Tuesday, December 31, 2013

Resolutions, part IV: Alcohol-related tissue damage lingers years after quitting

New Year’s often brings resolutions to quit or cut back and/or avoid relapse. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are additional long-term considerations about alcohol use disorders, quitting and staying sober.

Alcohol itself is toxic. It’s broken down in the body in the following sequence:
Alcohol>Acetaldehyde>Acetic Acid (vinegar)>Water+CO2
The first metabolite, acetaldehyde, is 30 times more toxic than alcohol and is responsible for damage to tissues.

The relationship between chemicals and your DNA is part of a field called epigenetics and epigenetics is now showing that the alcohol you consume and its acetaldehyde byproduct leave a biological imprint on your DNA, one that can surface in diseases later (Wall Street Journal, February 28, 2012). If the drinking doesn’t kill you immediately, it can kill you years down the road.

The weight of scientific evidence demonstrates a link between alcohol and a greater risk of mortality for diseases of the immunological, nervous, cardiovascular, and respiratory and digestive systems. This was most recently confirmed by researcher Domenico Palli, a scientist at the Cancer Research and Prevention Institute of Florence in 2012, and new links with diseases and alcohol are being reported nearly weekly. Absence of evidence is not evidence of absence. If you don’t have the following conditions now, there are provable connections to getting them years after abstinence… the longer a person waits to quit, the higher the risk.

Liver damage/disease
The alcohol user is eight times more likely to get cirrhosis, which is irreversible, incurable and fatal. Not all alcoholics will get it. One in 10 develops cirrhosis. However, it is not the only liver disease cause by alcohol/acetaldehyde.

A fatty liver occurs when alcohol consumption disrupts how the body chooses its fuel. Cell mitochondria—our body power plants—normally use fat to produce energy. As aacetaldehyde breaks down in the body it releases hydrogen, which mitochondria use before fat as fuel. The unused fat then accumulates around the liver. Even in someone who doesn’t look fat in their extremities or midsection, fat deposits choke the liver.

Alcoholic hepatitis is a third type of liver injury connected to alcohol misuse. It is a condition similar to the other hepatitis diseases, but is not the same as A, B or C hepatitis.

Liver problems are not the realm of only the hard drinker, they can be stimulated by amounts of alcohol between five to nine drinks in 24 hours. There are very few symptoms of liver injury until it becomes chronic because the liver has no pain nerves to tell you when it is hurt. If the liver had nerve endings, you’d never make it to the second drink.

Pancreatic damage
The pancreas is a long, flattened, pear-shaped organ located behind the stomach. It makes digestive enzymes and hormones including insulin. Alcohol users are 1.6 times more likely to develop pancreatic cancer, the most fatal of cancers. (Dr. Mirjam Heinen, Maastricht University, Netherlands, May 2009).

Men should be especially conscious of alcohol/acetaldehyde when it comes to the pancreas. University of Pittsburgh School of Medicine researchers isolated a gene variant in men that puts those who drink heavily at risk for pancreatitis.

Muscle disease
Acetaldehyde fragments muscle fibers, weakening them and allowing them to tear easily. Muscle atrophy or destruction can occur fairly easily. The weakness and atrophy have been known to medicine for 200 years as myopathy, but myopathy has come to be known as a common side effect of acetaldehyde and alcohol.

Nerve disease/neuropathy
Alcoholic neuropathy is identical to the neuropathy experienced as a side effect of diabetes. Neuropathy causes a tingling of burning sensation, or a loss of sensation all together. In Alcoholics, as with diabetics, it is an affliction of the limbs and especially the legs. Commonly there is a reduced sensitivity in the feet. You’re not able to feel pain. When this happens, foot injuries, like blisters, can become infected so severely because you cannot feel pain that amputation is necessary. But the fatal problem with the neuropathy is the increase in the risk of stroke it carries, covered in part five of this series.

Stomach disease
Gastritis—sharp stomach pains—and gastric ulcers are very common results of regular alcohol use and can last for years after abstinence. Alcohol slows the emptying of the stomach, which allows more acid to build up in the stomach and therefore more time for it to permanently damage the stomach lining. Cancer of the stomach is called gastric cancer. Gastric adenocarcinoma is the most common type of stomach cancer. It arises from those cells in the stomach lining.

Chronic gastritis also is a predisposing factor in developing stomach cancer (“Alcohol and stomach cancer in northern Italy,” in the Nutrition ResearchNewsletter, September 1994) The newsletter concluded, “heavy intake of total alcohol (at least eight drinks/day) or wine (six to eight or at least eight drinks/day) was associated with a small but significant increase in stomach cancer risk.”

A more recent study put the cancer risk in much more exact and troubling terms. Researchers evaluated information from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

More than 400 cases of stomach cancer were diagnosed among study participants. Heavy alcohol consumption increased the risk of stomach cancer in men. Men who consumed an average of more than four drinks per day were 65 percent more likely to develop stomach cancer than men who were very light drinkers. The link between alcohol and stomach cancer appeared to be stronger for beer than for wine or spirits.

Breast cancer
One out of eight women will have an encounter with breast cancer. Alcohol use is the ONLY dietary factor increasing the likelihood of getting breast cancer.

Breast cancer risks increase 10 percent for every 10 grams of alcohol consumed daily. That’s about one drink.) Women who consumed even “modest” alcohol (equivalent to 3-6 glasses of wine per week) were linked with a 15 percent increase of developing the disease. Researchers also found that the increased risk of breast cancer for those who drank at least 30 grams of alcohol per day on average (at least two drinks daily) was 51 percent higher compared to women who never drank alcohol.

In addition, when the researchers looked at alcohol consumption levels between the ages 18 to 40 and after the age of 40, they discovered that both were strongly linked with an increased risk of breast cancer. The connection with alcohol consumption still remained even after controlling, reducing or quitting alcohol consumption after the age of 40.

Other cancers
Dr. Palli’s 2012 research identified “significantly” higher risks for cancers of the pharynx, oral cavity and larynx and higher rates for cancers of the esophagus and rectum. “Alcohol’s role as a dietary carcinogen emerged quite clearly,” said Palli. An older study put the numbers at an estimated 75 percent of esophageal cancers in the U.S. are attributable to chronic, excessive alcohol consumption and nearly 50 percent of cancers of the mouth, pharynx, and larynx are associated with heavy drinking.

According to Annual Review of Pharmacology and Toxicology, alcohol misuse results in abnormalities in the way the body processes nutrients and may subsequently promote certain types of cancer later in life. Alcoholism also has been associated with suppression of the immune system. Immune suppression makes you more susceptible to various infectious diseases and, theoretically, to cancer.
--Adapted from Every Silver Lining Has a Cloud

Image: Adamr

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.