Death tragedies continue to mount from bootleg liquor in India

Indian authorities say the number of people killed after drinking home-brewed liquor thought to have been laced with a highly toxic chemical in the country’s most populous city, Mumbai, has soared to 94. It is possible for the number of the dead to rise to as much as a three-digit figure as more than 150 have consumed this alcohol. The death toll may rise.

Five people have so far been arrested in connection with distributing and selling the toxic liquor to poor workers. Eight police officers have also been suspended for “negligence” for allowing the sale to take place in their area.

An investigation is underway to determine whether high levels of methanol were present in the alcoholic drink.

There are reports that more than half of the victims still alive are in serious condition, and many of them have gone blind. Methanol is metabolized in the liver and the retinas, which explains why people who drink it are blinded.

Unlicensed liquor is widely consumed across India. The victims are mostly poor wage laborers, rickshaw pullers and hawkers, who can’t afford the alcohol at state-sanctioned shops.

The recent tragedy is the latest in a series of mass poisonings caused by tainted liquor in India. More than 31 people lost their lives near Lucknow in the northern state of Uttar Pradesh in January after consuming toxic drinks.

Alcoholic liver disease on rise in dry Gujarat

Ironically, close to 1,000 cases of liver cirrhosis are reported every month in dry Gujarat. Nearly 80% of these cases reported in various government and private hospitals of Ahmedabad are related to alcohol.

Many of the leading hospitals in big cities of Gujarat report hundreds of cases every month.

Cirrhosis is a slowly progressing disease where healthy liver tissue is replaced with scar tissue, which can lead to organ failure.

For many patients, cirrhosis degenerate into fourth state cancer and they die during the course of treatment.

Most of patients are males. The symptoms include rapid deterioration in kidney function, low oxygen levels in the blood of arteries, altered consciousness, accumulation of fluid in peritoneal cavity and peritonitis, an inflammation of peritoneum (thin tissue that covers most of abdominal organs).

It is not just the old who put their lives in peril due to the demon drink, but the young are also getting addicted to it. Many of the patients are in the age-group of 25 to 40 who are habitual drinkers. Prolonged alcohol misuse can cause long-term liver damage which is further aggravated by Hepatitis B and sedentary lifestyle.

Severe health problems of alcohol

Social drinking and occasional binging is just as bad in the long run. It may seem reasonable and one would imagine it to cause minimum damage to the liver. But it depends on how we define the word 'reasonable'. Alcohol-related ailments used to surface after 8-10 years of drinking but now we've seen patients develop liver cirrhosis in five. 

And just because you aren't pouring yourself a peg every evening, doesn't mean you are safe. Abstaining from alcohol for a period of time before a binge drinking session is equally hazardous. A single episode of binge drinking can cause acute pancreatitis (a sudden inflammation of the pancreas) which can even be fatal sometimes.

Alcohol in the system

To understand the effects of alcohol, we first need to understand what happens on consumption. Different enzymes in the body break down alcohol and metabolise it. This process varies across races and depends on the genetic predisposition of a person. For example, the Japanese tend to develop a reaction to alcohol similar to a rash. 

This is why some people may be more affected with just three units of alcohol, while others may not even after five. Also, women are more prone to develop alcohol-related conditions. This is because women are deficient in an enzyme called alcohol dehydrogenase that metabolises liquor in the body. Also, the female hormone, estrogen increases the permeability of the intestines putting your liver directly in the line of fire. 

The initial signs

The first stage is fatty liver. This can happen over a night of binge drinking. If one quits alcohol at this stage, the state of the liver can be reversed. But few people manage to get diagnosed as the condition is largely asymptomatic. This condition is caused when the triglyceride fats accumulate in the liver cells via abnormal retention of lipids. The silver lining, if you quit drinking, the condition is treatable with adequate restrictions and medication.

Occasional (think once a month) drinking can also lead to acidity, ulcer formation, nausea, weight gain, poor nutrition and an increased risk of pneumonia. Ignoring the initial signs of liver damage can be fatal. If you are diagnosed with a fatty liver, you need to quit alcohol immediately. Not doing so would be mean that the fat would go through peroxidation and lead to cirrhosis within 8-10 years. 

How far is death?

If it has been five years since you started drinking, you are right to start worrying. Within five years of drinking, one can acquire alcoholic hepatitis which can be fatal. Other terminal conditions that start off at the 10-year mark include liver cirrhosis and liver cancer. 

