“Beer: The cause of, and solution to, all of life’s problems.”
– Homer Simpson
As we discovered in our first article, alcohol has been around for at least 10,000 years and it is unlikely that people will ever stop drinking. However, whether you are a light or heavy drinker, there are certain things that you need to know about your favourite beverage.
It is obvious that people who misuse alcohol become physically dependent because they need alcohol to stave off the unpleasant consequences of abstinence. As alcohol is a depressant, the symptoms of withdrawal result from an increased activity of the body systems that were depressed. This is known as rebound hyperactivity.
In serious cases, people who misuse alcohol can suffer from delirium tremens after several days without drinking. There is a persistent tremor, extreme restlessness and agitation, often accompanied by terrifying visual hallucinations. People also become psychologically dependent as the habit becomes engrained in their behavior and alcohol may afford relief from feelings of anxiety, depression or guilt. People may be addicted to alcohol following a difficult period such as bereavement, loss of job or divorce.
Alcoholic Liver Disease
Did you know that ethanal is produced at twice the rate in habitual drinkers than in occasional drinkers? It is potentially very toxic as it is highly reactive. It reacts with proteins to form complexes, interferes with enzyme active sites and structural proteins in cell membranes, mitochondria and the cytoskeleton and inhibits protein synthesis and other aspects of cellular metabolism. The changed proteins are often recognized as foreign and antibodies are formed against them. This form of auto-immunity probably plays a part in damaging liver tissue, leading to alcoholic liver disease.
The high fat and low glucose concentrations in the blood, caused by a reduction in gluconeogenesis, lead to malfunction and disease in the brain, liver and blood vessels. Irreversible damage may be done and can lead to premature death due to alcohol and ethanal.
Now, let’s learn more about the stages of alcoholic liver disease:
- Fatty Liver:
Most of the fat stored in the liver is present as droplets in cells. The liver is swollen with cells full of fat droplets and plasma proteins unable to leave cells because of damage to the intracellular transport mechanisms. There are high plasma concentration of fats and cholesterol. This affects almost everyone with moderate to high alcohol intake. It is usually reversible if drinking stops. In severe cases, it may take four to six weeks.
Individual cells are damaged and die. The liver becomes inflamed and damaged cells are replaced with fibrous tissue. There are swollen cells with wispy cytoplasm with much fat stored in them. If this is severe it may give rise to jaundice, (which is the yellowing of eyes and skin that result from the inability of the cells to excrete bile pigments), nausea, loss of appetite and abdominal pain. There is a very high risk of hepatitis developing into the third stage of ALD or cirrhosis. However, keep in mind that if drinking stops, then the liver returns back to normal.
The liver cells are gradually replaced by fibrous tissue rich in collagen fibers. The liver appears nodular in appearance and hardens. Cells regenerate within lobules, but the cells in these nodules do not receive a good blood supply. Liver functions deteriorate and jaundice can get worse. Blood flow into the liver is obstructed and much of it is diverted to the arteries around the esophagus causing internal bleeding and vomiting with blood. Compared to the other two stages of ALD, cirrhosis is not reversible, but if drinking ceases, the disease’s progress can stop.
According to some studies, one third of heavy drinkers never develop severe liver disease while another third only develop fatty liver. However, liver cancer can develop in about one in five cases of cirrhosis.
Were you able to learn some new things about alcohol? Please share your comments!