The liver is an organ with a bunch of different functions, which are all essential to our wellbeing.
It helps us digest food. It produces a number of different proteins, including ones that help form blood clots. It stores vitamins and minerals, and deals with all the stuff that enters our blood. And all of the blood vessels that connect to our intestines are also connected to the liver, except for the posterior part of our guts.
One of the functions this organ performs is metabolizing and getting riff of toxins. So, for instance, you ate some sunflower seeds, and they contained small amounts of aflatoxin. Aflatoxin is produced by molds, and is a carcinogen that also causes mutations. It is normal to find traces of this toxin in a lot of different types of food, and up to a certain amount, the toxin is harmless (that's why we have food safety regulations). And the reason the toxin is harmless for us is because the liver is doing its job. It breaks the toxin down into harmless molecules, and excretes it out of the organism via feces.
The same thing goes for alcohol. In many different regions of the world, and in many different cultures, drinking alcohol is acceptable, and in some situations even encouraged. And, up until recently, whenever you opened my fridge, you could find at least four cans of beer, just in case. I really love beer.
But drinking often, drinking large amounts, of alcohol or binge drinking overloads the liver to the point of "burnout", and can cause permanent damage.
So, how much drinking is too much?
Well, that's not an easy question. Determining if somebody is an alcoholic, or determining if and how fast the liver is going to deteriorate depends on a number of factors. It can depend on the sex, since men can usually handle more alcohol than women. Age should also be taken into consideration. How much, and how often you drink plays an important role, binging every once in a while isn't the same as drinking a few beers every day.
It is generally considered that it's safe for men to drink up to four standard drinks per day, but less than 14 per week. Women should stick to three standard drinks per day, and less than seven per week. This, of course, doesn't apply to everybody. There have been cases of acute liver failure after a couple days of heavy drinking. Then, there are people, like late Lemmy Kilmister of Motorhead, who self-reportedly drank a bottle of Jack Daniels each day for decades. (He did, however, eventually die from alcohol-related complications, at the age of 70. Thank you for your music, Lemmy.) Years of research have led scientists to these general conclusions, and the majority of people fit into this rule. In fact, only two percent of alcoholics, and people with alcohol-related liver conditions, didn't fit into these recommendations.
And what is a standard drink? It depends on the beverage, but one standard drink always has 10g of alcohol in it. If we're talking about beer, one large beer containing 4.8 percent of alcohol equals to 1.6 standard drinks. A bottle of red wine equals eight standard drinks, and a glass of red wine equals 1.6 standard drinks. One shot of hard liquor equals one standard drink as well. There are useful guides online on how to calculate the amount of standard drinks in each beverage.
1. Portal hypertension and varices
The inflamed or scarred tissue within the liver makes it hard for the blood in the vessels to flow normally. Abnormal flow makes the blood pressure in those blood vessels rise, which, consequently, thins the wall the veins and weakens them. Weakened vein walls can burst, causing a bleeding, which can happen not only in the liver, but in the other veins connected to the liver as well (i.e. the veins around the intestines).
It is not rare for alcoholics to have esophageal varices, which basically means that they bleed from their esophagus, or the upper part of the stomach. This usually manifests as bloody vomit, or dark, even black stool called melena. But, don't start panicking right away if you had black stool — it can also be caused by taking iron supplements (which, as a little side note, are NOT recommended for people suffering from liver issues), or if you've eaten certain foods, such as blueberries or beetroot.
Consuming alcohol in large amounts is often associated with hemorrhoids. This happens for a couple of reasons. Firstly, alcohol is a diuretic, which means that it makes you urinate more, resulting in mild dehydration that in turn causes constipation. Or, if you prefer beer or spritzer, the amount of water in those drinks is too much for our lower intestines to take, resulting in diarrhea.
In both cases, the result is spending more time on the toilet than usual. This puts a lot of pressure on the blood vessels surrounding the anus, weakening them and making them easier to burst. Also, if the liver has deteriorated extensively and the organ cannot function properly any longer, forming blood clots can become a problem, which can also a person one bleed from the veins surrounding the anus.
Ascites is a term describing fluid accumulation in the abdomen. When the pressure in the abdominal blood vessels builds up, the liquid phase of the blood exits the vessels, and ends up in the abdomen. Also, if the liver is damaged and cannot produce enough albumin (a type of protein which helps keep the liquid inside the blood vessels), the liquid evacuates to the abdomen. (If you've ever seen photos of starving children with big bellies in Africa, the reason behind the big belly is the same: it's full of water. But the cause is different. They don't get enough protein in their food.)
Encephalon is a Greek word that means "the brain". The suffix -pathy means that something's wrong with that organ. Hence, encephalopathy is a broad term which means that something isn't right with the brain. As mentioned previously, one of the jobs the liver does is making sure that all the toxins are cleared out of the organism. If its not able to do so, the toxins enter the blood, and eventually end up in the brain, damaging the organ. This can manifest in a number of ways, such as drowsiness, confusion, slurred speech, and sometimes even coma, and death.