Whether drinking becomes harmful for you or not, depends on multiple factors which include: how much and how long you have been drinking, your genetic predisposition and your body’s response to drinking
Drinking can be harmful if:
When you drink too much in a short span of time, you are binge drinking. But how much is too much and what time span is ‘short span’? There are slightly different definitions from different agencies
WHO defines Heavy Episodic Drinking, HED or binge drinking, as drinking at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days
NIAAA defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 6 WHO standard drinks for men and 4 such drinks for women —in about 2 hours.
Binge drinking can lead to alcohol poisoning and serious GI (digestive system) side effects, which are all potentially life threatening
Alcohol can start to impair your coordination and memory between 0.10 to 0.12 percent. Anything higher than that will increase the harmful side effects such as blacking out, choking on vomit, seriously injuring yourself, suddenly passing out and extremely slowed breathing.
We tend to dismiss vomiting and passing out after binge drinking and think that the person will sleep it off! But, we need to watch out for irregular breathing, marked disorientation and such red flags, and if these could be present, the person should be taken to a hospital immediately
A very serious risk is choking on one’s own vomit, in this state, so the person should be made to lie on the side, so that the vomit does not go get inside
In people with diabetes, alcohol can lead to dangerously low blood sugar, especially if they skip eating while drinking
Sudden severe inflammation of liver, happens more commonly in people who drink regularly, when they binge
Majority of acute pancreatitis cases are caused by alcohol consumption and it has a high mortality rate. Also, repeated mild pancreatitis can lead to chronic pancreatitis, which is a debilitating and painful disease
Severe inflammation of stomach with pain, vomiting (often blood tinged) may need hospital based management
Due to severe retching with vomiting, lower esophageal tear may happen. Mostly it needs same care as gastritis mentioned above
People who binge drink are 56% more likely to get ischemic stroke, which makes 80% of all strokes than those who don’t in the next ten years.
Heavy alcohol use is considered to be more than four drinks (WHO standard drinks) per day or more than 14 drinks per week for men and more than three drinks per day or more than seven drinks per week for women.
Excess alcohol use refers to chronic consumption of more than 80 grams of ethanol per day, or a daily intake of approximately 250 mL of hard liquor (4 large) , 500 mL of fortified wine (2.53 large glasses) or 6 cans/pints of beer/day
Heavy or excess consumption can lead to the following:
Heavy alcohol consumption can lead to liver inflammation. In some cases, it is sub-clinical and not detectable by blood test, But, it can lead to fatty liver and in time progress to frank hepatitis or scarring of liver called cirrhosis
For others, alcoholic hepatitis can cause fever, nausea, appetite loss, abdominal pain, and even mental confusion and become life threatening!
In patients with severe alcoholic hepatitis, short-term mortality rates are high (approximately 25 to 35 percent at one month), whereas patients with mild to moderate alcoholic hepatitis have low short-term mortality rates (<10 percent at one to three months).
Fatty liver to cirrhosis
It is estimated that 8 to 20 percent of patients with alcoholic fatty liver will progress to develop alcoholic cirrhosis. Factors associated with an increased risk of progression to cirrhosis include daily drinking rather than periodic binge drinking, cigarette smoking, obesity, female sex, and superimposed liver disease (eg, hepatitis B or C).
On the other hand, drinking with meals appears to decrease the risk of progression.
Hepatitis to cirrhosis
Research shows that one among five heavy drinkers develop alcoholic hepatitis whereas one in four develop cirrhosis, as per NIAAA
Long term heavy drinking causes alterations in the nerve cells such as reductions in the size of brain cells.
It can manifest as instability or lack of coordination in movements or subtle signs such as decreases sleep, depression and problems in learning and memory
Heavy drinking is a major cause of high blood pressure. If one smokes as well the BP rises even more!
Weak heart and heart failure
Long term heavy drinking weakens the heart muscle, causing a condition called alcoholic cardiomyopathy. Symptoms of cardiomyopathy include shortness of breath and other breathing difficulties, fatigue, swollen legs and feet, and irregular heartbeat. It can even lead to heart failure
Alcoholism is associated with nutritional deficiencies of many vitamins and minerals, including vitamin A, vitamin D, thiamine, folate, pyridoxine, and zinc
In heavy smokers, often the intake of even protein and calories is not adequate, which furthers the risk of liver damage
People who drink and smoke are 15 times more likely to develop cancers of the mouth and throat than nondrinkers and nonsmokers
Alcohol and tobacco together are also responsible for 25 to 30 percent of all liver cancers. In addition, people who take five or more drinks per day have higher risk of colon and rectum cancer than non drinkers.
Read more about health risks of smoking and how to quit smoking
Heavy alcohol use depresses body’s immune functions and raises the risk for infections such as TB, pneumonia or even HIV
Drinking during pregnancy can do serious harm to the fetus and lead to an abnormal child
Fetal alcohol syndrome (FAS), is characterized by abnormal facial features and is usually associated with severe reductions in brain function and overall growth
So, are you drinking too much and risking liver disease? Find out! Read : low risk drinking in Indian context