If you’ve seen a liver with cirrhosis, it’s not an image you’d easily forget: brown, scarred, bubbly, and terrifying. Images of a liver with cirrhosis are often shown in high school health class to demonstrate the devastating physiological consequences of alcohol consumption.

So, what exactly is cirrhosis of the liver and how does alcohol facilitate its progression?

To answer this question we need to first understand how the liver functions. The liver is the largest organ of the body and is comprised of a complex, yet delicate, aggregation of fibrous tissue lobules. The liver performs a myriad of functions, but most relevant to our discussion is its ability to filter circulating blood, removing and destroying the toxic substances it may contain. It follows that when we drink, the liver is responsible for the metabolism – or break down – of alcohol. In this process, dangerous by-products are generated such as acetaldehyde and free radicals that enact damage on the liver and other organs in the body.

Alcohol-related liver damage happens in three ways. Even a single binge will leave fat deposits on the liver, leading to fatty liver – the first type of liver damage. In heavy drinkers, these fat deposits will be more prevalent. However, scientists believe them to be reversible if you completely refrain from drinking for six weeks. The second category of liver damage is alcoholic hepatitis, a medical term which describes the destruction and inflammation of the liver tissue, leading to its eventual scarring. According to the National Institute on Alcohol Abuse and Alcoholism, alcoholic hepatitis occurs in almost 50% of heavy drinkers. Some of the symptoms of alcoholic hepatitis include jaundice (yellow tinted skin), fever, and persistent stomach pain. The last, and most dangerous, way that alcohol affects the liver is alcoholic cirrhosis, characterized by significant scarring (or fibrosis) of the liver in a way that damages its complex inner structure. These three phenomena typically happen in order, implying that this progression can be stopped with sobriety.

Learn more about the effects of alcohol on the body and signs someone could be misusing here.

References:

https://pubs.niaaa.nih.gov/publications/arh21-1/05.pdf

http://my.clevelandclinic.org/health/articles/alcohol-your-heart-health

Originally published in 2018.