Research has revealed a steep increase in liver disease in recent years. Meanwhile, there is growing evidence of health harms from alcohol, including drinking at levels that were previously considered “moderate.” These developments make a persuasive case for viewing alcohol consumption from a public health perspective.

As an internal medicine physician and alcohol epidemiologist, I’m interested in the overlap between liver disease and alcohol use among patients and in the general population. As it turns out, these topics are closely related, but maybe in surprising ways.

The liver is essential: humans need it to live. The liver contributes to metabolism and food storage, produces proteins that help with blood clotting and plays a vital role in the immune system.

At the cellular level, alcohol is a toxic substance that is metabolized (broken down) primarily in the liver. When the dose of alcohol is too high, liver cells become inflamed and damaged (liver inflammation is called hepatitis).

Over time, inflamed or damaged cells are replaced by fibrosis, which is the replacement of normal liver tissue with scar tissue, resulting in cirrhosis, or severe scarring and liver dysfunction. Cirrhosis can be fatal on its own and can also lead to liver cancer.

Liver disease caused by........

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