Heavy Alcohol Drinker? You Might Be Having This!


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When “happy hour” actually makes sense to you, you know your life is indeed stressful. A glass of wine surely does no harm. At the end of a tough day, no doubt it is a luxury to be able to sit down at a bar, chat with friends, complain about your boss while sipping beer or wine from your glass.

Most people have the notion that drinking wine is beneficial to your heart, in fact, this is true, but do you know that 76% of alcohol consumption of average Malaysians is from beer? And only 2% contributes to wine!

 

alcoholic-liver-disease

Beer or Wine?


How much is too much?


Drinking to loosen up and drinking to the point of blacking out makes a big difference in life. Too much of alcohol will hinder you from functioning well in your daily life, stop you from performing well in your job, increase the possibility of getting scolded by your boss, or even being fired! So, what is the threshold for harmful drinking? One unit of alcohol contains 8 g of ethanol, a threshold of 14 units/week for women and 21 units/week for men is generally considered safe.

 

Binge drinker or regular heavy drinker?


You are wrong if you think either of them is more harmful than the other because both are equally harmful, but of different consequences. However, in this context, we are focusing on the effect of alcohol on the damage on liver, thus, the answer is, binge drinking brings less harm and less damage,  as this pattern of drinking gives the liver a chance to recover, even if it is just for a short duration. It is advised that people should have at least 2 alcohol-free days each week.

 

Risk factors and causes:


 

  • Gender: Women are said to be at higher risk due to higher ethanol level in the body after consuming the same amount of alcohol with men. It is just the difference in ways of processing alcohol in the body.


 

  • Genetics: Some studies suggest that the genes might affect the drinking pattern which could indirectly affect the manifestation of the disease.


 

  • Nutrition: Nutritional deficiencies due to alcohol has an impact you cannot imagine. Drinking alcohol makes your body pay more in terms of nutritional loss to process the alcohol. At the same time, while the organs are already damaged, nutrients are even harder to be absorbed!


 

  • Obesity: hmmm… Does this even need an explanation?


 

The gist of the context


 

Basically, alcoholic liver disease is divided into 3 types, though sometimes they might overlap or happen in sequence.

 

 



 


  • Alcoholic fatty liver disease (AFLD)



As the name implies, there is an accumulation of fatty acids in the liver cells. What causes the increase of fatty acid production is the by-product of the processing of alcohol. This is an early stage of the disease and definitely has a good prognosis. The only obvious sign can be found is the elevated ALT (Alanine Aminotransferase) or AST (Aspartate Aminotransferase) or both in the blood report. People who suffer from fatty liver disease  will recover after restraining from alcohol for 3 months.

 


  • Alcoholic hepatitis



This stage is an acute phase which happens due to long-term alcohol consumption. The severity varies, from mild jaundice (yellowish discoloration of the skin and mucous membrane) to hepatic encephalopathy ( inability of the liver to remove the toxin from the bloodstream causes accumulation of toxin in the brain) and death. People suffering from this phase usually present with:

  • jaundice

  • yellowish sclera (white of the eye)

  • enlargement of male breasts (gynaecomastia)

  • reddening of palm surface (palmar erythema)




 

  • red spots which spread like the shape of a spider (spider angioma)




 

  • enlargement of the liver

  • accumulation of fluid in the abdomen

  • black stool due to gastrointestinal bleeding

  • vomiting of blood

  • confusion and loss of consciousness

  • delay in blood clotting


For those who abstain, the 3-year and 5-year survival rate is 70%, while for those who do not abstain, the 3-year and 5-year survival rate is 60% and 34% respectively.

 


  • Alcoholic cirrhosis



Cirrhosis is the last stage of the disease. Sometimes the disease might progress from fatty liver to cirrhosis, skipping hepatitis. Unlike the previous two stages, this stage is irreversible. Cirrhosis is the development of scar tissue in the liver, replacing the healthy tissue.

 

What should you do next?


 

Physical examination can be done to check for the aforementioned signs.  Biological markers from the blood test might suggest alcohol misuse. The early stage of disease can be proved by elevated liver enzymes (ALT and AST). However, in order to determine the extent of liver damage, liver biopsy has to be done.

 
Management

We all want to lead a long and healthy life, so do not let the bad habits like smoking and drinking get the best of you. Cessation of alcohol consumption is the single best advice one can give. You never knew to what extent drinking alcohol can affect your life. Let’s take a look at the voice of people from Alcoholics Anonymous.



 

“I have found that the process of discovering who I really am begins with knowing who I really don't want to be.”

― Alcoholics Anonymous

 

“To this day, I am amazed at how many of my problems - most of which had nothing to do with drinking, I believed - have become manageable or have simply disappeared since I quit drinking.”

― Alcoholics Anonymous

 

“It will take time to clear away the wreck. Though old buildings will eventually be replaced by finer ones, the new structures will take years to complete.”

― Alcoholics Anonymous

 

Besides this, good nutrition is equally important to maintain health. Drugs like corticosteroids and pentoxifylline are beneficial in alcoholic liver disease. The ultimate solution is no doubt, liver transplantation.

 

Have a good relationship with alcohol. While it may help you relax, do not use alcohol as a problem solver. Also, never drink on an empty stomach, you will feel the effects of booze faster but you are much more likely to get sick faster too. And as always, talk to your doctor.

Get your health checked now!

 

References:

Wikipedia

Medscape

Turner White Communications

 


Angie Loh

by Angie Loh

A medical student with nothing but passion and a pen. Poems and novels never fail to make me feel alive. I'm inspired to make the world a better place and fill it with a little bit more love. But first, where's my coffee? View all articles by Angie Loh.




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