It’s estimated that one-third to one-half of individuals who abuse alcohol have gastrointestinal (GI) problems. Alcohol undermines the normal functioning of the digestive system in several ways:
- In the mouth, chronic alcohol abuse damages salivary glands and interferes with salivary secretion. It also increases the incidence of gum disease and tooth decay.
- Drinking too much can lead to inflammation of the esophagus, as well as acid reflux and heartburn. Damage to the lining of the esophagus also increases the risk of esophageal cancer.
- In the stomach, alcohol interferes with the secretion of gastric acid needed for the digestion of food. High doses of alcohol can injure the lining of the stomach, causing inflammation and possibly ulcers.
- In the intestines, alcohol disrupts normal muscle movement, shortening the time it takes for food to move through the intestinal track and pass from the body as waste. This can result in diarrhea, common for alcoholics.
- Both acute and chronic drinking can damage smooth muscle and the cells lining the intestine. This can limit the absorption of such nutrients as the B vitamins.
- Excessive drinking can cause an overgrowth of bacteria in the gut. In turn, this colonization may lead to mal-absorption of food and nutrients and increased gut permeability. With this condition, also known as “leaky gut syndrome,” large molecules of protein can enter the bloodstream and trigger an immune response, and toxins are now able to reach the liver and other organs where they can do damage.
- Alcohol interferes with the activity of such enzymes as lactase, which breaks down milk sugar, leading to an inability to digest dairy products.
- Alcohol can contribute to chronic inflammation of the pancreas, interfering with the absorption of fats and proteins. Although not part of the digestive system, the pancreas affects digestion because it produces enzymes that break down these components of food.
GI problems can occur even with a single dose of alcohol, but the good news is that the primary alcohol-related intestinal problems, diarrhea and mal-absorption, can be eliminated by maintaining abstinence and returning to a normal diet.
Second Stop: The Liver
Once alcohol has passed through the digestive tract, it is rapidly transported to the liver, where blood vessels spread it throughout this organ as much as possible. Here, alcohol can potentially disrupt normal liver function. Although there is little risk with low intake, vulnerability rapidly increases as a person drinks more. All alcoholics display some signs of injury to the liver, and over 2 million Americans suffer from alcohol-related liver disease. Obesity—that is, being 30 percent above ideal body weight, which is increasingly common in today’s society—is also an independent risk factor for alcoholic liver disease.
The demise of the liver happens in several fairly well defined stages:
Fatty liver: One of the primary tasks of the liver is to break down toxic compounds, such as alcohol. This process requires certain enzymes, substances that promote chemical reactions. Now, it happens that another important role of the liver is to metabolize fatty acids, a process that requires the same enzymes. When these enzymes are used up interacting with alcohol, and consequently fewer are available to break down the fatty acids, then fat deposits in liver tissue, hence fatty liver. This fat can also end up in the heart and arteries.
Alcoholic hepatitis: As fatty liver develops, the liver typically becomes inflamed and the result is alcoholic hepatitis. Symptoms are GI upset, loss of appetite, abdominal pain and tenderness, fever, jaundice, and mental confusion. Alcoholic hepatitis can be fatal if a person continues drinking but, if he or she abstains, the condition is often reversible. The hepatitis B and C viruses can also cause this condition. Consuming even small amounts of alcohol can be damaging to the liver for someone who is infected.
Cirrhosis of the liver: As hepatitis proceeds, the blood vessels in the liver become swollen and liver tissue becomes permanently damaged, with fibrous thickening of liver tissue, degeneration of cells, and severe scarring, a potentially fatal condition. Cirrhosis is not reversible but, with abstinence and adequate nourishment, chances of survival can increase and a person whose liver has begun this deterioration can restore a significant amount of liver function and health.
Frequently, patients with alcoholic liver disease have more than one of these conditions, such as fatty liver plus hepatitis, or hepatitis plus cirrhosis. In extreme cases, alcoholism can also lead to cancer of the liver and liver failure. Although the liver is an organ that can regenerate itself, severe liver damage is potentially fatal.
Third Stop: Almost Everywhere Else
The damage that alcohol can inflict on the body is not limited to the liver. Toxic compounds generated by the breakdown of alcohol also make their way to other areas in the system and cause trouble elsewhere. In addition, because the liver is an extraordinarily versatile organ and performs hundreds of different functions, when things go wrong with this organ, problems can show up in many other parts of the body. The liver connection:
The cardiovascular system: The liver affects heart health by building and breaking down blood fats. It also makes the majority of cholesterol in the body and is the only organ able to remove cholesterol from the bloodstream. And because of its ability to assemble proteins, it produces clotting factors, which regulate the blood’s ability to clot.
The immune system: The liver supports the immune system, producing antibodies that fight infection.
The skeletal system: Liver function impacts skeletal strength because vitamin D is metabolized in the liver and alcohol can disturb this process. Vitamin D is required for the absorption and transport of calcium and is involved in the modeling and remodeling of bone.
The pancreas: The liver assists the pancreas in steadying blood sugar levels by storing a form of sugar, glycogen, which it releases when needed to fuel muscle and other organs.
