Coronavirus: stay safe with our facts, information and practical advice about alcohol and your health
The liver is our largest internal organ and it has 500 different roles, including the breakdown of food into energy and helping the body get rid of waste products and fight infections - particularly in the bowel1. And yet, when your liver is damaged, you generally won’t know about it – until things get serious.

Drinking alcohol can increase your risk of developing liver disease and cause irreparable damage to this very important part of your body. In fact, alcohol is a major cause of the 25% increase in deaths from liver disease in England over the last decade (from 9,231 in 2001 to 11,575 in 2009)2.

Overall, alcohol-related liver disease accounts for well over a third (37%) of liver disease deaths. And figures show victims of liver disease are getting younger – more than one in 10 of deaths of people in their 40s are from liver disease, most of them from alcochol-related liver disease3.

The types of liver disease

There are many types of liver disease, four of the most common are:

1. Alcohol-related fatty liver-disease

Where the liver is damaged after alcohol abuse.

2. Non-alcoholic fatty liver disease

A build-up of fat within liver in liver cells.

3. Viral (Hepatitis)

An inflammation (swelling) of the liver caused by a viral infection.

4. Autoimmune (chronic hepatitis)

Severe form of hepatitis where blood cells attack and destroy liver cells.

All types of liver disease above can cause damage to the liver. The advice on this page is specific to alcohol-related liver disease.

Alcohol-related liver disease can be prevented if you understand the impact excessive alcohol drinking can have on your liver and take-steps to control the amount you drink. For more information on how alcohol affects your health, read about the short and long-term effects of alcohol in your body.

How does alocohol impact the liver?

Liver disease is the term used to describe damage to the liver. There are two types of liver disease:

  • Acute is when liver problems develop over a few months
  • Chronic is damage over a number of years

There are lots of different causes of liver disease, including drinking alcohol to excess which causes ‘alcoholic liver disease’. Scientists are not sure exactly why drinking too much alcohol can damage your liver but the reasons include:

  1. Oxidative stress. When our liver tries to break down alcohol, the resulting chemical reaction can damage its cells. This damage can lead to inflammation and scarring as the liver tries to repair itself.
  2. Toxins in gut bacteria. Alcohol can damage our intestine which lets toxins from our gut bacteria get into the liver. These toxins can also lead to inflammation and scarring.

 Use our simple Unit Calculator to find out exactly how much you're drinking

Drinking alcohol can increase your risk of developing liver disease

Evidence about how much and how often you need to drink to increase your chances of developing liver disease is unclear. But all the research shows that the more alcohol you drink, the more likely you are to develop liver disease.

Evidence suggests that other factors that increase your risk of developing liver disease include:

  • Being dependent on alcohol  around seven in 10 people with alcoholic liver disease have an alcohol dependency problem4.
  • Being overweight –excess weight can exacerbate many of the mechanisms of liver damage caused by excessive drinking5

Excessive drinking can make your liver get fat

Drink more than eight units a day (four pints of 4% lager) if you’re a man and over five units a day (a couple of 175ml glasses of wine) if you’re a woman, for two or three weeks and you’re likely to develop something called 'fatty liver’6.

This is when the liver turns glucose into fat, which it sends round the body to store for use when we need it. Alcohol affects the way the liver handles fat so your liver cells get stuffed full of it.

If this happens, you may feel a vague discomfort in your abdomen because your liver is swollen. You might also feel sick and lose your appetite. A blood test may be able to show if you have fatty liver.

The good news: If you stop drinking for two weeks and do not exceed the UK Chief Medical Officers' (CMO) low risk drinking guidelines, your liver should start shedding the excess fat. But if you don’t change your drinking pattern, that fatty liver is the first stage of developing liver disease.

Stopping drinking will help reduce damage and the progression of alcohol-related liver disease.
 Find out if you're drinking too much with our Alcohol Self Assessment tool

Identifying liver disease: the symptoms

People can spend 20 years damaging their liver and not feel any of the effects this is doing to them.

