Wednesday, July 31, 2013

Alcohol is Enemy Number 1 of Liver

Anacharsis, the famous Scythian philosopher, said about alcohol "The vine bears three clusters of grapes: the first wine, pleasure; the second, drunkenness; the third, disgust." So he became a kind of emblem for restrain and moderation and his statues are inscribed with: 'Restrain your tongues, your appetites, your passions.'

Today, we understand more about the toxic effects of alcohol on a chemical level. We have abundant and sickening experience with the effects of chronic excessive drinking, the ravages of alcoholism and the physical decline and death that results from addiction to the substance. Everyone knows, and many have first-hand experience with, the intoxicating effects of alcohol. The key ingredient is ethanol, a substance that moves effortlessly into the brain within minutes of consumption causing a range of mood changes from euphoria, relaxation, a loss of inhibitions and grandiose or garrulous behavior, to gloominess, belligerence and combativeness. Thinking becomes fuzzy, speech becomes slurred and coordination impaired. As the dose goes up, a general stupor, then coma results, with vomiting and aspiration, respiratory depression, and collapse of blood pressure, leading to the occasional death from acute alcohol intoxication. Our local emergency room, like most, frequently treats binge-drinking college students flirting with just such a disaster.

Among other things, ethanol is a toxin to the liver. In a gallant attempt to remove the toxic chemical from the blood stream, the liver suffers injury, cell death and inflammation. The effects in the short term, with an occasional binge, or with regular but moderate drinking, are minor or nonexistent as the liver has an abundant capacity to repair and regenerate itself. However, the alcoholic, the regular heavy drinker or the frequent binger is especially prone to acute alcoholic hepatitis. This is an inflammation of the liver, similar to a viral hepatitis, that causes abdominal pain, tenderness of the liver and transient liver dysfunction.

The patient feels weak, nauseated and fatigued, and may complain of abdominal pain. Blood tests will show leakage of liver enzymes into the blood stream, a rise in a substance called bilirubin (causing yellow jaundice), clotting problems and a reduced ability to synthesize proteins. While there is no specific treatment in western medicine, with abstinence, supportive care and alternative medicine, the liver heals and reconstitutes itself.

More serious problems occur with alcoholic cirrhosis of the liver. Some people are more prone to cirrhosis than others — there may be genetic factors involved — but it is a risk to all chronic heavy drinkers. Cirrhosis and hepatitis may result from beer, wine or liquor: It is not what you drink, but rather the quantity of ethanol consumed that causes the toxicity. Cirrhosis is a scarring process that results in shrinkage of the liver, sustained and progressive loss of function and ultimately liver failure. A patient with cirrhosis often looks chronically ill. They may appear unkempt or malnourished, a swollen abdomen may indicate a collection of ascitic fluid, and they are prone to sudden infections, internal bleeding and other complications. If the patient does not take proper care, finally it leads to cancer and untimely death.


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