The effects of abusive drinking on the internal organs
Alcoholics risk damaging just about every major system in their bodies, either through alcohol dependency or excessive drinking.
Liver diseases are the most common problems related to alcohol abuse. Because the liver bears the greatest responsibility for metabolizing alcohol, it inevitably suffers the impact of intoxication.
When a person drinks more than the liver can process, lesions begin to form. Alcohol-related liver disease progresses from a relatively benign condition of fat cell accumulation known as “fatty liver” (hepatic steatosis) to more serious inflammation (alcoholic hepatitis) and finally cirrhosis. Both hepatic steatosis and alcoholic hepatitis are reversible conditions that in some cases may improve without longterm consequences if the person stops drinking completely. However, if drinking continues, the once-reversible conditions will develop into severe hepatitis or cirrhosis in 25% of cases. Both of the latter are very serious diseases with a 5-year survival rate of 20% to 60%.
Alcohol’s toxic effect on the liver can first be seen with what is considered moderately excessive drinking. The risk of cirrhosis becomes significant when alcohol intake reaches 30 grams a day (3 drinks) for women or 50 grams a day (5 drinks) for men, and continues at that level for at least 10 years for women and 15 years for men.
In 80% to 90% of all cases, alcohol is the cause of both acute and chronic forms of pancreatitis. Acute pancreatitis can be treated and healthy function restored, but chronic pancreatitis causes permanent scarring that results in long-term impairment of pancreatic function and the possibility of multiple complications.
Acute pancreatitis is often an indicator of a chronic condition to come. Regular heavy drinking continues to take its toll on the pancreas, sometimes causing a permanent inflammation that can seriously impair the exocrine (glandular) function of the pancreas.
Acute pancreatitis generally results from “autodigestion,” a process whereby pancreatic enzymes destroy the tissue of the organ itself, leading to inflammation. The main symptoms of acute pancreatitis are abdominal pain and vomiting, which may persist even after the person quits drinking.
Chronic pancreatitis may present as an acute episode of the same symptoms (abdominal pain, nausea and vomiting). In some serious cases, there may also be serious metabolic disorders and acute circulatory complications that can be fatal.
Some people may develop pancreatic disease from drinking moderately (less than two drinks a day), while others may have up to 25 drinks a day before the symptoms appear. Still others will never develop pancreatitis, no matter how much they drink.
In high-risk people, chronic pancreatitis will develop with prolonged alcohol use, i.e. more than 10-15 years for women and 15-20 years for men. Each individual’s vulnerability to alcohol is a determining factor in pancreatic disease.
People who abuse alcohol are at risk for developing a condition called gastroesophageal reflux disease, or GERD (commonly known as gastric reflux). Normally, food passes from the esophagus to the stomach and into the intestine. Gastric reflux causes a back flow of acidic fluid from the stomach into the esophagus, resulting in an uncomfortable burning sensation.
Gastric reflux can lead to reflux esophagitis, a more advanced condition involving inflammation of the esophageal mucosa and more severe acid back flow.
Esophagitis may be acute (severe, sudden and short-lived) or chronic (develops and worsens over a long period of time). The burning sensation may be provoked by food, alcohol or hot liquids.
In alcoholics, chronic esophagitis can lead to ulcers in the esophagus. Heavy, regular drinkers may also develop a tear in the mucous lining at the point where the esophagus joins the stomach. The tearing is caused by repeated, prolonged retching that, in 5% of cases, leads to digestive hemorrhaging, in which the person vomits blood (hematemesis) in quantities that can be considerable and fatal.
Chronic alcoholism is the primary contributing factor in cancer of the esophagus, and the risk is increased significantly by smoking.
Alcohol intoxication can cause an inflammation in the stomach mucosa – the lining that protects the stomach walls. This condition is called acute gastritis. Heavy drinking can cause heartburn, nausea, vomiting (sometimes with blood) and pain in the upper abdominal area (epigastric pain). The symptoms generally disappear two or three days after the person stops drinking.
Regular abusive drinking can result in chronic gastritis, which is often asymptomatic and very difficult to cure, as it develops slowly over many years. It is generally accompanied by anemia and malnutrition; sometimes, it is seen in conjunction with gastric reflux (see above). Alcoholics may also develop digestive hemorrhaging, due primarily to ruptures in the esophageal veins, or the deterioration or ulceration of the gastric mucosa.
Alcohol impairs the body’s ability to absorb various nutrients, including amino acids, vitamins A and C, minerals and glucose. It also damages the cells lining the intestinal tract and affects the production of secretions essential for transporting nutrients to the blood. One of the effects is diarrhea, observed in 10% to 50% of alcoholics. The effects of alcohol on the intestines are generally moderate and, with the help of nutritional and vitamin support, can disappear 2 to 6 weeks after the person quits drinking.
The effects of abusive drinking on the circulatory system
Alcoholics risk also damaging their circulatory system, either through alcohol dependency or excessive drinking.
The more you drink, the higher your blood pressure. The relationship between alcohol and blood pressure is even more obvious in drinkers over the age of 40. Systolic pressure increases on average by 2.7 mmHg in those who have 4 to 6 drinks a day, and by 4.6 mmHg in those who have at least 7 drinks a day. Alcohol-related hypertension (high blood pressure) tends to disappear when the person quits drinking, but returns if drinking resumes.
Hypertension can cause a variety of health problems, including angina and heart rhythm disturbances.
Regular, heavy drinking over at least 10 years can weaken the heart muscle and prevent it from pumping blood efficiently (a condition called alcoholic cardiomyopathy). In some drinkers, the disease may be asymptomatic and be discovered only accidentally. In others, it causes chest pain, palpitations, night coughing, and abnormal fatigue, difficulty breathing and sometimes even cardiac arrest from arrhythmia.
Alcoholics suffering from cardiomyopathy often experience heart rhythm problems (tachycardia, palpitations) when they drink an excessive amount. In most cases, normal heart rhythm returns spontaneously within 24 hours.
In cases of extreme intoxication, even non-alcoholics with healthy hearts can have heart rhythm disturbances.
- Cerebrovascular accidents (CVA)
Abusive drinking is a risk factor in cerebrovascular accidents (CVA), also known as strokes. Chronic heavy drinking increases the risk of death from a cerebral hemorrhage, while episodes of intoxication can obstruct the flow of blood to the brain, which can also cause a stroke.