Liver disease due to alcohol: pain in the right upper abdomen

Liver disease caused by alcohol can cause pain in the right upper abdomen. Alcohol-induced liver diseases or liver disorders are – as the name suggests – caused by excessive alcohol consumption and are quite common. There are three primary forms of alcohol-induced liver disease: fatty liver disease, alcoholic hepatitis and alcoholic cirrhosis. These diseases can be prevented by not drinking alcohol or drinking it in moderation. With liver disease caused by alcohol abuse, it is important to seek professional help from addiction care and to stop drinking alcohol before irreversible damage to the liver occurs.

Liver disease due to alcohol

    • What does the liver do?
  • Carbohydrate metabolism
  • Protein metabolism
  • Fat metabolism
  • Detoxification
  • Formation of bile
  • Storage function
    • What happens when you drink alcohol?
  • Breakdown of alcohol
  • Decomposition products
    • Liver disease due to alcohol
    • Fatty liver (hepatic steatosis)
    • Alcoholic hepatitis: pain in the right upper abdomen
  • Liver inflammation due to alcohol
  • Severe hepatitis
  • Symptoms
    • Alcoholic cirrhosis of the liver
  • Scar tissue
  • Increasing complaints
  • Moderate alcohol consumption prevents cirrhosis

Anatomy of the Liver / Source: BlueRingMedia/

What does the liver do?

The liver consists of a left and right liver lobe separated by a ligament (fold of tissue). The liver of an adult weighs about 1,500 grams. The liver is located in the upper right part of the abdominal cavity, next to the stomach and is a versatile organ. The functions of the liver include:

Carbohydrate metabolism

Storing glycogen, a chemical made from sugars (carbohydrates). When there is a need for it, glycogen is broken down and when there is an excess of energy (glucose), glycogen is built up. Glycogen is also stored in the muscles and is a quickly available energy supply.

Protein metabolism

The liver plays a role in converting amino acids into new, usable proteins, which are needed, for example, to build muscle tissue. The liver also produces a number of essential blood proteins such as globulin, which plays a role in the body’s defense against pathogens, and prothrombin, which is involved in blood clotting.

Location of the liver / Source: Nerthuz/

Fat metabolism

Fats are digested in the small intestine, producing fatty acids. The liver then changes the structure of the fatty acids so that they are more useful for metabolism.


The liver absorbs harmful substances from the blood and neutralizes them. These substances are then removed from the body via the bile or urine. Metabolism can produce harmful by-products for the body, but harmful substances can also enter the body through smoking, alcohol consumption and the use of medicines.

Formation of bile

Producing bile fluid, which is transported from the liver via the bile ducts to the gallbladder. Bile fluid helps digest fats.

Storage function

Numerous substances can be temporarily stored in the liver cells until the body needs them. For example, glycogen, fats, amino acids, vitamins and metals such as iron and copper.

Alcohol and the liver / Source:

What happens when you drink alcohol?

Breakdown of alcohol

When someone drinks alcohol, it is absorbed into the blood in the gastrointestinal tract. All blood from the stomach and intestines first passes through the liver before circulating throughout the body. So the highest concentration of alcohol in the blood flows through the liver. Liver cells contain enzymes (chemical substances) that play a role in the breakdown of alcohol. The enzymes break down alcohol into other chemicals, which in turn are converted into carbon dioxide and water.

Decomposition products

The liver cells can only process a certain amount of alcohol per hour. When alcohol is broken down in the liver, breakdown products such as acetaldehyde are formed. This is a highly toxic substance, which in larger quantities can damage the liver. If this happens, the metabolism in the liver can no longer proceed completely and, as a result, fat accumulation takes place. That is the beginning of fatty liver disease, which can eventually develop into inflammation or connective tissue. The latter is scar tissue formation in the liver and is called liver cirrhosis.

Liver disease due to alcohol

Chronic alcohol use has consequences for the body, both in the short and long term. In the long term, damage is caused to the organs involved in the absorption and breakdown of alcohol. Liver disorders can develop, among other things. Drinking too much alcohol can lead to three types of liver disease:

    • fatty liver disease;
    • hepatitis; and
    • cirrhosis of the liver.

