We have been told that alcohol is bad for our bodies but that is too general and easy to ignore. Agatha Ayebazibwe breaks down just how badly excessive consumption of alcohol affects different body parts.
It’s Friday! The perfect day to meet up with the gang and throw back two or seven non-water beverages - the alcoholic kind that is. But before you take more than just a few, here are some statistics to chew on.
Uganda is the highest consumer of alcohol per capita in the East African region, according to the Global Status on Alcohol and Health 2014.
The report indicates that 23.7 litres of pure alcohol are consumed per capita by drinkers annually in Uganda. More worrying, Ugandans according to the report, consume the unregulated type of alcohol classified as “others”. We seek to understand how alcohol affects the different body parts.
When consumed responsibly and in moderation, alcohol can be enjoyed without repercussions. Unfortunately, when drinking becomes a problem the effects can be disastrous for the health of the human body. According to the National Institute on Alcohol Abuse and Alcoholism, the immediate effects of alcohol including an increase in blood alcohol concentration can begin 10 minutes after your first sip.
According to Dr Sheila Ndyanabangi, the principal medical officer Mental Health and Control of Substance Abuse in the Ministry of Health, alcohol beyond a certain level becomes poison – ideally two pints of standard gin or two bottles of beer. When taken in excess, it can cause severe damage to almost all of the body’s major organs.
Because alcohol is alien to our bodies, when it goes in, the liver ensures that the excess goes out since the body can only digest an equivalent of one beer bottle per hour, according Dr Sarah Naluja, a consultant psychiatrist at the Psychiatry unit at Mulago hospital. “This therefore means that the liver will have a burden to exhaust it for people who drink more than one beer. Eventually, the liver wears out and liver complications begin to manifest – most notably, swollen legs, swollen bellies, yellow eyes, liver cancer, liver failure and death.”
Alcohol does not stop at that - Liver cells are destroyed. Liver is the main factory process through which nutrients for the body are made. If the things we eat are not processed, the toxic materials remain and destroy other body parts like the eyes, kidney because all the toxins remain in the body. Eventually, these toxins will cause liver cancer and or total liver failure that will lead to death where a liver transplant cannot be made.
The liver’s primary role is to filter all the blood in our bodies by breaking down and eliminating toxins and storing excess blood sugar. It also produces enzymes that break down fats, manufactures proteins that regulate blood clotting, and stores a number of essential vitamins and minerals. By enabling us to digest food, absorb nutrients, control infections, and get rid of toxic substances in our bodies, the liver keeps a person a live.
“To the human body, alcohol is a toxin that is broken down by the liver as the body begins the process of getting rid of these foreign components. But chronic heavy drinking causes the liver to become fatty. This condition makes the liver more vulnerable to dangerous inflammation, such as alcoholic hepatitis, and its associated complications,” says Dr Naluja.
However, continued drinking means persistent inflammation of the liver, which prevents the necessary blood supply from reaching the liver cells. Without the oxygen and other nutrients supplied by this blood, the liver cells eventually die and are replaced with scar tissue, creating a condition known as cirrhosis. in some cases, the liver can actually make repairs and continue to function but advanced cirrhosis causes deterioration and liver failure.
One of the main functions of the kidneys is to regulate both the volume and the composition of body fluid. However, alcohol can have effect of increasing urine volume.
“Due to the increased amount of urine the body produces, the kidneys are not able to do their job of regulating the flow and makeup of body fluids. This can in turn lead to high blood pressure, the second leading cause of kidney failure,” says Dr Henry Nabeta, a general physician at Mulago hospital.
“When alcohol crosses the blood-brain barrier, it settles into the satiation centre – reaching neurons directly. Once alcohol touches these cells, they are changed, resulting in changes in behavior. It then takes charge of that sensitive part of the brain,” says James Nsereko, a clinical psychologist at the Alcohol and Drug Unit at Butabika hospital.
With time – the brain only responds to alcohol and every time you take a little sip, it’s activated since it’s now programed to respond to alcohol. At this stage, addiction sets in – food becomes tasteless, sex no longer appeals to them and working doesn’t make sense anymore, Nsereko further explains.
By slowing the relay of information between neurotransmitters, the ethanol found in alcoholic drinks can cause damage to multiple areas of the brain. Prolonged damage to the brain’s neurotransmitters can result in behavioural and mood changes such as depression, anxiety, memory loss, and epileptic seizures, confusion, hallucinations, loss of muscle coordination, and an inability to form new memories.
“The sense of judgment, walking, thinking and the general performance of the brain become slow in making decisions. They suffer forgetfulness because the central nervous system has been slowed down,” says Dr Sheila Ndyanabangi, the principal medical officer Mental Health and Control of Substance Abuse in the Ministry of Health.
