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V. Associated Conditions

What are the medical consequences of alcoholism?

Can alcoholism cause dementia?

Are there other neurological effects of alcoholism?


What are the medical consequences of alcoholism?

The medical consequences of alcoholism are manifold. Until clearer criteria were developed to diagnose alcoholism, these conditions allowed for the definitive diagnosis of alcoholism. The most obvious and direct medical consequences are the injuries resulting from intoxication and its resulting impact on impulse and judgment. Everyone is acutely aware of the impact of drunken driving, but alcohol has a devastating impact on the human body, leaving few organ systems free of its toxic effects. These organ systems include the respiratory system, the gastrointestinal system, the cardiovascular system, the hematological system, the immune system, the musculoskeletal system, the genitourinary system, the endocrine system, metabolism, and finally, the central nervous system. The most important issues of each system (excluding the central nervous system, discussed in Questions 62 and 63) are covered in this question.

The most obvious and direct medical consequences are the injuries resulting from intoxication and its resulting impact on impulse and judgment.

Respiratory System

Before going into alcohol's chronic and pernicious effects on various organ systems, you must understand that acute alcohol intoxication or alcohol poisoning can kill, and it does so with alarming regularity particularly in adolescents and young adults. A year does not go by where an article in a local paper discusses a youth who is found dead in a fraternity room, a dorm room, a friend's house after a high school party, or their own home after a binge drinking episode. This occurs simply because alcohol in high doses can lead to unconsciousness and can suppress respiratory drive, leading one to stop breathing. This is one of the biggest risks that alcohol has when consumed rapidly in large quantities, and young people are forever ignorant of this potential danger.

Gastrointestinal System

The most commonly known effects on the gastrointestinal system are alcoholic hepatitis and eventual cirrhosis, which ultimately culminates in liver failure and death. Everyone has also heard of the alcoholic developing stomach ulcers. This is due to the fact that alcohol promotes the growth of the bacteria H. pylori in the stomach, well known to be the cause of peptic ulcers. Less well known are its effects on the pancreas, leading initially to pancreatitis and over time pancreatic failure and a panoply of illnesses associated with it, not the least of which is insulin-dependent diabetes, as the pancreas is the source of the body's insulin production.

Cardiovascular System

Chronic heavy drinking can lead to hypertension (high blood pressure). It can also raise cholesterol and triglycerides in the bloodstream, all risk factors for the development of coronary artery disease, or the build up of plaques, which clogs the coronary arteries. This buildup increases the odds of suffering from a heart attack. Additionally, the poor nutrition that is often associated with chronic alcoholism can lead to vitamin deficiencies that can lead to heart muscle damage, particularly thiamine, which causes a rare condition commonly known as alcoholic beriberi or thiamine- dependent cardiomyopathy.

Hypertension high blood pressure, which can appear without an apparent cause. Hypertension can damage other organs in the body and is freguently the cause of strokes.

Coronary artery disease the build up of plague in the coronary arteries constricting blood flow to the heart muscle, leading to chest pain (angina) and the potential for muscle death (myocardial Infarction).

Beriberi from Sri Lankan for "I cannot, I cannot." A condition caused by thiamine deficiency, leading to damage to the central nervous system and causing memory and emotional disturbances (Wernicke's encephalopathy), weakness and pain in the limbs, and periods of Irregular heart beats. Swelling of bodily tissues Is common. In advanced cases, the disease may cause heart failure and death.

There is a more direct and pernicious impact that chronic heavy drinking has on the heart, however. This affects up to one in four individuals who have a greater than 10-year history of sustained alcohol dependency. Alcohol is directly toxic to heart muscle, thus bypassing the eventual buildup of coronary artery-clogging plaque that causes heart muscle damage from coronary artery disease. This direct toxicity causes an inflammation to the heart muscle called myocarditis, just like it causes inflammation to the liver called hepatitis. Eventually, the inflammation can lead to heart muscle death just as chronic inflammation to the liver can lead to liver cell death known as cirrhosis. When too much heart muscle dies off, whether from coronary artery disease or from the toxic effects of alcohol, the heart either pumps irregularly or fails to pump. Irregular pumping is known as an arrhythmia or dysrhythmia, which can be fatal. Alternatively, when the heart fails to pump an adequate amount of blood to the body, it leads to a condition known as congestive heart failure. The most distressing event occurs when congestive heart failure causes a buildup of fluid in the lungs, making it difficult to breathe. This is particularly acute at night when one is lying down and gravity doesn't have the opportunity to pull the fluids away from the lungs.

Congestive heart failure the heart is unable to maintain adequate circulation of blood to the body's tissues and is unable to pump out venous blood via the venous circulation system.

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