Early symptoms of liver disease can include:

  • Abdominal pains 
  • Diarrhoea
  • Fatigue
  • Nausea
  • Vomiting

Later stage liver damage symptoms are more serious – and you’ll know about them.

They can include:

  • Bleeding in the gut
  • Easy bruising
  • Fatigue
  • Jaundice (yellow skin)
  • Increased sensitivity to alcohol and drugs, both medical and recreational (because the liver cannot process them
  • Itching
  • Liver cancer
  • Swelling of the legs ankles, or abdomen
  • Vomiting blood
  • Weakness, loss of appetite7

When you develop cirrhosis, cutting out alcohol is essential to prevent you from dying from liver failure which is when your liver stops working completely. In the most serious cases of cirrhosis, you will only be considered for a liver transplant if you do not drink alcohol for at least three months8

If you start soon enough, you can reverse problems with your liver caused by alcohol

Drinking within the UK Chief Medical Officers' (CMO) low risk drinking guidelines (drinking no more 14 units a week for both men and women) and spreading those units over three days or more will help keep your risk of developing liver disease low. Reducing the amount you drink can help reverse damage of  the earlier stage alcohol-related liver disease.

Visit the British Liver Trust's Love Your Liver website for tips on how to achieve better liver health and to use their liver Health Check tool

Once cirrhosis develops, prognosis partly depends on whether or not you continue drinking. Those who continue to drink will feel sicker and die sooner. Even for those with symptoms, stopping drinking has a beneficial effect – it is never “too late” to stop drinking – even with cirrhosis.  

Staying in control

You can keep your risk low by staying within the government’s recommended low risk guidance. Here are three ways you can cut back: 

  1. Spread your alcohol-intake out over three days or more. . If you want to cut down, a great way is to spread your drinking out over the  days a week. Test out having a break for yourself and see what positive results you notice. 
  2. Eat well.A healthy meal before you start drinking, and low-fat, low-salt snacks between drinks can help to slow down the absorption of alcohol. Good nutrition can help to support your liver to function and plays a crucial role in your health9.
  3. Keep track of what you’re drinking.Your liver can't tell you if you're drinking too much, but the MyDrinkaware drink tracking tool can. It can even help you cut down.

Further information

Your GP can help you figure out if you should make any changes in your drinking, and offer help and advice along the way.

If you’re concerned about someone’s drinking, or your own, Drinkline runs a free, confidential helpline. Call 0300 123 1110 (weekdays 9am – 8pm, weekends 11am – 4pm).

The British Liver Trust provides support and information on liver disease and also funds research. Call their free helpline Monday to Friday from 10am to 4.30pm on 0800 652 7330 or visit the British Liver Trust website.


(1) British Liver Trust website. About The Liver. The Information Standard member organisation. Last reviewed: not known. Accessed: 30/11/15. Available at:
(2) (3) National End of Life Care Intelligence Network website. Deaths from Liver Disease: Implications for end of life care in England. Available at:
(4) NHS Choices website. Alcohol-related liver disease – Treatment. The Information Standard member organisation. Last reviewed: 24/9/15. Available at:
(5) Marchesini G, Moscatiello S, Di Domizio S, Forlani G, 'Obesity-associated liver disease', J Clin Endocrinol Metab, 2008 Nov, vol. 93, no.11, suppl 1, pp. S74-80, Accessed August 2014. Available at:
(6) Drinkaware interview with Professor Chris Day
(7) NHS Choices website. Symptoms of alcohol-related liver disease. The Information Standard member organisation. Last reviewed: 24/09/2015. Available at:
(8) British Liver Trust website. Cirrhosis. The Information Standard member organisation. Last reviewed: March 2011. Available at:
(9) British Liver Trust website. Diet & liver disease. The Information Standard member organisation. Last reviewed: August 2011. Available at:

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