How can I reverse liver damage?

If you have fatty liver disease, the damage may be reversed if you abstain from alcohol for a period of time (this could be months or years). After this point, it's usually safe to start drinking again if you stick to the NHS guidelines on alcohol units. However, it's important to check with your doctor first.

nhs.uk - Treatment – Alcohol-related liver disease - NHS

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Successful treatment for alcohol-related liver disease (ARLD) often depends on whether someone is willing to stop drinking alcohol and make changes to their lifestyle.

Stopping drinking alcohol

Treatment for ARLD involves stopping drinking alcohol. This is known as abstinence, which can be vital depending on what stage the condition is at. If you have fatty liver disease, the damage may be reversed if you abstain from alcohol for a period of time (this could be months or years). After this point, it's usually safe to start drinking again if you stick to the NHS guidelines on alcohol units. However, it's important to check with your doctor first. If you have a more serious form of ARLD (alcoholic hepatitis or cirrhosis) lifelong abstinence is recommended. This is because stopping drinking is the only way to prevent your liver damage getting worse and potentially stop you dying of liver disease. Stopping drinking is not easy, especially as an estimated 70% of people with ARLD have an alcohol dependency problem. Nevertheless, if you have alcohol-related cirrhosis or alcoholic hepatitis and do not stop drinking, no medical or surgical treatment can prevent liver failure.

Withdrawal symptoms

If you're abstaining from alcohol, you may suffer withdrawal symptoms.

These will be at their worst for the first 48 hours, but should start to improve as your body adjusts to being without alcohol. This usually takes 3 to 7 days from the time of your last drink. Many people initially experience disturbed sleep when abstaining from alcohol, but in most cases their sleep pattern returns to normal within a month. In some cases, you may be advised to reduce your alcohol intake in a gradual and planned way to help avoid withdrawal problems. You may also be offered a medicine called a benzodiazepine and psychological therapy, such as cognitive behavioural therapy (CBT), to help you through the withdrawal process. Some people need to stay in hospital or a specialist rehabilitation clinic during the initial withdrawal phases so their progress can be closely monitored. If you're staying at home, you'll regularly see a nurse or another health professional. You might see them at home, your GP surgery or a specialist NHS service.

Preventing relapses

Once you have stopped drinking, you may need further treatment to help ensure you do not start drinking again. The first treatment usually offered is psychological therapy. This involves seeing a therapist to talk about your thoughts and feelings, and how these affect your behaviour and wellbeing. If psychological therapy alone is not effective, you may also need medicine to help you abstain from alcohol, such as:

acamprosate

disulfiram

naltrexone

Find out more about treatment for alcohol misuse

Self-help groups

Many people with alcohol dependence find it useful to attend self-help groups to help them stop drinking. One of the most well-known is Alcoholics Anonymous (see the AA website for details), but there are many other groups that can help.

See alcohol support for more information about the help available.

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When should I worry about my liver?

As the liver becomes more severely damaged, more obvious and serious symptoms can develop, such as: yellowing of the skin or whites of the eyes (jaundice) swelling in the legs, ankles and feet caused by a build-up of fluid (oedema) swelling in your abdomen caused by a build-up of fluid known as ascites.

nhs.uk - Symptoms: Alcohol-related liver disease - NHS

In many cases, people with alcohol-related liver disease (ARLD) do not have any noticeable symptoms until their liver is badly damaged. If you do experience early symptoms of ARLD, these are often quite vague, such as: As the liver becomes more severely damaged, more obvious and serious symptoms can develop, such as:

When to seek medical advice

ARLD does not often cause symptoms until it's reached an advanced stage. If you misuse alcohol, you may have liver damage, even though you have none of the symptoms above. A good way to assess your history and pattern of drinking is to use a short test known as the CAGE test, which consists of 4 questions:

Have you ever thought you should cut down on your drinking?

Have people annoyed you by criticising your drinking?

Have you ever felt guilty about your drinking?

Have you ever drunk an "eye-opener", which means: have you ever drunk alcohol first thing in the morning to get over a hangover and steady your nerves?

If you answer "yes" to one or more of the questions above, you may have an alcohol problem and are advised to see your GP. See your GP as soon as possible if you have symptoms of ARLD.