The digestive system: The liver supports digestive function by manufacturing bile, which is stored in the gallbladder and released into the small intestine, where it aids in the breakdown of fatty foods and promotes the absorption of fat-soluble vitamins. The liver also affects nutritional status by storing most of the iron in the body and keeping reserves of vitamin B12 and copper and 90 percent of the body’s vitamin A.
The entire body: All areas of the body benefit from the liver’s ability to filter more than one liter of blood every minute, removing toxins and microbes that might otherwise cause health problems.
The chemistry involved in liver function is indeed complex, and researchers are still exploring what’s going on within the cells to learn more. What is quite clear is that many areas of the body may be adversely affected when the liver is damaged by alcohol. Making changes for the better in what you eat can help repair the liver and keep the damage from spreading.
Passing It Along
Fetal alcohol syndrome is one of the best publicized and tragic consequences of drinking while pregnant. This results in infants with low birth weight, premature births, and physical and cognitive disabilities as well as behavioral problems later on. If one is pregnant or thinking about becoming a parent, it is literally vitally important to avoid alcohol. The future child deserves to be healthy—and to be reared by a healthy parent, too.
Other Health Areas Affected by Alcohol
Excessive drinking can result in various chronic diseases, as well as less critical but still troublesome conditions such as an inability to handle stress and problems with sexual performance. The following are the list of health issues to watch out for.
With alcohol abuse, the adrenal glands produce less cortisol, a hormone that plays a key role in managing stress. Although abstaining from alcohol will help, a person who is abstinent may still have a lingering weakness in this area.
While excessive intake of alcohol is likely to increase a person’s interest in sex, it actually leads to sexual dysfunction. In men, alcohol abuse can cause a loss of sex drive, reduced fertility, and impotence. Levels of testosterone fall as estrogen increases. Drinking—in particular, binge drinking, which is commonly defined as, for women, four or more drinks on one occasion, and for men, five or more—suppresses the central nervous system, cutting off sensations. In women, alcohol lowers physiological arousal and raises estrogen levels. Women who abuse alcohol also are more prone to having menstrual problems, infertility, and an early menopause.
Heart Disease and Stroke
Light to moderate drinking has been getting a thumbs-up recently for its protective effect on heart health, although this remains a controversial subject. According to some research, light drinkers may have a healthier lifestyle and better eating habits than do heavier drinkers, accounting for their lower rates of heart disease. Then there’s the question of who decides to drink. When a team of researchers at the University of Victoria in British Columbia and the University of California–San Francisco took a close look at fifty four studies focusing on alcohol intake and health, they discovered that the great majority of these studies did not consider why abstainers chose not to drink in the first place. This opens the possibility that alcohol’s apparent benefits are actually the result of comparing abstainers who had health problems and decided not to drink with drinkers who were already relatively fit.
What is certain is that heavy drinking is not good for the circulatory system. High intake raises blood pressure and increases the risk of arrhythmias, coronary heart disease, peripheral vascular disease, and stroke. According to the Institute of Alcohol Studies in England, if drinking does cut coronary heart disease risk, the amount needed for medicinal benefits isn’t much. One drink every other day gives almost all the protection alcohol offers. More than two drinks a day increases your risk of heart disease, and the risk rises as intake increases.
Heavy drinking for at least ten years can cause a condition known as alcoholic cardiomyopathy: the heart becomes enlarged and the heart muscle can lose some of its ability to pump blood effectively. Women are especially susceptible to this condition, which often leads to heart failure.
Binge drinking comes with its own special risks: arrhythmias, an increased possibility of angina in those with heart disease, and increased risk of fatal heart attack. A study published in the British Medical Journal in 1997 concluded that binge drinkers were at a higher risk of heart attack and other major coronary events than were abstainers, even when overall volume of drinking was low.
Abusing alcohol, particularly binge drinking, which raises blood pressure, also increases the risk of stroke, the kind caused by a blood clot and, even more commonly, hemorrhagic stroke, caused by a burst vessel’s bleeding into brain tissue. Even in young people, alcoholism is a risk factor for stroke. Besides abstinence, a heart-healthy diet can do much to prevent these conditions.
Glucose Intolerance and Diabetes
As many as 80 to 95 percent of alcoholics suffer from low blood glucose, or hypoglycemia. Hypoglycemia can occur after having a drink and can last as long as twelve hours. The symptoms of hypoglycemia are very similar to those of alcohol withdrawal—sweating, brain fog, blurred vision, confusion, headache, dizziness, hunger, anxiety, tremor, rapid heartbeat, and depression.
General glucose intolerance can persist for a period of time during abstinence until your body recovers, which unfortunately can put at risk for relapse: low blood sugar creates a craving for anything that will rapidly raise the level of blood sugar, such as cookies, candy, a sugary cola—or an alcoholic drink. Alcohol can also affect how the body handles sugar, by causing permanent damage to the pancreas, reducing its ability to secrete insulin, which results in type 1 diabetes. Frequent heavy drinking is also associated with type 2 diabetes, in which blood levels of both insulin and blood sugar are elevated. Alcohol coupled with already existing diabetes does extra harm, contributing to high blood pressure, elevated blood fats, and nerve damage.
