WHO recently published a statement in The Lancet Public Health that ‘when it comes to alcohol consumption, there is no safe amount that does not affect health’.
Dr Sanjiv Saigal, MD, DM, DNB, MAMS, MRCP, FRCP, FINASL, CCST (UK), Principal Director and Head, Hepatology & Liver Transplant, Max Hospital, Saket shares, “I frequently encounter patients who say that they drink only beer and do not consider beer as alcohol. It is important to note that beer consumption is as good as consuming any other type of alcohol.
The type of alcohol such as beer, whisky, rum, gin etc. fall into the same category of alcoholic drinks. It is the percentage weight by volume of alcohol which is important. For example – the content of alcohol in beer is about 5%, whereas in whisky it is 40%; stronger beer has a higher alcohol content. One should also know what is “one standard drink” which is roughly equivalent to 10 gm of alcohol regardless of the container size or alcohol type (beer, wine, whiskey).”
Dr Neeraj Kumar Tulara – General Medicine & Infectious disease specialist, Dr. LH Hiranandani Hospital, Powai further adds, “I often encounter questions from patients who believe that beer is not actually made into alcohol due to its low alcohol content compared to other beverages. However, it is important to clarify that beer does contain alcohol and it can affect your health. Alcohol, in whatever form, has the same effect on the body. It can impair decision-making, planning, and cognitive functioning. Regular and excessive consumption, like any alcohol, can pose health risks. These risks include an increased risk of liver damage, addiction, cardiovascular problems and certain cancers.”
Why is it difficult to diagnose alcohol-related liver disease (ARLD)?
You will commonly hear from doctors and experts that it’s very tricky to diagnose alcohol related liver issues. And the condition gets worse rapidly. But why so? Dr Adrita Banerjee, MD Internal Medicine, consultant physician, Godrej Memorial Hospital, Mumbai explains, “Unfortunately the symptoms of ARLD appear only when the liver is severely damaged. They include lethargy, weight loss, loss of appetite, yellowish discoloration of eyes and skin, Swelling in legs and ankle or abdomen, confusion/drowsiness, blood in vomit or stool. Hence it is quite difficult to diagnose alcohol related fatty liver if the patient is not getting routine preventive health checkups done.
Another important factor is denial of the person having a drinking problem. It delays diagnosis. Patients have excuses and explanations of the amount of alcohol they are consuming as well as the frequency. On leading questions, especially when accompanied with family, they feel skeptical to open up and identify the consumption as a problem. This in turn poses a challenge to the physician to reiterate the damage the consumption can cause to the individual in the long run.”
Dr Sanjiv adds, “Firstly, the level of alcohol that leads to liver damage and damage to other organs in the body varies person to person & some can develop damage even at a lower level of alcohol drinking.”
It is important to note that each time our hepatocytes (liver cells) filter alcohol, some of the cells get degenerated. Liver has an excellent capability to regenerate cells and make new cells but if prolonged alcohol misuse is done, it is going to reduce the regenerating abilities of the liver cells and hence cause permanent damage to structure and function of the liver. Alcohol addiction is a common problem for individuals who are taking daily drinks even in moderation. As a result the consumption may keep increasing without realizing that this is starting to pose a significant health risk. Hence “ No amount of alcohol is safe”, warns Dr Aditya.
Signs of alcohol related liver disease to watch out for include…
Sometimes the first symptoms of alcoholic fatty liver can be subtle and easily overlooked, especially in the early stages. However, Dr Neeraj says there are a few symptoms that can indicate the presence of alcoholic fatty liver disease, and it is important not to rule it out. Fatigue and weakness are common symptoms of fatty liver disease, which can be due to various reasons. Pain and discomfort in the right upper abdomen is also common, as the liver swells due to the accumulation of fat. Loss of appetite can lead to a loss in appetite and weight loss, and unintentional weight loss can occur. Jaundice is a relatively late sign of severe liver damage, and the skin and eyes may appear yellow when the liver is damaged. While weight gain is often closely associated with liver disease, some individuals with alcoholic fatty liver may experience unexplained weight loss. This weight loss can occur even without significant changes in diet or exercise.
Godrej Memorial Hospital recently launched Health Genometer Smart plan which is using Exome analysis as a part of identifying and risk stratifying individuals of future diseases based on their genetic makeup. Alcohol addiction trait as well as non alcoholic fatty liver disease trait can be identified at an early stage in life and adequate lifestyle and dietary modifications as well as medical management can ascertain halting the disease progression.