Alcohol and the Digestive Tract

Metabolism of Ethanol and Some Associated Adverse Effects on the Liver and the Stomach

“…In addition, chronic ethanol consumption has a profound interaction with testosterone metabolism, resulting in a castrationlike effect in males, 39 whereas there is evidence that the progression to more severe liver injury is accelerated in women 111 and the incidence of chronic advanced liver disease is higher among women than among men for a similar history of alcohol abuse. 112 A daily intake of alcohol of 40 g in men (3 drinks) 113,114 but only 20 g in women 113,114 resulted in a statistically significant increase in the incidence of cirrhosis in a well-nourished population.…”

“…Indeed, long-term ethanol consumption is associated with increases in the content of a specific cytochrome (P4504A1) that promotes microsomal ω -hydroxylation of fatty acids, which may be followed by ω -oxidation; this could compensate, at least in part, for the deficit in fatty acid oxidation due to the ethanol-induced injury of the mitochondria. 39 Products of ω -oxidation also increase liver cytosolic fatty acid-binding protein (L-FABPc) content and peroxisomal β-oxidation, 89 an alternate but modest pathway for fatty acid disposition (see Section 3.1).…”

“…39 Fatty liver, the first manifestation of alcoholic liver disease, can begin within days of heavy drinking. This is followed by early fibrosis, which in turn can be associated with alcoholic hepatitis.…”

“…Ethanol acts as a preferred substrate and displaces up to 90% of the liver's normal fuel, which is fat. 39 Consequently, the latter accumulates, resulting in a fatty liver, the first stage of alcoholic liver disease.…”

“…Acute and chronic gastritis, common in the alcoholic, is discussed elsewhere. 39 Since a substantial amount of alcohol can be metabolized by human gastric cells, 16 the resulting toxic acetaldehyde could play a pathological role. In addition, Helicobacter pylori (HP) infection is more common in alcoholics than in nonalcoholics, 40 raising the question of the relative role of alcohol and HP in the pathogenesis of gastritis in the alcoholic.…”