Alcoholism

Alcoholism is a condition in which an individual gets addicted to and starts craving for regular consumption of alcohol. Alcohol becomes a part and parcel of an alcoholic’s daily intake and the amount of alcohol undertaken increases gradually with time.

Alcoholism can be divided into acute and chronic alcoholism.

Acute alcoholism: In this type of alcoholism, there is a sudden intake of excess alcoholic drinks that affects the central nervous system in various ways.

Clinical features of Acute Alcoholism

When the Blood Ethanol concentration is less than 500, then the person becomes talkative and possess a sense of well-being.
When this concentration ranges from 500-1000, there is emotional instability, in-coordination and slurred speech seen in the individual.
With further increase in the Blood Ethanol concentration between the level of 1000-3000, the person faces loss of sensory perception, muscular in-coordination, ataxia, blurred vision, slurred speech and the reaction level also becomes slow.
At the range of 3000 – 4000, there is severe intoxication leading to severe ataxia, double or blurred vision and also coma or convulsions.
If the Blood Ethanol concentration reaches more than 5000, then it affects the alcoholic person in the form of coma, hypo-reflexes, hypothermia, respiratory depression, etc.

Chronic alcoholism: Regular consumption of excessive amounts of alcohol is the feature seen in a Chronic alcoholic person. This is a severe condition and it maybe hereditiery for some individuals. However, the harmful effects of chronic alcoholism are far reaching.

Clinical features of Chronic Alcoholism

Various Body Systems are affected due to chronic alcoholism:

1. Gastrointestinal tract

Nausea and retching/vomiting (particularly in early morning), anorexia and diarrhea.
*Parotitis*, pharyngeal cancer, heartburn, bleeding from esophagitis, ruptured varices and mucosal tears following retching.
Acute hemorrhagic gastritis causing vomiting of blood.
Bacterial colonization and mal-absorption.
Irritable bowel syndrome and rectal cancer more common in heavy drinkers.

2. Hepatobiliary (liver) and Pancreatic

Fatty liver, alcoholic hepatitis and fibrosis of liver.
Cirrhosis of liver and carcinoma of liver.
Acute and chronic relapsing pancreatitis.
Zieve’s syndrome- gross fatty liver changes, hemolysis (destruction of blood cells) and pancreatitis.

3. Central Nervous System

Nutritional deficiencies-
- Korsakoff syndrome.
- Pellagra.
- Tobacco-alcohol amblyopic vision.

Others-
- Cerebral dementia.
- Demyelization syndromes and electrolyte imbalance.
- Fetal alcohol syndrome- mental impairment, attention deficit and hyperkinetic disorders, specific learning difficulties.
- Peripheral nervous system- sensory, motor and mixed neuropathy is seen.

4. Muscle and skeletal disorders

Like impaired bone formation, enhanced bone degradation, nutritional deficiencies (e.g. calcium, magnesium, phosphate, vitamin D), generalized proximal muscle weakness with or without wasting in chronic alcoholics, gout, avascular necrosis of bones (e.g. femoral bone head) and fractures.

5. Endocrine system

Pseudo-Cushing’s syndrome and pseudo-thyrotoxicosis.

6. Metabolic

Alcohol induced hypoglycemia, essential reactive hypoglycemia following a rich carbohydrate meal.
Hyperglycemia- long continued heavy drinking can precipitate symptomatic diabetes mellitus which remits on abstaining from alcohol.
Ketoacidosis, hyper-uremia, lactic acidosis and hyperlipoproteinemia.

7. Hematological defects

Anemia is seen as a result of blood loss, folic acid deficiency and mal-absorption. Rarely hemolysis. Reduction in WBC and platelets.

8. Cardiovascular disease

Dysrhythmias such as atrial fibrillation. Hypertension and other disorders such as coagulation and clotting abnormalities, myocardial infarction and renovascular disease.

9. Respiratory disorders

Asthma and chronic obstructive pulmonary disorders.
Respiratory tract malignancy, post-operative infections and inhalation of vomit (Mendelson’s syndrome) may follow a drinking binge.

10. Skin disorders

Acne rosacea, spider naevi, palmar erythema and finger clubbing.
Skin infections- bacterial, fungal and viral.
Psoriasis, discoid eczema and nutritional deficiencies including pellagra.

11. Reproductive disorders

Men- impotence due to testicular atrophy, liver damage with accumulation of estrogen metabolites and autonomic neuropathy.
Women- ovarian dysfunction and uterine damage commonly associated with amenorrhea, sub-fertility, recurrent abortion and fetal damage including fetal alcohol syndrome.

After going through all the Clinical features and ill-effects that one can facea due to alcoholism, it is better to take a step towards helping ourselves and the society at large by combating the disease of Alcoholism by taking help of the professional institutions and doctors catering to this solution.

Related Topics

Alcoholism | Acute Alcoholism | Chronic Alcoholism | Types of Alcoholism