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Physiological Impacts of Alcohol By C Kohn, Waterford Agricultural Sciences.

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1 Physiological Impacts of Alcohol By C Kohn, Waterford Agricultural Sciences

2 Alcohol  Alcohol for consumption has the same molecular structure as fuel ethanol: CH 3 CH 2 OH  Alcohol is poisonous to the human body  Many of the effects associated with consuming alcohol are actually a result of either the toxic impact on the body or the body’s method of coping with the toxin  When alcohol is consumed, the body immediately tries to eliminate it.  Alcohol is also a drug and can form both dependency and addiction

3 Pathway of Alcohol  The route taken by alcohol during consumption is as follows: 1. Mouth & Esophagus – alcohol is diluted by saliva before being swallowed. Some is immediately absorbed 2. Stomach – more alcohol is absorbed here, irritating the lining of the stomach and increasing the acidity 3. Small Intestine – any remaining alcohol is passed here and is the site of most alcohol absorption 4. Bloodstream – alcohol quickly diffuses through the body, affecting almost all cells 5. Brain - these cells are more susceptible because they are usually protected from toxins by the blood-brain barrier 6. Liver – blood-alcohol is metabolized in two stages and then respired into CO2, H2O, and fatty acids. 7. Excretion via urine, the lungs, and sweat.

4 Steps of Metabolism  The metabolism of alcohol is the process in which the body converts alcohol into a less toxic substance.  Alcohol metabolism (processing) has three steps 1. Consumption – getting the liquid into your body 2. Absorption – absorbing the alcohol into your bloodstream 3. Processing – converting the I) alcohol into II) acetaldehyde, then III) acetate (or acetic acid) and finally into fatty acids, carbon dioxide, and water

5 Consumption  Consumption – mouth and esophagus  20% of consumed alcohol is immediately absorbed into the bloodstream before reaching the rest of the gastrointestinal tract  Alcohol is an irritant to the sensitive lining of the esophagus  Excess consumption can significantly raise your risk of esophageal cancer

6 Absorption  Alcohol is absorbed into the blood through the stomach walls  The emptier the stomach, the faster the absorption, the greater the impact, and the more pronounced the side-effects  Absorption of alcohol also irritates the lining of the stomach, leading to some symptoms commonly associated with a hangover (nausea, vomiting, diarrhea)  This also accelerates productions of hydrochloric acid in the stomach, leading to the ‘upset stomach’ feeling common with consumption and/or hangover  If HCl secretion increases too rapidly or too high (or both), nausea and vomiting pathways are triggered.  If vomiting does not occur, diarrhea is more likely for the same reason  Alcohol not absorbed by the stomach is absorbed in the small intestine (where most absorption occurs)

7 Absorption  Once in the bloodstream, alcohol is rapidly distributed throughout the body  Different tissues absorb alcohol at differing rates  E.g. muscle absorbs alcohol more rapidly than fat  People with higher percentages of body fat will absorb alcohol less quickly, lengthening the time it circulates in the bloodstream  Women physiologically have a higher body fat percentage than men, typically increasing the impact of alcohol on their bodies  Body size also is a factor – the smaller the body, the more concentrated the effects will be (because alcohol will be a bigger proportion of the bodily fluid in a smaller person)  Rate of absorption is also affected by rate and type of consumption  Faster consumption, faster absorption  Carbonated beverages also increase the rate of absorption – includes champagne, wine coolers, and drinks made with soda

8 Processing  Alcohol is processed by the liver as it arrives from the bloodstream  The liver produces enzymes called alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH).  Alcohol metabolism via ADH produces a secondary product more toxic than alcohol itself – acetaldehyde  Acetaldehyde is then converted into acetate by ALDH  Acetate is digested into fatty acids, CO2, and water  Fatty acids, when digested, create 7 calories per gram of alcohol  ‘Beer gut’ has some truth to it

9 Overview of Processing 1. Alcohol arrives at the liver via the bloodstream 2. ADH turns alcohol into acetaldehyde  This is the “bad” version 3. ALDH converts acetaldehyde into acetate  This is the “good” version that can be broken down 4. Acetate is converted into CO2, H2O, and fatty acids by liver cell mitochondria. If fatty acids accumulate too fast, cirrhosis can occur

10 Effects of Alcohol  Impaired Judgment  Amnesia  Anxiety  “Breaking the Seal” – Increased Urination  Flushing (Red-Faced)  Disrupted Balance  Hangovers, Nausea, & Dehydration

11 Impaired Judgment  Alcohol depresses the central nervous system  This means that alcohol slows the rate at which the nervous system can function and communicate  This will prevent all neurological processes from occurring at the normal rate or extent ranging from judgment to control of bodily function.  Structures of the brain affected include the frontal lobe where rational decision making and judgment occurs.  Consumption of alcohol will also cause increased self-confidence as well as decreased judgment – a very bad combination.  Those that are too drunk to drive are less likely to be able to make this determination as they drink more  Those that are too drunk too drive will also feel more confident in their own ability to safely do so (despite the contrary being true)

12 Amnesia  Because the central nervous system is impaired, the process of creating and storing memory is also impaired.  This can lead to short-term amnesia – excess alcohol consumption can cause people to be unable to form memories during consumption to varying extents.

13 Anxiety  Part of the brain, called the amygdala, regulates human emotion  The amygdala is responsible for creating emotion appropriate for a circumstance  Because alcohol depresses the central nervous system, the emotional regulatory function of the amygdala will also be impaired.  This can lead to anxiety, anger, frustration, lust, and other primal human emotions to become over- or under-expressed.

