Dangers Of Alcoholism, A Deeper Look Into The Alcoholic Gut

What Does the Gut of an Alcoholic Person Look Like?

Imagine a volcano full of lava, when the  amount of lava exceeds the limit and the time comes it finally erupts pushing up all the trapped lava. Esophageal reflux is the same thing, when the gastro-esophageal sphincter becomes weak and the amount of stomach acid increases, it erupts. Gastric acid moves upward toward the esophagus causing inflammation and heart burn.

Alcohol is your gut’s enemy, when you ingest it, the direct contact with esophageal mucosa leads to mucosal damage . Also, it affects the muscle tone of the lower esophageal sphincter(4) aggravating reflux symptoms.

• Ulcerations of the esophagus, stomach and duodenum are another expected complication for chronic alcohol intake. Breaking the lining of your gut is not an easy insult to deal with especially when it carries the possibility of bleeding and perforation if remain neglected. According to studies(5), drinking more than 14 drinks per week increases the risk of bleeding peptic ulcer. 

• Inflammation of the lining of the stomach due to direct contact with alcohol is too painful. Persistent feeling of nausea and irritating stomach pain is the picture of alcoholic gastritis. In a study(6) performed on 102 alcoholic men, it revealed that regular alcohol intake is the reason for chronic gastritis and the severity of the mucosal lesion is directly related to the duration of excess drinking.

• Not only this, alcohol disrupts the function of colonic muscles, hence causing too much faster motility leading to diarrhea. The extremely high sugar content in many alcoholic beverages is considered an extra cause of diarrhea as well.

Imagine a person suffering from heartburn, stomachaches, nausea, vomiting and diarrhea and how it  looks on endoscopy?  Your doctor will see reflux, peptic ulcers, gastritis and duodenitis! Yes, that’s what comprises the alcoholic gut.

Does Alcohol Consumption Affect Your Gut Microbiome? 

Have you ever heard the quote; Not all prisoners are criminals ? Same goes to the huge flora of bacteria in your gut! Not all bacteria are bad, there are useful gut microorganisms as well. Infact, the presence of these organisms is too important for maintaining the right balance in your gut. This balance is called gut haemostasis. Imbalance between these organisms due to different conditions can lead to unpleasant consequences. One such threat that affects this balance is alcohol. 

A study was conducted by Ali Keshavarzian in 2009 on rats to assess the occurrence of endotoxemia and gut leakiness. The results revealed that after ingestion of alcohol for ten weeks, there was significant increase in intestinal permeability and endotoxemia.

Intestinal hyperpermeability causes further complications, making it easier for bacteria to go through your systemic and portal circulation leading to gut dysbiosis. 

When your gut microbiome is imbalanced, known as microbial dysbiosis, it may lead to many gastrointestinal disorders such as: 

• H. Pylori and C. Difficile infections

• Intestinal bacterial overgrowth 

• Irritable bowel syndrome 

• Inflammatory bowel disease

• Malabsorption 

• Food intolerance

So, when gram negative bacteria increase, they produce endotoxins causing small intestinal bacterial overgrowth. This syndrome leads to malabsorption. It is one of the most common causes of chronic diarrhea.

Does Alcohol Lead to Leaky Gut?

Have you ever seen a porous membrane which allows particles to seep through its pores? That's what a leaky gut looks like. Leaky gut syndrome is a condition in which the lining of your gut is cracked, making it permeable to many kinds of toxins to your circulation. 

According to a study(10) which was performed on 36 alcoholic patients to evaluate their intestinal permeability with Chromium-51-EDTA revealed significant increase in their intestinal permeability compared to the controls. 

So, when your alcohol consumption increases, it blocks the effect of prostaglandins and leads to inflammation. The more you drink, the more you get this inflammation which will eventually lead to a leaky gut.

Symptoms of leaky gut syndrome include: 

• Bloating 

• Diarrhea 

• Indigestion 

• Burning abdominal pain 

• Distension 

How Does Alcohol Affect Various Organs?

Yes, liver and pancreas are among victims! 

You probably leave a piece of your liver on the table every time you drink. Even only one drink per day doesn’t guarantee you won’t get liver damage. 

How does alcohol damage your liver? Well, alcohol is mainly metabolized through the liver. Liver cells are called hepatocytes. Alcohol metabolism leads to hepatocyte death. Damaged hepatocytes release damage associated with molecular patterns (DAMPs) which activate the receptors leading to inflammation. 