Alcohol beyond a certain level becomes poisonous. The speech becomes impaired, a person stammers, they get scars in the brain, disruption in the brain activity as well as mental illnesses known as psychosis and when consumed quickly and on an empty stomach, it can produce a blackout, according to Dr Henry Nabeta, a general physician at Mulago hospital.
“The majority of alcoholics have no appetite and therefore eat less. The lack of important vitamins results into shrinking of the brain, consequently leading to brain functioning problems, as well as other nutritional complications,” Dr Nabeta explains.
Some studies also indicate that alcoholic liver disease can also damage the brain. The liver breaks down alcohol—and the toxins it releases. During this process, alcohol’s byproducts damage liver cells. These damaged liver cells no longer function as well as they should and allow most of these toxic substances to travel to the brain. These substances also damage brain cells, causing a serious and potentially fatal brain disorder characterised by sleep disturbances, mood and personality changes, anxiety, depression, short attention span, coordination problems, including asterixis, which results in hand shaking or flapping, coma and death.
Blood vessels and heart
Several studies have linked heart problems to alcohol drinking. According to the World Health Organisation, alcohol is among the top three causes of heart problems. This is because alcohol weakens blood vessels. As a result, the supply of blood to different body organs is limited and sometimes falls short. This leads to several heart complications.
According to Dr Sarah Naluja, a consultant psychiatrist at the Psychiatry unit at Mulago hospital, over time, excessive alcohol consumption begins to weaken the heart muscle resulting in blood flow irregularities. Alcoholics often suffer a condition known as cardiomyopathy – where the heart stretches and droops.
“People with cardiomyopathy caused by alcohol tend to experience shortness of breath, irregular heartbeat, fatigue, enlarged liver, and a persistent cough. Alcohol can also increase the risk of a heart attack, stroke, and hypertension,” she says adding that, in some cases, this blood flow shortage causes severe damage to organs and tissues.
But Dr Sheila Ndyanabangi, the principal medical officer Mental Health and Control of Substance Abuse in the Ministry of Health also warns on excessive drinking saying it can lead to strokes, even in people without coronary heart disease. Accordingly, in other cases, chronic alcohol use can cause high blood pressure, or hypertension.
“Your blood pressure is a measurement of the pressure your heart creates as it beats, and the pressure inside your veins and arteries. Heavy alcohol consumption triggers the release of certain stress hormones that in turn constrict blood vessels. This elevates blood pressure,” she says.
But most importantly, because blood vessels are limited in their function, some body parts may not receive enough blood. This, in men, results into sexual organs dysfunction. This is because the male organ does not receive enough blood hence the man may fail to get aroused.
Dr Sarah Naluja, a consultant psychiatrist at the Psychiatry Unit, Mulago hospital, explains that large amounts of alcohol can confuse the pancreas causing it to secret enzymes internally, instead of sending them to the small intestines. The build up of enzymes in the pancreas will therefore cause inflammation known as pancreatitis.
“It can either occur as a sudden attack which may present with abdominal pain, nausea or vomiting, increased heart rate, diarrhoea, and fever or chronic pancreatitis which slowly deteriorates the pancreas, leading to diabetes and even death.”
Because alcohol affects the absorption and use of food nutrients mostly vitamins, alcoholics tend to get nutritional deficiency. This mostly happens for minerals and vitamins whose absorption becomes difficult as a result of too much alcohol in the body but also because alcoholics eat less. This makes them vulnerable to skin infections and wounds. “The same happens with their muscles since they are not getting nourishment, the majority of chronic alcohol drinkers tend to get wasted. The person eventually becomes very thin, with swollen feet and cheeks,” says James Nsereko, a clinical psychologist at the Alcohol and Drug Unit at Butabika hospital.
They also get a lot of fluid collecting in their stomach, weak heart, become irritable and suspicious. The head muscle becomes weak and so the heart also becomes too weak to pump blood at its right pace.
Usually, due to the weakening of the blood vessels, blood pressure will develop, and so will premature ageing, dementia and lack of coordination of the general body system
Virtually, according to Dr Sarah Naluja, a consultant psychiatrist at the Psychiatry Unit at Mulago hospital, the entire human functioning system will be disrupted, but majorly the brain, the liver and the heart suffer the most consequences.
However, the impact of alcohol is not limited to body organs but also stretches to social economic being of an individual, breeding effects like violence in homes, poverty, frustration among others.
Alcohol and pregnancy
During pregnancy, the facial features develop in the first three months; alcohol interferes with the process leading to a condition known as the foetal alcohol syndrome. When this happens, the baby can be born with a disfigured face.
According to James Nsereko, a clinical psychologist at the Alcohol and Drug Unit at Butabika hospital, when a pregnant woman drinks alcohol, it crosses to the foetus through the placenta. This slows the baby’s brain development because it is just forming, and when the child grows, they suffer brain functionality problems.