It's bad news for those who stay sober on weekdays but exceed the permissible number of pegs on weekends as well. Drinking high levels of alcohol over a short period of time can lead to permanent damage of the brain. Alcohol causes damage to the cerebellum, the part of the brain responsible for balance. People who drink heavily will struggle with balance, even when sober. 

Alcohol causes brain toxicity, which can lead to memory loss and dementia, in addition to its effect on the spinal chord, lungs, pancreas, muscles and bone. 

The Cancer scare

From the two billion people worldwide who consume alcohol, 76.3 million suffer from nearly 60 types of alcohol related diseases and injury. Alcohol causes 1.8 million deaths (3.2 per cent of total). 

Alcohol is also related to cancers of the mouth, oropharynx, liver, oesophagus and breast. It causes cirrhosis, pancreatitis, gastritis, polyneuropathy, hemorrhagic stroke, epileptic seizures and other mental conditions. 

When we consume alcohol, an enzyme alcohol dehydrogenase is metabolised to create highly toxic acetaldehyde in the oral cavity. Among the two, the activity of aldehyde dehydrogenase is lesser than that of alcohol dehydrogenase, which leads to an accumulation of cytotoxic acetaldehyde in the oral tissue and makes one susceptible to cancer. 

Even moderate drinking can cause liver cancer

Researchers have confirmed that even moderate drinking can cause liver cancer. A survey was published by the World Cancer Research Fund covering 8.2m people which established that three drinks a day can cause liver cancer.

The World Cancer Fund recommends men and women should try to limit their alcohol intake and if possible avoid it completely.

The link between alcohol and cancer is undeniable yet it is something of which many people aren’t fully aware. This research from the World Cancer Research Fund helps highlight the important fact that as little as three alcoholic drinks a day can be enough to cause liver cancer.

Like tobacco, alcohol is a group one carcinogen. As many people are not aware of link between alcohol and cancer, the Governments should run campaigns making people aware of the harm alcohol can cause and make health warnings compulsory.

Most people who suffer alcohol-related health problems are not alcoholics or binge drinkers. They are people who have been drinking at or above the recommended limits on a daily or almost daily basis over a number of years.

Alcohol can harm multiple organs not just liver

Some of the ways alcohol affects our health are well known, but others may surprise you. Here are six less-known effects that alcohol has on your body:

1. Drinking gives your body work to do that keeps it from other processes. Once you take a drink, your body makes metabolizing it a priority — above processing anything else. Unlike proteins, carbohydrates and fats, your body doesn’t have a way to store alcohol, so it has to move to the front of the metabolizing line. This is why it affects your liver, as it’s your liver’s job to detoxify and remove alcohol from your blood.

2.Abusing alcohol causes bacteria to grow in your gut, which can eventually migrate through the intestinal wall and into the liver, leading to liver damage.

3.Too much is bad for your heart. It can cause the heart to become weak (cardiomyopathy) and have an irregular beat pattern (arrhythmias). It also puts people at higher risk for developing high blood pressure.

4.People can develop pancreatitis, or inflammation of the pancreas, from alcohol abuse.

5.Drinking too much puts you at risk for some cancers, such as cancer of the mouth, esophagus, throat, liver and breast.

6.It can affect your immune system. If you drink every day, or almost every day, you might notice that you catch colds, flu or other illnesses more frequently than people who don’t drink. This is because alcohol can weaken the immune system and make the body more susceptible to infections.

Your liver heads up alcohol breakdown process

When you drink, here’s what happens in your liver, where alcohol metabolism takes place.

Your liver detoxifies and removes alcohol from the blood through a process known as oxidation. Once the liver finishes the process, alcohol becomes water and carbon dioxide. If alcohol accumulates in the system, it can destroy cells and, eventually, organs. Oxidative metabolism prevents this.

But when you’ve ingested too much alcohol for your liver to process in a timely manner, the toxic substance begins to take its toll on your body, starting with your liver. The oxidative metabolism of alcohol generates molecules that inhibit fat oxidation in the liver and, subsequently, can lead to a condition known as fatty liver.

Fatty liver, early stage alcoholic liver disease, develops in about 90 percent of people who drink more than one and a half to two ounces of alcohol per day. So, if you drink that much or more on most days of the week, you probably have fatty liver. Continued alcohol use leads to liver fibrosis and, finally, cirrhosis.

The good news is that fatty liver is usually completely reversible in about four to six weeks if you completely abstain from drinking alcohol. Cirrhosis, on the other hand, is likely to lead to liver failure despite abstinence from alcohol.