
Previously, the volume of alcohol consumed was assumed to be the most important factor in determining the risk of cirrhosis—simply, the more alcohol your liver has had to process, no matter how frequently it happens, the bigger your risk. However, research on the effect of drinking patterns was limited. To determine if drinking patterns affect cirrhosis risk, researchers from Denmark used data on 56,000 participants between the ages of 50 and 64 from the Danish Cancer, Diet and Health study (1993-2011). There was information provided on alcohol intake (at present and in the past, as well as details about the specific type of alcohol consumed), drinking patterns and various potentially important variables. The researchers also took follow-up information from national registers. Daily Drinkers at Greatest Risk for Cirrhosis
The researchers found 257 cases of cirrhosis among the men, 85 among the women and no cases in lifetime abstainers from alcohol, as expected. The main finding was that—among men—daily drinking was associated with over 3.6 times the risk of developing cirrhosis as drinking between two and four days per week. The findings also showed that recent drinking habits—in this sample, between the ages of 40 and 59—were associated with increased risk, but consumption in earlier periods wasn’t. Additionally, when consumed in moderate amounts each week, wine appears to be associated with a lower cirrhosis risk than beer or hard liquor, according to the findings. Generally, the results were the same for women, but the low number of cases in women limited the ability to draw firm statistical conclusions.
Commenting on the findings, lead author Dr. Gro Askgaard said, “For the first time, our study points to a risk difference between drinking daily and drinking five or six days a week in the general male population.” He continued, “Since the details of alcohol induced liver injury are unknown, we can only speculate that the reason may be that daily alcohol exposure worsens liver damage or inhibits liver regeneration.”
Dr. Askgaard also explained how previous research came to conflicting conclusions on issues such as whether past heavy drinking predicted future cirrhosis risk even after the individual had cut back, and this study therefore has potential to help with evidence-based counseling and other interventions at the general population level. Simply put, the better we understand how cirrhosis risk is related to the patterns of alcohol consumption, the better we can help people lower their risks.
Alcohol Addiction and Cirrhosis Risk
The finding has one clear implication for those struggling with alcohol addiction: the risk of cirrhosis is greater for those with daily, addict-like drinking habits, but can be minimized by changing those habits. Previously, when cirrhosis risk was assumed to be solely linked to the volume of alcohol consumed, experts thought that there was nothing that could be done to lower risk, but the new finding suggests prolonged abstinence could lead to a notable reduction over time. However, the unavoidable truth is that once cirrhosis begins and parts of the liver become scarred, they can’t be recovered. Abstinence can reduce your risk over time, but it’s important not to leave it until too late.