Amit (44) had nausea, no appetite and pain in the upper right abdomen.

He browsed the internet and found seven illnesses with similar symptoms. At first, he popped a few painkillers and antacids, but the discomfort was back.

A doctor's examination found that Amit's liver enzymes were on the higher side. More tests ruled out the possibility of viral hepatitis, a liver infection. But excess consumption of alcohol had damaged his liver. He was advised abstinence and put on antioxidant drugs.

City–based doctors said there is a considerable rise in alcoholic liver disease (ALD) in the productive age group. "We see such patients from all walks of life and they belong to the 30 to 50 years age group," hepatologist Harshal Gadhikar of Deenanath Mangeshkar Hospital said.

Gadhikar sees around 8 to 10 patients of ALD each month. “The age threshold to develop ALD has gone down. My youngest patient is a 27–yearold from the automobile industry,” he said.

“If a person downs three pegs of alcohol a day consistently for 8 to 10 years, he will develop ALD. Genetics plays a role too. But since you do not know whether you are genetically predisposed to ALD, it is better not to drink or drink in moderation,” Gadhikar said.

Gastroenterologist S H Kayamkhani said he saw patients of alcohol–induced liver disease from all walks of life, more often from middle class income group with disposable income.

"Increasing cases of ALD are extremely worrying and demonstrate how drinking alcohol at a young age can impact one's health. Till a few years ago, alcoholic liver disease was unusual in young age group. Unless our drinking habits change, the problem will only worsen," he said.

Early symptoms of liver disease can be non–specific, including fatigue, nausea, vomiting, diarrhoea or abdominal pains. For heavy drinkers, early monitoring could help detect liver damage before it reaches an advanced stage, experts say.

Acute liver disease is caused by heavy drinking over a period of years. This is the pattern that is likely to occur when young people get liver disease, although older people who drink excessively later in life are also susceptible.

“Alcoholic hepatitis which is an early stage is potentially reversible with no long–term effects if you recover and stop drinking alcohol completely,” gastroenterologist Vinod Shah said.

Alcoholic liver disease usually occurs after years of drinking too much, he added. “The longer the alcohol use has occurred, and the more alcohol that was consumed, the greater the likelihood of developing liver disease. Alcohol may cause swelling and inflammation (hepatitis) in the liver. Over time, this can lead to scarring and then cirrhosis of the liver. Cirrhosis is the final phase of alcoholic liver disease,” he said.

The body has remarkable powers of healing and it is never too late to stop drinking, he added.

Researchers from Pune and Miraj, who studied around 100 patients of alcohol–induced liver disease, said that other factors such as gender, genetic background, and viral infection also play a role in the genesis of alcoholic liver disease (ALD).

Liver damage caused by alcohol is not uniform. Classically, alcoholic liver injury comprises three major forms such as fatty liver, alcoholic hepatitis and alcoholic cirrhosis. Fatty liver is present in over 90% of binge and heavy drinkers.

A much smaller percentage of drinkers progress to alcoholic hepatitis, thought to be a precursor of cirrhosis. Although alcohol is considered as a direct hepatotoxin, 10–20% of alcoholics develop alcoholic hepatitis, states the research paper published in the medical journal Biomedical Research in 2010 by researcher Ashok Shinde of department of biochemistry at Sinhgad Dental College and Hospital, in Pune.

Liver disease is often discovered during routine testing. Having no symptoms at all is not uncommon

• Acute liver diseases present themselves with symptoms such as high bilirubincounts (bilirubin is a byproduct derived from the breakdown of red blood cells), jaundice (yellowing of the skin and eyes), dark yellow/orange coloured urine, or light, clay–coloured stools Loss of appetite, nausea, vomiting, and diarrhoea
• Chronic liver disease can present itself through abdominal swelling due to accumulation of fluid, unexplained weight loss or gain, itching, and abdominal pain
• Many symptoms may not be present until the disease has advanced
• Three types of tests detect liver disease; these tests measure levels of specific enzymes, bilirubin, or protein THE PRICE ONE PAYS Three types of alcohol–related liver disease

• It is the build up of extra fat in liver cells. It is the earliest stage of alcohol–related liver disease. If symptoms do occur, they may include fatigue, weakness, and weight loss
• Almost all heavy drinkers have fatty liver disease. If they stop drinking, fatty liver disease will usually go away

• It causes the liver to swell and become damaged. Symptoms may include loss of appetite, nausea, vomiting, abdominal pain, fever and jaundice. Up to 35 % of heavy drinkers develop alcoholic hepatitis
• Alcoholic hepatitis can be mild or severe. If it is mild, liver damage may be reversed. If it is severe, it may occur suddenly and quickly lead to serious complications including liver failure and death

• Alcoholic cirrhosis is the scarring of the liver—hard scar tissue replaces soft healthy tissue. It is the most serious type of alcoholrelated liver disease
• Symptoms of cirrhosis are similar to those of alcoholic hepatitis. Between 10 and 20 % of heavy drinkers develop cirrhosis. The damage from cirrhosis cannot be reversed and can cause liver failure. Not drinking alcohol can help prevent further damage
Ways To Improve Liver Health
• Don’t eat too much
• Drink lots of water Limit sugar intake
• Keep away from food you are allergic to
• Keep your intestines clean
• Avoid binge eating when worried and anxious
• Eat organic and natural foods
• Eat more protein–based foods
• Avoid constipation (source: liver care foundation, new delhi)

The liver is an organ on the right side of the body weighing about 1.5 kg. The muddy red organ is the largest and the first port of entry for digestion before nutrients enter the rest of the body. It is the only organ in the human body that can regenerate unless struck by disease