EXCESSIVE alcohol intake has severe health consequences, contributing to 6% of global deaths (3.3 million annually) and 5.1% of the global disease burden. It is linked to approximately 200 diseases, including 14 types of cancer. More than half of alcohol-related deaths result from gastrointestinal diseases, with liver cirrhosis (50%), pancreatitis (25%), and oesophageal cancer (22%) being the most common causes.
Chronic alcohol consumption damages the entire digestive system, causing both inflammatory and toxic effects. The severity depends on the amount and frequency of intake, with gender differences and drug interactions further influencing ethanol metabolism. Acetaldehyde, a toxic by-product of alcohol metabolism, triggers inflammation and liver damage, while alcohol-related endotoxaemia worsens liver injury.
Liver cirrhosis remains the leading cause of alcohol-related deaths, affecting about 50% of individuals with digestive complications. Pancreatitis, both acute and chronic, can lead to severe complications, including diabetes and pancreatic cancer. Oesophageal cancer, strongly associated with alcohol use, accounts for 22% of alcohol-related deaths. Notably, even low alcohol consumption increases the risk of digestive system cancers, including gallbladder cancer.
Despite the significant health burden, there are gaps in managing alcohol-related digestive diseases. Research is exploring treatments such as antioxidants, antimicrobial agents, and anti-inflammatory drugs to reduce alcohol-induced liver damage. However, early detection and intervention remain critical in preventing disease progression.
To minimise risks, individuals should limit alcohol intake to moderate levels—up to one drink per day for women and two for men. Those experiencing persistent digestive symptoms, such as abdominal pain, nausea, vomiting, or bloody stools, should seek immediate medical evaluation. People with alcohol use disorder should pursue professional support, including counselling, medication, and self-help groups.
Addressing alcohol-related digestive diseases requires further research and improved clinical management strategies. Greater awareness and early intervention can help reduce the significant health burden associated with excessive alcohol consumption.
Katie Wright, EMJ
Reference
Caputo F et al. Effects of ethanol on the digestive system: a narrative review. J Transl Gastroenterol. 2024;2(4):186-92.