Alcohol-induced liver damage starts with reversible stages like fatty liver and alcoholic hepatitis which could be fixed if you stop drinking. But when it progresses to cirrhosis, which means damage and fibrosis of big portions of the liver, then this damage is irreversible. At this stage, liver failure could happen anytime. 

According to the National institute on alcohol abuse and alcoholism alcoholic hepatitis occurs in up to 50% of heavy drinkers. 

Alcohol consumption may lead to pancreatitis as well. It increases the viscosity of pancreatic secretions. This leads to formation of protein plugs inside the ducts causing inflammation.

Symptoms of pancreatitis are: 

• Severe abdominal pain, 

• Vomiting

• Fever

• Chronic pancreatitis may eventually lead to malabsorption and pancreatic diabetes.

Why Does Alcohol Cause an Aggressive Course of illness with Some People While  Others Not?

Of course, you might be wondering, why don’t some people get sick, while others catch it so easily? The answer is, your bodies react differently and most importantly it's your GENETICS. That’s why the risk of getting alcoholic hepatitis increases if you have a family history.

According to twin studies(14), the risk of acquiring alcoholic hepatitis is three fold higher in monozygotic than dizygotic twins.

What about Cancer? Is alcohol a Risk Factor or a Cause?

You'll be surprised to know that alcohol doesn't merely damage your organs but its impact goes deep down to your DNA. According to the National Cancer Institute, chronic alcohol consumption leads to DNA damage. When this damage takes place, cells will grow out like a wildfire, out of control and develop cancer. 

Mendelian randomization (MR) is a method that uses genetic variants to study the relationship between a disease and its exposure. According to MR studies, 6000 oro-pharyngeal cancer cases and 6600 controls were studied and revealed a positive effect of alcohol on oral cancer. Another MR study revealed that drinking 14 units per week leads to head and neck cancers.

Several studies show a significant relationship between alcohol intake and liver, colon, stomach and breast cancers. That’s why The International Agency For Cancer Research classified alcohol as group 1 carcinogen.

Will You Get the Best Version of Yourself if You Stop Drinking?

Before answering this question, let’s first discuss the short-term and the long- term benefits of alcohol cessation.

Short- term benefits are:

• Protecting yourself from violence.

• Protecting yourself from possible sexual behaviors related to drinking. 

• Weight reduction. 

• Better sleep.

• Improve personal relationships. 

• Better productivity at the workplace.

Long- term benefits are:

• Improve concentration and decision making. 

• Better digestion.

• Healthier liver and pancreas. 

• Better immunity. 

• Protecting yourself from cancer.

• Protecting yourself from cardiovascular diseases and stroke. 

• Better mood. 

There is no need to measure the risk benefit ratio here, it’s so obvious. Alcohol is a very dangerous enemy to your health and for this you need to consider stopping it.

According to a study(18), which was performed for 16 years observation period after alcohol cessation, it revealed that relapsed patients died prematurely at the mean age of 48 years.

Frequently Asked Questions:

Q:What is the safe amount of alcohol intake per day?

A:According to WHO, there is no safe amount of alcohol consumption. However, studies(19) suggest that moderate drinking decreases mortality risk by 16-19%. While mortality risk was the lowest at 6 gm ethanol per day.

Q:Why do some people get drunk with a specific kind of alcohol while others don’t ?

A:Our bodies contain a gene called ALDH, they call it the drinking gene. Some people have this gene more active than others. Having a high activity of this gene means a high capacity to metabolize alcohol and vice versa.

Other factors like gut sensitivity to a specific ingredient, alcohol absorption and intestinal factors are also valid explanations.

Q:What is the worst alcohol for the gut?

A:Of course, alcoholic beverages with the highest ethanol concentration are believed to be the most harmful to the liver and the gastrointestinal tract. Also, those which contain high sugar content like fruity rum and dessert wine are causing gastric upset.

Q:The bottom Line

A:Undoubtedly, alcohol causes vast range of damage to your body and with cessation, 

withdrawal symptoms may be hard to tackle but you know you are stronger. One or two weeks of headaches, insomnia and depression is nothing compared to the benefits you gain if you stop. Stay away from temporary pleasures and it's better to get rid of this evil as early as possible, as true pleasure is in living a long and healthy life.