A Family Doctor's Tale - ALCOHOLISM

DOC I HAVE ALCOHOLISM

Alcohol has an adverse effect on the brain first stimulating it then depressing it.

It can damage the liver and the pancreas as well as the stomach and bleeding in the intestinal tract.

Nowadays teenagers are starting early to drink alcohol.

Stress is another problem causing a person to drink. I know of one patient who drinks in order to sleep.


Once addicted to alcohol the danger is the difficulty to withdraw from alcohol.

So prevention is always better than cure.


Alcoholism is a chronic disease manifested by a pattern of pathological alcohol usage with inability to stop drinking more than temporary resulting in physical, psychological and social consequences.

People who are at risk of getting Alcoholism are:


1.People with a Family history of alcoholism

2.Men have a higher rate of alcoholism than women


3.Cultural factors especially alcohol drinking friends

4.Social pressure and Stress

5.Depression may be a cause of Alcoholism

6.broken homes




Common symptoms of Alcoholism are:

1.Need for daily use of alcohol

2.Binge drinking

3.Inability to stop drinking more than a temporary phase

4.Impairment of social and occupational function

5.Blackouts and amnesia

6.Violent behavior when intoxicated with arguments with friends and family

7.Absence from work or loss of job

8.Legal problems such as arrests for drink driving or traffic accidents

9.Evidence of tolerance for more alcohol to achieve sense of comfort

10.Development of alcohol withdrawal (tremors on awakening, insomnia, hallucinations)

Diagnosis of Alcoholism  is made through:


1. level of blood alcohol above the permitted limit.

2.Liver function tests are abnormal:
a.Aminotransferases  -

AST and ALT are moderately elevated, with AST > ALT.
b.Alkaline phosphatase  - usually slightly elevated.


c.GGT  - correlates with AP levels- much higher in chronic liver disease from alcohol.

3. ECG and EEG to detect heart and brain disturbances


Complications of Alcoholism are:


Complications may develop with progression of the alcoholism.

1.Delirium tremors

2.Acute alcohol delusional states

3.Untidy appearance
a.neglect of personal appearance,
b.unresponsiveness,
c.forgetfulness,
d.trouble concentrating,
e.changes in sleep habits.

5.Alcoholic hepatitis and cirrhosis

6.Wernicke's encephalopathy

7.Alcoholic cerebellar degeneration

8.gastric ulcers,  gastrointestinal bleeding

9.Pancreatitis

10.nutritional deficiency

11.high blood pressure and heart disease

12.low bone mineral deficiency and osteoporosis


Treatment of Alcoholism is:


In all cases of Alcoholism,  assessment of the patient's alcoholism and complications are needed.
1. Detoxification in special centers

2. treatment of complications

3.Alcohol withdrawal with the help of transquilizers and vitamin supplements

4.Antabuse or Revia therapy to cure alcohol dependence

5.Psychological therapy and Alcoholic Anonymous

6.Healthy lifestyle with adequate exercise and proper diet

Other unconventional methods of treatment includes:

1.Herbal therapy

2.Acupuncture

3.Mind/body medicine


Prognosis for Alcoholism is:

Prognosis is dependent on initial severity and the patient's motivation to return to sobriety

Alcoholism is a serious chronic disease which can be controlled but seldom cured.

Prevention for Alcoholism is:


1. No drinking of any form of alcohol

2. Family support and psychotherapy and self help groups

3.Early intervention for teenagers who are drinking