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Alcohol & the Liver

What is alcohol?

Alcohol is derived from the fermentation of sugar by yeast. The main psychoactive ingredient in alcoholic drinks is ethanol, or ethyl alcohol.

Ethanol dissolves quickly in water and is quickly absorbed into the bloodstream. In the short term, in small doses, it acts on receptors in the brain to make people feel uninhibited and provides a general sense of well-being. Drinking more alcohol starts to affect the balance and the speech centre of the brain. If you drink regularly, the brain’s receptors adapt to the alcohol and higher doses are needed to cause the same effect.

2 people holding on to a cup of whiskey raising a toast

An illustration of what will happen to your organs if you consume alcohol

What happens when you drink alcohol?

Alcohol is quickly soaked up through the lining of the stomach and the upper part of the intestine and into your blood stream. The higher the concentration of alcohol, the faster it will be absorbed (whisky will be faster than beer, for example).

From there, the alcohol is carried to your liver as well as other organs such as the brain and may alter your physical coordination and mental judgement.

Your liver cannot store alcohol. It processes about 90 per cent of the alcohol you drink to eliminate it from your body.

What happens to the liver if you drink too much?

Along with the central nervous system, the liver suffers the most from alcohol consumption.

Your liver can only handle a certain amount of alcohol in any given time (one unit an hour). If you are drinking quickly, your liver cells will have to work overtime to process the alcohol. When this is more than the liver can deal with, the excess is transported to the rest of your organs.

Regular and heavy drinking over time can lead to alcoholic liver disease.

The first stage of disease may not seem all that significant but must be acted upon. The later stages are very serious and can threaten your life.

An illustration of the stages of liver damage

Fatty Liver Cells

Fatty liver

When the liver breaks down alcohol, it stores the fat in your liver. There should be little or no fat in a healthy liver. Too much of this fat can build up if you drink more than the liver can cope with, leading to fatty liver disease.

Fatty livers return to normal if you drink within the sensible limit. If you carry on drinking above that limit you are running the risk of more serious damage.

Alcoholic hepatitis

If you have a fatty liver and continue to drink, you have up to a one in three chance of getting alcoholic hepatitis. This is a condition where your liver becomes puffy, swollen and tender. It can affect you suddenly – after a weekend of heavy drinking, for example – and if your liver fails, it can kill you. Alcoholic hepatitis can happen to you at an early stage or after many years of excessive drinking.


The final stage of any chronic liver disease is cirrhosis. This is usually the result of long-term, continuous damage to the liver. The odds are one in ten that will develop cirrhosis if you drink too much over a long period of time. The complications of liver cirrhosis include liver failure, bleeding problems and liver cancer.

All these complications are potential life threatening.

Alcoholic hepatitis

Picture of a few happy ladies holding on to a glass of champagne

What is sensible drinking?

Women are more susceptible to liver damage than men, even if they drink less.

The following guidelines are for sensible drinking:

Women should not regularly drink more than 2
to 3 units of alcohol in a single day (no more
than 14 units in a week)

Men should not regularly drink more than 3 to 4
units of alcohol in a single day (no more than 21
units in a week)

These are guidelines for Caucasian patients. Asian patients may be more susceptible to alcohol.

Calculating units

An accurate way of calculating how many units you are drinking is to multiply the alcohol content figure (abv) by the size of your drink in millilitres and divide by 1,000.

For example, a typical can of beer these days is 440ml, at 5% abv strength. Therefore: 440 x 5 = 2,200; divide this by 1,000 = 2.2 units.

Find out more information on the adverse effects of alcohol at Andrea's Digestive Clinic.

alcohol content (unit) in wine
A standard glass of wine (175ml) at 12% abv is 2.1 units and a large 250ml glass is 3 units
alcohol content (unit) in whiskey
A measure (35ml) of whisky/brandy spirits (40% abv) is 1.4 units
Alcohol content (unit) in beer
A can of beer (330ml) at 5% abv is 1.6 units. A large bottle of beer at 5% is 3 units. A jug (1000 ml) of regular strength (5% abv) beer or stout is 5 units
alcohol content (unit) in brandy
A 750ml bottle of spirits (whisky, brandy, vodka etc) is 30 units

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