Alcohol and your liver explained

Written by: Professor Roger Williams CBE
Edited by: Cal Murphy

It is no secret that alcohol and liver disease go hand in hand. Drinking too much is associated with liver cirrhosis (scarring), liver failure and even liver cancer. What you might not know is how alcohol damages the liver, how much is “too much”, and if the damage can be reversed. Leading hepatologist Professor Roger Williams CBE answers all these questions and more.

How does alcohol damage the liver? What occurs on a molecular or cellular level?

Alcohol is directly damaging to the cells of the liver due to a breakdown product in the liver known as acetaldehyde and there is a cut-off level of 14 units of alcohol a week (the equivalent of six glasses of wine or six pints of beer or 14 single shots of a spirit) at which this becomes significant.


Is all alcohol intake damaging, or do you need to have a certain “threshold” of alcohol consumption at a time?

Below the level of 14 units of alcohol a week, the risk of liver damage is relatively minimal. What is not well known by the public is that there is an increased risk of cancer development with excess alcohol consumption, particularly of the common cancers, which are namely breast cancer in females and colon cancer in males. There is also an increased risk with harmful drinking of developing hypertension and cardiac disease, and in the elderly this is a major route to dementia.


Is the damage reversible?

Stopping excess drinking or reducing the level of drinking does enable the liver to recover to some extent, even at late stages of the condition. This should be better known to encourage a person to do so.

A good way of cutting down on alcohol consumption is to have several drink-free days each week and the safest way of drinking is with a meal.

Binge drinking is a particularly harmful activity and should be avoided at all costs.


Are some people more susceptible to liver damage than others? Why?

Though drinkers tend to blame the genes they have inherited, genetic influences play only a small part in susceptibility to alcohol.


Visit Professor Williams’s Top Doctors profile to book an appointment.

Professor Roger Williams CBE

By Professor Roger Williams CBE
Hepatology (liver specialist)

Professor Williams is the Director of the Institute of Hepatology, London and Medical Director of the Foundation of Liver Research, a UK-registered charity. He holds an honorary consultant hepatology position in King's College Hospital.

The Institute of Hepatology is an independent research institute funded and managed by the Foundation for Liver Research, a charity set up by Professor Williams in 1974. It has affiliate status to the King's College London and King's College Hospital. Between 1996 and 2010 Professor Williams established a major research institute at University College London and built a major clinical service in hepatology at University College Hospital. During that time he was also responsible for setting up the liver centre at The London Clinic. In his current position he remains close to the world-renowned Institute of Liver Studies at King's College Hospital which he started from scratch as a liver unit in 1966. For 30 years he was Director, building it to become one of the largest clinical and research liver units worldwide. He was responsible, together with Professor Sir Roy Calne, for the early pioneering start of liver transplants in the UK.

He is a fellow of the Academy of Medical Sciences, London and Royal College of Physicians where he was Clinical Vice President and Director of the International Office. He is a recipient of numerous honorary fellowships, medals and prizes including the American Society of Transplantation Senior Achievement Award in 2004, a Hans Popper Lifetime Achievement in 2008, the Distinguished Service Award of the International Liver Transplant Society in 2011, and in 2013 the Distinguished Achievement Award of the American Association for Study of Liver Disease. Since 2013 he has been Chairman of the Lancet Commission into Liver Disease in the UK which, with its body of experts and its annual reports and Parliamentary meetings, has addressed the main lifestyle causes of liver disease in the country, namely alcohol, viral hepatitis and obesity.

His main clinical and research interests are in acute and chronic liver failure, liver support devices, liver transplantation, complications or cirrhosis and management of viral hepatitis.

Professor Williams has wide experience of providing expert medical legal reports and can be contacted through his office at the Institute of Hepatology.

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