The Effects of Alcohol Addiction
These result from continued use of excessive amounts of alcohol. Binge drinking and chronic drinking of alcohol are more likely to cause harm.
- Liver: alcoholic hepatitis, cirrhosis, liver cancer.
- Gastrointestinal tract: oral cavity cancer, esophageal neoplasm, esophageal varices, pancreatitis.
- Cardiovascular system: atrial fibrillation, hypertension, strokes and cardiomyopathy with heart failure.
- Neurological system: acute intoxication with loss of consciousness, withdrawal, seizures, subdural hemorrhage, peripheral neuropathy, Wernicke-Korsakoff syndrome and cerebellar degeneration.
- Alcohol dependence syndrome
- Suicidal ideation
- Loss of libido
- Fetal alcohol syndrome
Social problems related to alcohol
- Impaired performance at work.
- Relationship problems.
- Violent crimes - e.g., domestic violence and drunk driving offenses.
- Antisocial behavior.
Affects of alcohol on the liver
Alcoholic liver disease includes fatty liver, alcoholic hepatitis and cirrhosis. These three conditions probably represent a spectrum of liver damage resulting from continued abuse of alcohol.
- In fatty liver, there is an accumulation of fat within the hepatocytes. This is reversible with abstention from alcohol.
- Alcoholic hepatitis presents as acute right upper quadrant (RUQ) pain with jaundice, fever and marked derangement of LFTs. At a microscopic level there is inflammation of the liver.
- In liver cirrhosis, the hepatocytes are damaged so much that they are replaced by scar tissue which is permanent. Alcoholic hepatitis and cirrhosis may co-exist. Alcoholic hepatitis and cirrhosis may lead to encephalopathy, portal vein hypertension and hepato-renal syndrome. This group of patients is also at increased risk of infections and they are usually also malnourished.
- Treatment involves abstinence from alcohol, and good nutrition. There is no specific therapy for alcohol-related hepatitis and cirrhosis. It is important to look for, and promptly treat, the complications which include ascites, spontaneous bacterial peritonitis, hepatic encephalopathy and esophageal varices.
- Patients with ascites may need to be maintained on high doses of diuretics. Again, abstinence from alcohol is crucial.
Affects of alcohol on the gastrointestinal tract
Alcohol increases the risk of oral cancers. This is especially associated with spirits and the risk is increased with concomitant use of tobacco. Adenocarcinoma of the stomach and oesophagus is thought to be related to alcohol use. Some of these cases may be genetically determined.
Portal hypertension is a complication of cirrhosis and leads to a raised venous pressure in veins in the oesophagus and stomach. These swollen veins are superficial and bleed easily. Bleeding from esophageal varices is serious and is associated with a high level of morbidity and mortality.
Management of bleeding varices is a medical emergency and requires adequate resuscitation (patients may need to be intubated to protect their airway). Blood transfusions are necessary and correction of abnormal clotting with vitamin K and fresh frozen plasma (FFP) may also be required. Various options for treatment are available including vasoactive drugs, obturation with glue and balloon tube tamponade.
Both acute and chronic pancreatitis are associated with excessive alcohol consumption. One study found that consumption of spirits was more likely than wine or beer to cause acute pancreatitis.The pathophysiology of alcohol-related pancreatitis is not clearly understood. Patients usually present with epigastric pain with vomiting. The amylase is high in acute pancreatitis but may be normal in patients with chronic pancreatitis. Pancreatitis can be associated with a number of complications such as shock, sepsis and abscess formation. Long-term complications include diabetes mellitus and weight loss from steatorrhoea.
Affects of alcohol on the cardiovascular system
- Excessive alcohol use is associated with hypertension and subsequent target organ damage such as strokes, myocardial events and renal failure.
- It is also associated with a dilated cardiomyopathy with heart failure and atrial fibrillation which may revert to sinus rhythm.
Again, abstinence from alcohol is paramount.
Affects of alcohol on the nervous system
- Acute alcohol intoxication can present with blackouts, head injuries and subdural hemorrhages. Alcohol withdrawal is associated with fits which may be unresponsive to anti-epileptics.
- The Wernicke-Korsakoff syndrome results from lack of thiamine (commonly seen in alcoholics due to malnutrition). Wernicke's syndrome occurs acutely and patients present with confusion, visual impairment (diplopia) and ataxia. Korsakoff's syndrome occurs more chronically and is characterized by memory deficits and confabulation .
See separate article Wernicke-Korsakoff Syndrome for more details.
Alcohol withdrawal occurs within a few hours of not having a drink and can last beyond 48 hours. Patients experience hallucinations, anxiety and a coarse peripheral tremor. On examination, patients may become hypertensive, feverish, or may also develop seizures and auditory and visual hallucinations.
Delirium tremens is the severe end of the spectrum of alcohol withdrawal and consists of a severe form of the above symptoms; it may be associated with circulatory collapse and ketoacidosis.
This is characterized by the following:
- A strong desire to drink.
- Difficulty controlling alcohol intake.
- Physiological withdrawal when intake is reduced.
- Tolerance, such that increasing amounts are required to produce the same effect.
- Harm resulting from continued alcohol use - eg, work or relationship problems.
Treatment of alcohol dependence includes education, support, counseling and controlled alcohol withdrawal. Patients may need to be admitted to a hospital for medical detoxification.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. MW has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.