The liver breaks down almost all the alcohol we drink. Regular drinking over years can injure it, usually without any symptoms until the damage is advanced.
How the damage builds up
- Fatty liver: fat builds up in the liver. It is common in regular drinkers, and usually reverses within weeks to months of stopping.
- Alcohol-related hepatitis: inflammation of the liver, sometimes after a period of heavy drinking. It can cause yellowing of the eyes, fever and a swollen abdomen, and can be serious.
- Fibrosis and cirrhosis: scarring that builds up over years. Cirrhosis raises the risk of liver failure and liver cancer.
Who is at higher risk
- People who drink more, or more often, and for more years
- Women, who are affected at lower amounts than men
- People who already have fatty liver, hepatitis B or hepatitis C, or who are overweight or have diabetes
- People whose face turns red after drinking. This flushing means the body is slow to clear acetaldehyde, a toxic product of alcohol, and is linked to a higher risk of cancer of the food pipe.
There is no amount of alcohol that is completely safe. If you have liver disease, the safest choice is not to drink at all.
Tests
- Liver blood tests, such as ALT, AST and GGT
- An ultrasound scan of the liver
- A FibroScan to measure scarring
- Tests for other causes of liver disease, such as hepatitis B and C
Recovery
The liver can recover well. Fatty liver often clears after stopping, and even with scarring, stopping alcohol slows or halts further damage and improves survival. If cutting down is difficult, ask for help; counselling and medicines are available.
Seek urgent care at an emergency department for yellowing of the eyes with confusion or drowsiness, vomiting blood, black stools, or severe shaking or confusion after stopping heavy drinking.
General information only. Reviewed by Dr Chia Chung King, 2026-11-13. Book a consultation.