Alcoholism: Causes and symptoms

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There are probably a number of factors that work together to cause a person to become an alcoholic. Recent genetic studies have demonstrated that close relatives of an alcoholic are four times more likely to become alcoholics themselves. Furthermore, this risk holds true even for children who were adopted away from their biological families at birth and raised in a non-alcoholic adoptive family, with no knowledge of their biological family's difficulties with alcohol. More research is being conducted to determine if genetic factors could account for differences in alcohol metabolism that may increase the risk of an individual becoming an alcoholic.

The symptoms of alcoholism can be broken down into two major categories: symptoms of acute alcohol use and symptoms of long-term alcohol use.

Alcohol exerts a depressive effect on the brain. The blood-brain barrier does not prevent alcohol from entering the brain, so the brain alcohol level will quickly become equivalent to the blood alcohol level. Alcohol's depressive effects result in difficulty walking, poor balance, slurring of speech, and generally poor coordination (accounting in part for the increased likelihood of injury). The affected person may also have impairment of periperal vision. At higher alcohol levels, a person's breathing and heart rates will be slowed, and vomiting may occur (with a high risk of the vomit being breathed into the lungs, resulting in severe problems, including the possibility of pneumonia). Still higher alcohol levels may result in coma and death.

Long-term use of alcohol affects virtually every organ system of the body:

• Nervous system. An estimated 30-40% of all men in their teens and twenties have experienced alcoholic blackout, which occurs when drinking a large quantity of alcohol results in the loss of memory of the time surrounding the episode of drinking. Alcohol is well-known to cause sleep disturbances, so that overall sleep quality is affected. Numbness and tingling may occur in the arms and legs. Two syndromes, which can occur together or separately, are known as Wernicke's and Korsakoff's syndromes. Both are due to the low thiamine (a form of vitamin B complex) levels found in alcoholics. Wernicke's syndrome results in disordered eye movements, very poor balance and difficulty walking, while Korsakoff's syndrome severely affects one's memory, preventing new learning from taking place.
• Gastrointestinal system. Alcohol causes loosening of the muscular ring that prevents the stomach's contents from re-entering the esophagus. Therefore, the acid from the stomach flows backwards into the esophagus, burning those tissues, and causing pain and bleeding. Inflammation of the stomach can also result in bleeding and pain, and decreased desire to eat. A major cause of severe, uncontrollable bleeding (hemorrhage) in an alcoholic is the development of enlarged (dilated) blood vessels within the esophagus, which are called esophageal varices. These varices are actually developed in response to liver disease, and are extremely prone to bursting and hemorrhaging. Diarrhea is a common symptom, due to alcohol's effect on the pancreas. In addition, inflammation of the pancreas (pancreatitis) is a serious and painful problem in alcoholics. Throughout the intestinal tract, alcohol interferes with the absorption of nutrients, creating a malnourished state. Because alcohol is broken down (metabolized) within the liver, that organ is severely affected by constant levels of alcohol. Alcohol interferes with a number of important chemical processes that also occur in the liver. The liver begins to enlarge and fill with fat (fatty liver), fibrous scar tissue interferes with the liver's normal structure and function (cirrhosis), and the liver may become inflamed (hepatitis).
• Blood. Alcohol can cause changes to all the types of blood cells. Red blood cells become abnormally large. White blood cells (important for fighting infections) decrease in number, resulting in a weakened immune system. This places alcoholics at increased risk for infections, and is thought to account in part for the increased risk of cancer faced by alcoholics (ten times increased over normal). Platelets and blood clotting factors are affected, causing an increased risk of bleeding.
• Heart. Small amounts of alcohol cause a drop in blood pressure, but with increased use, alcohol begins to increase blood pressure into a dangerous range. High levels of fats circulating in the bloodstream increase the risk of heart disease. Heavy drinking results in an increase in heart size, weakening of the heart muscle, abnormal heart rhythms, a risk of blood clots forming within the chambers of the heart, and a greatly increased risk of stroke (due to a blood clot from the heart entering the circulatory system, going to the brain, and blocking a brain blood vessel).
• Reproductive system. Heavy drinking has a negative effect on fertility in both men and women, by decreasing testicle and ovary size, and interfering with both sperm and egg production. When pregnancy is achieved in an alcoholic woman, the baby has a great risk of being born with fetal alcohol syndrome, which causes distinctive facial defects, lowered IQ, and behavioral problems.

— Bill Asenjo, MS, CRC