Alcohol & the digestive system

Since having a major bowel operation last year (2023) I’ve become even more interested in the gut and what goes on from when something goes in my mouth to the far end (you know what I mean!!!) and how it can affect our health.

I got most of this information from the GutsUk website. It’s easy to digest (pardon the pun) and an interesting read, so it’s pretty much verbatim, ‘why change what’s already there’ was my thought. I just wanted to share it with you,.

HOW IS ALCOHOL CONTENT MEASURED?

Alcohol content is often expressed as ‘units’ in the UK, which refers to 10ml or 8g of pure alcohol. However different types of alcoholic beverages have a range of units in one serving, even within the same types of drinks. It can also be labelled as ‘alcohol by volume’ (ABV), which is the percentage of the drink that is pure alcohol. It can be tricky to estimate the units in a drink, especially if you are ordering it whilst you’re out, where drinks are often served in an unlabelled glass. Also, different places may mix cocktails in different ways, and thus with different alcohol contents.

• Average alcohol content of beer: 4.5 – 5.3%

• Average alcohol content of red or white wine including sparkling wine: 12 – 14%

• Average alcohol content of spirits (e.g. gin, whisky or vodka): 35 – 40%

• Average alcohol content of alcopops: 4%

The recommended alcohol intake is no more than 14 units per week, ideally spread out over 3 or more days. The advice is in respect to reducing the risk of alcohol harm to a low level. This means that the harm from alcohol is less likely. But evidence suggests that there is no level of drinking without risk. This level of consumption can be assumed to be a harm level of 1 person in 100 dying from an alcohol related problem for 14 units. It also must be considered that these guidelines are population level and each person’s individual risk might be different. But for most people, the chances are that if you are drinking within these guidelines, alcohol will not alter the length of your life.

When considering the risks associated with alcohol consumption, we can be talking about short-term (immediate) or long-term (later) effects. So, what does 14 units look like? It is approximately 6 pints of beer, or seven glasses of wine. 

CALORIES

Another thing we often forget is that alcohol contains calories and can impact our daily energy intake and weight. Alcohol calories are often referred to as ‘empty calories’ because they do not contribute anything to you nutritionally. Alcohol contains 7 calories per gram, but it’s perhaps easier to think about it in terms of drinks and foods you know. A glass of wine (250ml) contains approximately 190 calories, which is the equivalent of a plain glazed doughnut. A pint of beer contains approximately 240 calories, which almost as much as a slice of pizza. Even spirits, which contain far less sugar and calories than other types of alcohol still have calories. 24ml (or one ounce) of alcohol contains approximately 80 calories depending on the type.

WHAT HAPPENS TO YOUR BODY WHEN YOU DRINK ALCOHOL?

When you drink alcohol, you swallow it and it ends up in your stomach. From there, it moves to your small bowel (intestine). From your small intestine, it is absorbed into your bloodstream. The alcohol is then processed by your liver, which can process approximately 24ml (one ounce) of alcohol per hour. Any additional alcohol will circulate in your blood stream until your liver can process alcohol again. This is why you can still feel the effects of alcohol even after you have stopped drinking it.

SHORT TERM EFFECTS

The short-term effects of excessive alcohol consumption refer to the effects of alcohol that happen immediately, such as:
• Falling or stumbling
• Nausea and vomiting
• Slurred speech
• Slower reflexes and reactions

Harmful levels of alcohol are also associated with a significantly higher excess risk of
unintentional or intentional injury (head injuries, fractures, facial injuries due to falls, road traffic accidents, poisoning, drowning) to yourself and others. It is also associated with incidents of domestic abuse and exacerbation of underlying mental health problems including suicide, as well as alcohol poisoning. In addition, it is associated with loss of control in respect to judging risky situations, like engaging in unprotected sex. Alcohol is the biggest risk factor for death, ill health and disability among 15-49-year-olds in the UK.

LONG TERM EFFECTS

 Excessive intake of alcohol is the third largest risk factor for preventable disability and disease. Alcohol dependency can cause problems for nearly every major organ in the body. The definition of harmful drinking is more than 35 units a week in women and greater than 50 units in men.

Women who drink between 14 and 35 units, and men who drink between 14 units and 50 units are drinking hazardous levels of alcohol. Some of the affects that can occur with this level of alcohol consumption will depend on the individual. People do react individually to alcohol. There is no level of drinking without risk of harm, and the risk increases the more alcohol you drink on a regular basis.

THROAT

In the larynx, a part of the throat, long term alcohol use carries a cancer risk, particularly in people who also smoke cigarettes. Statistics suggest that just under a quarter of cases of laryngeal cancer are caused by alcohol. The number of people diagnosed with laryngeal cancer, a type of head and neck cancer, has increased by a fifth over 10 years. This cancer is diagnosed in more males than females – but rates in females are increasing at a higher rate. Alcohol can be a factor in other types of head and neck cancers, including mouth cancer.

OESPHAGUS

Alcohol can cause episodes of heartburn and reflux, this is because it relaxes the ring of muscle at the bottom of the gullet, causing acid to reflux into the gullet. Alcohol itself can irritate the lining of the gullet causing swelling and inflammation (oesophagitis). In those people with the most severe symptoms, ulcers can develop, causing pain on swallowing, vomiting and sometimes bleeding.

STOMACH

Alcohol can affect the stomach lining, causing inflammation (gastritis), and reducing the ability for the damage to repair. It also affects how the stomach empties and alters the amount of acid that is produced. Alcohol can increase the risk of developing stomach cancer.

BOWELS

In the first part of the small bowel, alcohol can cause inflammation (duodenitis) and ulcers. Because all alcohol goes into the blood stream, it can also reach the bowel and increase the risk of developing bowel cancer. This is because the bacteria in the bowel change the alcohol into other substances that increase the risk of developing bowel cancer.

LIVER

The liver has around 500 functions in the body and is the site where alcohol is processed to reduce its toxicity. It is therefore not too surprising that if excessive alcohol is consumed, damage can result. Alcohol is the second most common cause of liver disease and the leading cause of death from liver disease in the UK. Alcohol dependency can result in inflammation of the liver (alcoholic hepatitis) and over time, this can result in scarring of the liver in some people (called cirrhosis). When cirrhosis develops, the liver may be prevented from working correctly. While liver inflammation and early scarring is reversible if a person stops drinking, cirrhosis in general is not. Early liver scarring and liver cirrhosis does not cause any symptoms initially so a person may not know they have it. However, a person
may eventually develop ‘liver decompensation’, particularly if they continue to drink. This can result in debilitating symptoms including abdominal swelling due to a build-up of fluid (ascites), bleeding from the digestive tract and confusion (encephalopathy). Often these symptoms need to be managed in hospital. Excessive alcohol intake can also be a factor increasing the risk of liver cancer.

PANCREAS

Drinking too much is the second most common cause of acute and chronic pancreatitis, though there are other causes you have no control over, such as genetics or gallstones. Around 1 in 4 cases of acute pancreatitis in the UK are caused by alcohol, though it is not yet fully understood how alcohol causes acute pancreatitis. However, we do know that the more alcohol you drink, the greater your risk of developing acute pancreatitis. The risk of pancreatic cancer can also increase with excessive alcohol intake.

I’m not sharing this to scare people (it scares the shit out of me tbh!!) just to be informed and if you’re considering reducing alcohol intake, this certainly gives you more reasons for that.  Drinking responsibly and in a moderate fashion is the best way forward.