Most research to date has focused primarily on heavy drinking in men, the results showing that most male alcoholics have some degree of osteoporosis.
Degeneration of the Nervous System
Chronic drinking and, in particular, binge drinking, puts the brain at risk. Memory may be impaired and there may be problems with cognitive function and even dementia in extreme cases. In addiction, according to research sponsored by the National Institute on Alcohol Abuse and Alcoholism and published in Alcohol Research and Health in 2003, about half of the nearly 20 million alcoholics in the United States are thought to have some form of psychological problems ranging from mild to severe.
The Liver’s Link to the Brain
When a person drinks more alcohol than the liver can readily detoxify, dangerous by-products of alcohol metabolism can pass through the normally protective blood-brain barrier. In the brain, alcohol triggers inflammation and fluid retention and increases free radicals in brain tissue. Fewer healthy new nerve cells are formed to replace damaged ones. Consequently, brain activity slows, causing disruptions in normal thinking processes and changes in behavior and motor function.
When the liver is sluggish, its detoxification processes slow down and toxins accumulate. The toxin buildup can result in a person’s having difficulty thinking clearly and waking up in the morning with “brain fog.”
Prolonged liver dysfunction associated with fibrosis and cirrhosis can lead to hepatic encephalopathy, a condition that can result in cognitive, motor, and psychiatric problems. This condition can be fatal but may be reversible with adequate nutrition and hydration.
The brain requires thiamine/vitamin B1, for normal functioning. Alcohol interferes with the body’s absorption, storage, and use of this vital nutrient. A lack of thiamine can contribute to damage deep within the brain, leading to severe problems with cognition. Alcohol abuse, in extreme instances, can result in the condition known as Wernicke-Korsakoff syndrome. Malnourished alcoholics may develop this syndrome as poor eating habits increase the risk.
Alcohol as a Depressant
Alcohol also depletes hormones the brain produces that regulate mood. Specifically, alcohol lowers serotonin, known as the “feel-good” hormone. Although low doses of alcohol act as a stimulant, in fact, it is classified as a depressant. Drinking too much can bring on feelings of depression as well as anxiety and aggression. For individuals with mood and anxiety disorder, symptoms are likely to worsen even with moderate alcohol intake.
One of the most overlooked medical complications of alcohol abuse is its effect on immunity. Abusing alcohol can affect the regulation of the immune system and disrupt its normal functioning, increasing susceptibility to such diseases as pneumonia and tuberculosis as well as less serious ailments, such as urinary tract infections.
The immune system fights infection with many different types of “warrior” cells, some of which the liver produces. Both chronic and binge drinking can reduce the effectiveness of these cells. A healthy diet that supplies such nutrients as zinc and vitamins A and C can help support an immune system impaired by alcohol.
Alcoholism is a major risk factor for various cancers. The strongest link between alcohol and cancer is cancer of the upper digestive tract, including the esophagus, mouth, and throat. There’s also a greater risk of stomach cancer, particularly in the upper portion of the stomach. While alcohol poses a lower risk of colon and rectal cancer, one study conducted at Northwestern University and published in the Archives of Internal Medicine in 2006 found that colon cancer patients with a history of both smoking and drinking contracted the disease eight years earlier than did patients who did not both smoke and drink.
Poor eating habits that result in nutrient deficiencies are another factor contributing to cancer risk. Research suggests that heavy drinkers are probably deficient in folic acid, iron, riboflavin, selenium, vitamin E, and zinc; these deficiencies may contribute to cancer development. They may also be lacking in beta-carotene, vitamin C, and the phytonutrients lutein and zeaxanthin, nutrients thought to help prevent cancer. Eating an abundance of fruits, vegetables, and other plant foods can replenish these and supply additional cancer-protective compounds as well.
Alcohol and Breast Cancer
Studies show a link between alcohol consumption and a modest increase in the risk of breast cancer, with a greater impact when intake is high. In research that combined results from six different studies, published in the International Journal of Cancer in 1991, women who consumed three or more drinks a day had a 69 percent higher rate of breast cancer than did nondrinkers. There’s even evidence that having as few as one to two drinks a day can result in some increase in risk. However, not all studies show this close association, and more research is needed to give women guidance. What does seem to be fairly clear is that the risk of breast cancer rises as greater amounts of alcohol are consumed, regardless of the source, whether wine, beer, or some form of distilled spirits.
How alcohol increases the risk of breast cancer may include such factors as:
- Drinking patterns
- Use of supplemental hormones
- The health of a woman’s immune system
- Family history of breast cancer
- Alcohol’s effect on the chemistry within cells
Alcohol can raise estrogen levels, a risk factor for breast cancer, by increasing the conversion of precursor hormones to estrogen. Even as little as one drink a day can increase levels of this hormone, according to a study of postmenopausal women. An insufficient intake of fruits and vegetables, often a problem associated with drinking, can also be a factor. Research shows that women who eat the lowest quantities of these foods have a higher risk for breast cancer. Once again, here is evidence that eating wholesome foods is key to preventing disease.