At nearly every doctor’s appointment, you’ll be asked how much alcohol you drink. Before you automatically answer, “I drink socially” so your doctor moves on to the next question, take a moment to really think about your drinking habits. It’s easy to underestimate how much you drink when you’re out with friends, or how frequently you drink if you regularly have beer or wine with dinner.

While you may still be able to function normally and meet all of your responsibilities, drinking too much can take a toll on your body and your liver. Nearly 20,000 people die from alcohol-induced liver disease (ALD) every year in the United States. Your risk for developing ALD increases with the frequency and amount of alcohol you drink.

How Much Alcohol is Too Much?

That’s not an easy question to answer since some people can drink frequently and not develop long-term problems with their liver, while others drink less and develop ALD.

A good guideline for safe drinking limits comes from the American Heart Association: No more than two drinks per day for men and one drink per day for women. One drink is considered a 12-ounce glass of regular beer, a 5-ounce glass of wine, or 1.5 ounces of spirits. If you go beyond these limits, you increase your risk of developing alcohol-related problems, including ALD.

The Stages of Alcohol-Induced Liver Disease

ALD occurs in three stages of increasing severity. It’s important to note that not everyone who drinks – even those who drink heavily – will progress from one stage to the next.

• Fatty Liver: Drinking heavily can cause fat to collect in the liver, which is reversible if you stop drinking. Many times you won’t experience any symptoms, but you may have a loss of appetite, pain in your abdomen, and nausea.
• Alcoholic Hepatitis: Alcoholic hepatitis is an inflammation of your liver, which can happen if you drink heavily for many years. It’s usually reversible if you abstain from alcohol for weeks or years. Symptoms include pain and tenderness in the abdomen, jaundice (yellowing of skin and eyes), tiredness, nausea, and a general unwell feeling.
• Cirrhosis: Cirrhosis is advanced liver disease, which happens after the liver has been inflamed for a long time. This inflammation leads to irreversible scarring, which keeps the liver from working efficiently to detoxify your blood, synthesize proteins, and produce the chemicals needed to digest food. Early-stage symptoms include tiredness, abdominal pain, weight loss, itchy skin, and loss of appetite. Late-stage symptoms include jaundice, hair loss, bruising, muscle cramps, vomiting, accelerated heart rate, confusion, and increased abdominal swelling.

Treating Alcohol-Induced Liver Disease

The first step in treating ALD is to abstain from drinking. This can help reverse the damage to your liver if the disease is in the early stages and prevent future damage. Quitting drinking on your own can be hard, so your doctor may recommend counseling and support groups to help.

Your doctor may also treat related problems common to people with ALD, such as malnutrition. You may also be given medications such corticosteroids to reduce liver inflammation.

If you think you may be drinking too much, talk to your doctor to come up with a plan to reduce your consumption – and your risks.