Paging Dr. Frischer - Alcohol

My wife and I recently returned from a wonderful weekend up in Sonoma County, where we indulged in a little wine tasting. While I'm actually not much of a drinker, learning about wine and winemaking is always fascinating. Upon our return, we've plunged into this season of holiday parties, with alcoholic drinks being served at most. All of this has started me thinking about the physiology of how alcohol affects our bodies.Whether or not we are aware of it, the first sips of an alcoholic beverage result in the immediate impairment of brain function, and the more that we drink, the more that function deteriorates. The rate of deterioration may be affected by how empty or full our stomach is; our gender, age and weight; and race. Certain medicines, such as aspirin, slow the breakdown of alcohol and greatly increase the blood alcohol level. Cognitive abilities such as conduct and behavior are the first to go. There can be a mild euphoria and loss of inhibition. The most vulnerable brain cells are associated with memory, attention, sleep and coordination. Alcohol affects the heart. Our pulses quicken after very little is consumed. Alcohol is a vasodilator, meaning that it makes the blood vessels relax in order to allow more blood to flow through the skin and tissues. This results in a drop in blood pressure, so in order to get sufficient blood to organs and tissues, the pulse speeds up. After a significant intake of alcohol, the heart develops "holiday heart syndrome," in which the heart goes into an irregular rapid heart rhythm (atrial fibrillation). This can lead to weakness and shortness of breath, and an increased risk of stroke. The lungs are involved because alcohol speeds up the breathing rate. However, at higher levels of intoxication, the stimulating affects are replaced by an anesthetic effect, which actually depresses the central nervous system. (Note that as our blood passes through our lungs, a proportional amount of alcohol passes into the air that we exhale. This is why Breathalyzers can accurately detect the blood alcohol level.) The digestive system is affected. As a rough guideline, it takes as many hours as the number of drinks consumed to burn up the alcohol. Alcohol is absorbed through the stomach and small intestine. Even small amounts can irritate the stomach lining, and larger quantities of alcohol can block absorption of essential vitamins and minerals. Only a few weeks of heavy drinking can lead to pancreatitis. The kidneys are affected because alcohol is a diuretic. It promotes urine production, which then leads to dehydration. Due to this stimulation, the kidneys are working overtime. Alcohol affects the skin. It increases blood flow, making us feel warm and look flushed. Since it also dehydrates, it increases the appearance of fine lines. The destructive effects of alcohol on the liver are well known. Large quantities can lead to both acute and then chronic liver disease. It is in the liver that alcohol is metabolized, and as it breaks down, its by-products (including acetaldehyde) are formed. Some of these by-products are even more toxic to the body than the alcohol. Even a single episode of heavy drinking affects the delicate balance of enzymes in the liver and fat metabolism. Over time, drinking can lead to the development of fatty globules that cause the liver to swell, ultimately leading to cirrhosis. On top of all of this…is the hangover! Its precise cause is unclear. There are many theories, including hypoglycemia, dehydration, acetaldehyde intoxication, and glutamine rebound. Some symptoms may actually be due to alcohol withdrawal. They include fatigue, headache, body aches, vomiting, diarrhea, flatulence, weakness, elevated body temperature and heart rate, hyper-salivation, difficulty concentrating, sweating, anxiety, dysphoria, irritability, sensitivity to light and noise, erratic motor function, tremors, trouble sleeping, severe hunger, halitosis, and lack of depth perception. Hangovers may include psychological symptoms including depression and anxiety. Symptoms usually begin after the intoxicating effects of alcohol wear off; typically, a hangover is experienced the morning after a night of drinking. Of course, these symptoms vary from person to person, and it's possible that up to 30% of drinkers may actually be resistant to hangover symptoms. With long-term heavy drinking, the picture gets pretty ugly. It leads to a drop in testosterone, impotence, testicle shrinking, infertility in both men and women, and permanent damage to the brain by damaging the connections between nerve cells. It is a depressant, and can trigger anxiety and lethargy. It leads to anemia, and is linked to an increased risk of a number of cancers. Drinkers can die from bleeding ulcers, or from swollen blood vessels in the intestine. Eventually drinking can lead to "alcohol dementia," poor coordination, cirrhosis, and liver and kidney failure. So as we bid farewell to 2011 and welcome in 2012, let's remember to practice moderation and treat our body with the respect it needs and deserves. Let me also take this opportunity to remind all of you not to drink and drive. Happy holidays to you all! Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

********** Published: December 22, 2011 - Volume 10 - Issue 36