All of these liver diseases can occur at the same time in a person.

Normal liver and fatty liver / Source: Alila Medical Media/

Fatty liver (hepatic steatosis)

Fatty liver disease is a build-up of fat in the liver cells and is found in many people who regularly drink too much. Fat can accumulate in the liver due to a disturbance in the fat and sugar metabolism of the liver, which is caused by regular excessive alcohol consumption. Usually, fatty liver disease does not cause any symptoms. However, the liver may feel enlarged on physical examination. This can lead to (vague) pain in the upper right side of the abdomen. There is no permanent liver damage in this phase. If caught in time, the fatty degeneration can be reversed by stopping (excessive) drinking of alcohol. Hepatitis can develop from fatty liver disease.

Alcoholic hepatitis: pain in the right upper abdomen

Liver inflammation due to alcohol

Hepatitis means inflammation of the liver. Alcoholic liver inflammation is caused by damage to liver cells due to the breakdown products of alcohol. The inflammation can range from mild to severe. Mild hepatitis may not cause any symptoms. The only indication of the inflammation may be an increased level of liver enzymes in the blood, which can be detected by blood tests. The damage caused to the liver by alcohol consumption can still be repaired if alcohol consumption is stopped in time. The inflammation can worsen with more drinking and in some cases the inflammation progresses to chronic hepatitis, which gradually attacks the liver, causing cirrhosis. This is known as healthy liver tissue being replaced by fibrous scar tissue. This can ultimately lead to liver failure.

Excessive alcohol consumption / Source: Deli

Severe hepatitis

More serious hepatitis can cause complaints such as nausea, jaundice, general malaise and sometimes pain in the liver (pain in the right upper abdomen) or star-shaped bruises under the skin. Acute hepatitis can develop when large amounts of alcohol are consumed over a long period of time. In very serious cases, brain damage can even occur. Acute liver inflammation can also lead to death due to additional complications.


All possible symptoms of alcoholic hepatitis at a glance:

    • ascites (fluid accumulation in the abdomen)
    • bleeding gums
    • stomach ache
    • darker or lighter skin color
    • a dark bowel movement
    • loss of appetite or lack of appetite

Stomachache / Source: Andrey Popov/

    • swollen ankles and legs
    • pass out
    • jaundice
    • weight loss
    • high fever associated with liver necrosis
    • nausea
    • agitation (excitement)
    • red hands or feet
    • mood swings
    • enlarged breasts in men (gynaecomastia)
    • fatigue
    • confusion

Liver cirrhosis / Source: Alila Medical Media/

Alcoholic cirrhosis of the liver

Scar tissue

Cirrhosis is a condition in which normal and healthy liver tissue is gradually replaced by scar tissue (fibrosis), with the result that at a certain point the liver no longer functions properly. This is a gradual process and about 1 in 10 heavy drinkers will eventually develop liver cirrhosis. It mainly occurs after 10 or more years of heavy drinking. Not only years of alcohol abuse, but also other causes can underlie liver cirrhosis. People who never drink a drop of alcohol can also develop liver cirrhosis, for example as a result of certain hereditary diseases or chronic viral hepatitis.

Increasing complaints

Initially, there are often no symptoms. As the disease progresses, all kinds of symptoms may occur, such as a swollen, enlarged liver and (vague) abdominal pain, reduced appetite, fatigue and weight loss or sudden weight gain. Cirrhosis can eventually lead to liver failure. There are treatments available that can halt the progression of the disease process. Quitting alcohol is absolutely necessary for survival.

Moderate alcohol consumption prevents cirrhosis

It is not clear exactly why some people’s liver cells are more likely to be damaged by alcohol and as a result develop hepatitis and/or cirrhosis. But as a rule, the heavier and more regularly a person drinks, the more likely he is to develop hepatitis and/or cirrhosis. Moderate alcohol consumption prevents this.

read more

    • Liver pain: causes and symptoms of liver pain
    • Liver diseases: symptoms, causes and treatment
    • Consequences and damage from long-term (excessive) alcohol use
    • Liver cirrhosis: symptoms, liver complaints, causes and alcohol
    • Alcoholism: Symptoms, Causes, Stages and Treatment

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