Liver disease: can the liver repair itself after years of drinking?

Written by: Dr Ghazanfar Ali
Published: | Updated: 21/02/2020
Edited by: Emma McLeod

The liver is an organ with the ability to regenerate, but after consuming excess alcohol over a long time, there is a stage in which this ability can become impaired or impossible. Dr Ghazanfar Ali has been treating alcohol related liver disease (ARLD) for many years, and here he explains the stages of ARLD, if the liver can heal itself and more.

A close up of six glasses of wine in the hands of various people. They are clinking the glasses together, presumably after a speech or toast.


What is alcohol-related liver disease (ARLD) exactly?

Alcohol is used as a drink to enjoy life, but many people may not be aware of the damage it can cause if consumed on a regular basis over a long period of time. If more than 14 units of alcohol are consumed weekly over the years, it can cause irreversible damage to the liver, even if the units are consumed over only two to three days a week.


What are the 3 stages of ARLD?

Alcohol causes liver damage in three stages.


  1. In the first stage, people develop fatty liver. This is an accumulation of fat in the liver cells which occurs due to alcohol being metabolised and the production of fat in the liver. It occurs readily in people who are overweight, sedentary and have an unhealthy diet.
  2. If one continues to drink, the second stage is alcoholic hepatitis. This is due to inflammation in the liver cells and at this stage, liver blood test results become abnormal. It can develop after many years of drinking or relatively early-on.
  3. The third stage is liver cirrhosis. It develops after many years of harmful drinking. In earlier stages after alcoholic hepatitis, liver cells start to die and this leads to scarring and fibrosis (excess tissue) of the liver cells. At this stage the liver starts to become stiff with reduced elasticity, forms nodules, its shape becomes distorted and the liver shrinks in size.


Can the liver repair itself after years of drinking?

Liver cells can regenerate if there is a single injury or trauma and if only some of the liver cells are damaged. If the liver injury occurs over the years with continuous prolonged damage, then cirrhosis develops and the damage becomes irreversible. Once cirrhosis has finally developed, the only treatment option is a liver transplant.


Is liver disease common in the UK?

Liver disease is the third leading cause of death in the UK and over 40 people die of the disease every day. Liver disease is now the biggest cause of death in those aged between 35-90 years old and since 1970 deaths due to liver disease have increased by 400%


ARLD, along with fatty liver and hepatitis C, is the most common cause of cirrhosis in the UK. ARLD accounts for 60% of all liver disease.


Can you offer any advice to avoid ARLD?

Prolonged and excess use of alcohol is what leads to liver damage. Drinking in moderation with two or more alcohol-free days a week should minimise the damage, and to be within safe limits, one should not drink more than 14 units of alcohol a week, whether male or female, and avoid binge drinking as it’s harmful to the liver.


However, alcohol consumption, even in moderation, may cause liver damage if a person is overweight, has diabetes, and/or an unhealthy lifestyle. For a person with these characteristics, even drinking less than 14 units may cause liver damage, hence to prevent ARLD, one needs to avoid excess use of alcohol and adopt a healthy lifestyle.



Dr Ghazanfar Ali is a leading gastroenterologist with many years of experience in treating liver disease. Don’t hesitate to visit Dr Ali’s profile and book a consultation.

Dr Ghazanfar Ali

By Dr Ghazanfar Ali

Dr Ghazanfar Ali is a leading consultant gastroenterologist based in Chorley and Bolton, Greater Manchester. He specialises in liver diseases, irritable bowel syndrome, dyspepsia, reflux disorders and diarrhoea and constipation. He currently practices general gastroenterology with a special interest in hepatology.

Dr Ali qualified in 1984 in Pakistan, where he completed his initial training before arriving in the UK, where he was trained in both general internal medicine and gastroenterology. During his education, he worked in many hospitals across the Northwest and went on to specialise in gastroenterology at Royal Albert Edward Infirmary, Wigan in 2002. He now practices privately at BMI The Beaumont Hospital in Bolton and the Euxton Hall Hospital in Chorley.

He also currently holds an NHS position, practicing as a consultant gastroenterologist at the WWL, where he provides his services to the Metropolitan Borough of Wigan. Whilst being a consultant gastroenterologist, he also works as a tutor, teaching third-year medical students at the University of Manchester medical school and is also a qualified coach and mentor. This year, Dr Ali was proudly awarded the Fellowship of the Royal College of Physicians of Ireland - an international benchmark of professional excellence. He has been the clinical governance lead for gastroenterology and has a strong interest in service improvements and enhancing patient care.

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