By: Jean Johnson for Reflux1Alcohol may be a legal drug in our country, but it can be tricky business when it comes to its effects on the body. That’s why the healthiest among us generally refrain from the substance right along with caffeine and nicotine.
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Cutting Back
According to the New York City Department of Health, a good guideline to moderate drinking is:
Have no more than one to two drinks a day.
Never have more than four drinks in one day.
A woman may want to cut alcohol use if she has more than 7 drinks a week or three drinks in one sitting.
A man may want to cut alcohol use if he has more than 14 drinks a week or four in one sitting.
Moderate Drinking and Cancer
According to Harvey Finkel, M.D. “A number of studies have demonstrated that wine, in particular, possesses several properties that would tend to prevent or inhibit cancer, no doubt through the actions of its antioxidant compounds.”
“Epidemiologic research has revealed substantial reduction of risk of cancers of the esophagus, and upper stomach and colon and rectum in wine drinkers as compared to non-drinkers,” said Finkel.
Infections and Alcohol
“Some alcoholics exhibit an abnormality of esophageal motility know as a ‘nutcracker esophagus’ which mimics symptoms of coronary heart disease,” write Christian and Christiane Bode.
The muscular motility of the intestine may be reduced in alcoholics, thereby unpredictably altering function and allowing toxic bacterial overgrowth.
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Alcohol tempts us worldwide: There are the French with their proverbial glasses of red wine held high and the Japanese with their potent shots of sake. Or if you want to think German; anyone who’s ever savored an Oktoberfest meal of potatoes glistening in butter and caraway seeds alongside cabbage and sausage with country mustard knows that a hefty mug of foaming amber brew complements the sturdy fare like nothing else. All that and we haven’t even got down to Mexican food and pizza – and summer has barely begun in the good old “U.S. of A.” Those hazy, lazy days that find us out on the veranda once again. Bring on the mint juleps, the margaritas and the bubbly.
Before we get to partying too much, however, there are some considerations. Most of us are well versed in the mantra that booze is no friend to the liver. But what is lesser known is that alcohol takes a toll on the entire gastrointestinal tract.
How It Works
Think of the GI tract as a highly sophisticated tube extending from the mouth to the anus which breaks down food and absorbs nutrients into the bloodstream. The esophagus links the oral cavity and pharynx to the stomach which in turn gives way to more tubing: The small and large intestines, the rectum and the anal canal. The supporting cast includes the liver, pancreas and salivary glands.
Now think of upending a few drinks or sedate glasses of wine sloshing elegantly about in crystal stemware. Voila – the uninvited and unexpected physical repercussions.
Before we get too far along here, we should be clear. When it comes to alcohol and consequences, the issue is generally one of excess. As the venerable ancient Greek, Paracelsus, wrote, “Whether wine is a poison, medicine or a nourishment is a matter of dosage.” Or put another way as Harvey E. Finkel, M.D. did in a contemporary www.aim-digest.com article, the “unpleasant consequences of heavy drinking may be lasting and as severe as cancer.”
However, before you stop reading on the grounds that you’re not an alcoholic and just tipple a bit now and again, consider this from Christiane Bode, Ph.D. and J. Christian Bode, M.D., both German professors: Alcohol in any quantity takes a significant toll on the lining of the GI tract and compromises the ability of the gut to take in nutrition and ward off invaders.
Particularly in the esophagus, stomach, and upper small intestine where it is the most concentrated, alcohol can counteract normal function and metabolism when used habitually or to excess, as in the case of an alcoholic or simply in acute fashion as in someone who might binge or at a party where the crowd gets a little too happy.
The Nitty Gritty
For those who like to hear the details, we turn to Edy Stermer, M.D. and a 2002 paper she wrote for the IMAJ, an Israeli medical journal. While Stermer stated that “in terms of mortality, the effect of alcohol on the liver and the pancreas is probably more significant than on the tubular gastrointestinal tract,” she went on to provide the details on what GI problems can arise in response to drinking too much, either regularly or even occasionally.
First, the esophagus: “It is noteworthy that alcohol has a different pathophysiologic action in the lower esophageal sphincter depending on whether the ingestion is acute (as in the occasional binge drinker) or chronic (as in alcoholics).” Heartburn, writes Stermer, is what acute consumption can bring, while gastro-esophageal reflux or GERD can arise from chronic drinking.
Then the stomach. As Christian and Christiane Bode write, “Researchers have known for more than 100 years that alcohol abuse can cause mucosal inflammation. In addition, alcohol is an important cause of bleeding gastric lesions that can destroy parts of the mucosa. Although low or moderate alcohol does not cause such damage in healthy subjects, even a single episode of heavy drinking can induce mucosal inflammation and hemorrhagic lesions.” Christian and Christiane Bode also point out that alcohol makes the gut sluggish and unable to propel food adequately resulting in diarrhea, which is frequently observed in alcoholics.
In the small intestine, “alcohol inhibits absorption of a variety of nutrients.” Christian and Christiane Bode also point out that “excessive alcohol consumption frequently causes mucosal damage in the upper region of the duodenum. Even in healthy people, a single episode of heavy drinking can result in duodenal erosions and bleeding.”
As for the large intestine and colon, according to Stermer, “alcohol consumption in moderate quantity has been related to an increased risk of carcinoma and adenoma of the colon and rectum, but these results have not been unanimously confirmed.”
For their part, Christian and Christiane Bode note that alcohol’s effects on the large intestine have received only minor attention until recently. “Studies in dogs, however, found that acute alcohol administration depressed the colon... significantly reducing the frequency and strength of muscle contractions. These effects could reduce the transit time – and thus the compaction – of the intestinal contents and thereby contribute to the diarrhea frequently observed in alcoholics.”
Keeping the Effects of Alcohol at Bay
Lots of fun: Diarrhea, GERD, cancer, heartburn, erosions and bleeding. All that, plus the nutritional problems excessive drinkers are known to suffer because the GI tract has to deal with alcohol all the while it’s trying to metabolize food.
So how to be a fun-in-the-sun American who enjoys a drink or two and still stay healthy? The drink or two seems to be the ticket. Holding the line there is the key.
More, having a bite to eat while drinking slows down the absorption of the alcohol and makes it less toxic on the GI tract. Indeed, there’s a reason for hors d’euvres. Like my mother always said, “I never offer a guest a drink without having some food out.” While she was famous for her hors d’oeuvres, in a pinch even she made do with just a few nice crackers and cubes of ham and cheese alongside some olives and pickles.
Aside from having some nibbles, attention to gender pays off. As Harvey Finkel puts the science behind it, “Women’s stomachs contain about 60 percent as much alcohol dehydrogenase as do men’s, likely the chief reason for the long-observed lesser tolerance of women for alcohol and the recommendation that their safe and healthy portion should be about half of men’s. So when a couple shares a bottle of wine at dinner, he should get two-thirds.”