14 “Breaking the Seal”  “Breaking the seal” and Water Loss  A common myth associated with alcohol consumption is that if you urinate once, you will have to urinate constantly – this is called “breaking the seal”  In reality, you’ve ‘broken the seal’ as soon as you have your first sip  Alcohol affects urination in 3 major ways –  Alcohol is a diuretic, causing cells to shed water  Alcohol interferes with water reabsorption in the kidneys, causing excess water to be moved to the bladder  Alcohol causes stretch receptors ‘miscalculate’ the amount of urine in the bladder, making it feel fuller than it is.  A combination of excess water lost, reduced water reabsorption, and a miscalculating bladder creates the need to urinate more frequently with greater consumption.

15 Thinned Blood  Alcohol is a blood thinner  Alcohol has a lower density than water  This is why alcohol floats on top of water  Consumption and absorption of alcohol will reduce the thickness of your blood.  Moderate consumption of alcohol (< 2 drinks per day) by legal adults can actually improve heart health by lessening the work required to pump blood  Thinner blood is easier to pump  Do not self-diagnose!

16 Flushing  A common symptom of inebriation is flushing, or being “red faced”  Flushing in the face is due to an excess of acetaldehyde in the body, a decrease in the ALDH enzyme, or both.  Because acetaldehyde is more toxic to the body than the alcohol itself, it can cause an inflammation response similar to injury or infection in skin blood vessels.

17 Lost Balance  Balance is regulated by the semicircular canals inside your ear.  The semicircular canals are looped structures that are filled with fluid called endolymph  The movement of fluid inside these loops tells your body your position and orientation in space  Alcohol thickens this fluid, reducing the ability to sense movement.  The sensory system responsible for sensing movement is now less sensitive, causing stumbling and loss of coordination and balance.  The cerebellum (muscle coordination center of the brain) also is impaired

18 Hangovers  A hangover is the ill-effects experienced by excess alcohol consumption after the ‘high’ of alcohol has worn off.  Symptoms of a hangover include:  Fatigue  Dehydration  Nausea & Stomach Irritation  Headache

19 Fatigue  The exhaustion associated with excess consumption is due to alcohol’s inhibition of glutamine  Glutamine is a bodily stimulant whose production is inhibited by alcohol  When the effects of alcohol wear off, glutamine production is increased to compensate for previous inhibition  This causes a drinker to wake more in their sleep as glutamine production increases, preventing the deepest and most restful stages of sleep  Glutamine rebound can also lead to tremors, anxiety, and restlessness  Glutamine, like caffeine, is a stimulant  Excess glutamine production is going to have effects similar to excess caffeine consumption

20 Dehydration  Alcohol is a diuretic and causes cells to shed water.  Alcohol also interferes with the kidney’s ability to regulate water balance in the body  Job of an aquaporin protein is to regulate reabsorption of water filtered out of the blood by the kidney.  Vasopressin is a hormone that regulates whether or not an aquaporin channel is open  Alcohol inhibits the function of vasopressin, limiting its ability to open aquaporin channels that would let filtered water back into the bloodstream  This causes water to be moved to the bladder at an increased rate  This coupled with the diuretic effects of alcohol leads to a dehydrating effect when consumed Opened by Vasopressin

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22 Nausea & Stomach Ache  Stomach Irritation is largely due to excess production of HCl in the stomach as a result of absorption into the bloodstream through the stomach lining.  Excess hydrochloric acid increases the acidity of the stomach, creating the ‘sour stomach’ feeling in a very literal way  If the pH of the stomach drops too much or too fast (or both), it will cause vomiting, diarrhea, or both.  This can also be caused by a ‘fight or flight’ response of the body due to the poisonous nature of alcohol

23 Headache  A headache can be due to numerous effects of alcohol, including –  Inflammation of blood vessels, creating pressure in the skull  Dehydration  Acetaldehyde’s presence in the blood  Increased stimulation and anxiety caused by glutamine resurgence  Stress from nausea  A combination of all these and more

24 Cures to a Hangover  There is only one truly effective cure to a hangover – TIME  Pain relievers that do not contain acetaminophen can lessen perceived pain but not actual damage (aspirin can cause increased liver damage)  Caffeine is a diuretic and will compound damage caused by water lost and dehydration  “Hair of the Dog” or drinking again in the morning to lessen a hangover, only worsens the problem while lessening the perception of it (for the time being)

25 Cures to Inebriation  Similarly, you cannot “sober up” with anything other than time.  Caffeine will not reverse the depresion of the central nervous system, thicken your blood, restore your balance, or negate any other effects of inebriation  What’s worse, mixing an ‘upper’ with a ‘downer’ (caffeine with alcohol) can cause the brain to send conflicting signals to organs such as your heart and lungs.  Stimulant/alcohol combinations can lead to heart or lung failure.  Consuming food to sober up will not reduce the amount of alcohol already in your bloodstream  Additionally, you cannot ‘fool’ a blood alcohol meter.

26 Long Term Effects of Excess Consumption  Tissue damage – alcohol is an irritant to the mouth, throat, and stomach and can raise the risk of cancers to these structures  Liver Damage – the liver can be overwhelmed by fatty acid, causing it to swell and lose its ability to filter the body of other toxins  Brain damage – alcohol can permanently damage brain cells, particularly in brains that are still developing and maturing (the brain does not finish maturing until age 20-25).  Weight gain – alcohol has 7 calories per gram. This is almost as high as pure fat (9 cal) and higher than carbohydrates (4 cal/g)  Skin Damage – the conversion of alcohol into acetaldehyde causes inflammation.  Excess consumption will cause excess inflammation that can lead to the rupture of blood vessels in the skin creating blotchy scarring.  Accidents – impaired judgment, lost coordination, and an increased sense of confidence is a deadly and all-too-often fatal combination.


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