Disorders of Hepatobiliary and Exocrine Pancreas Function
Alcohol abusers suffer from a variety of adverse physical and psychological outcomes. While mental health can be improved with the help of specialists, family support, and different group therapy methods, it is much more complicated to deal with the destructive effect of alcohol on one’s body. The case study under consideration presents the situation of a 68-year-old man who has been dealing with alcoholism for over 30 years. The paper will discuss several crucial questions associated with the impact of alcoholism on the human organism.
Alcoholic liver disease is a rather severe health complication pertaining to alcoholics since the liver is the organ performing multiple crucial functions in the human body. The liver takes part in protein, carbohydrate, and lipid metabolism (Behera & Dash, 2020). Additionally, this organ plays an important role in the maintenance of a person’s immune system and in the synthesis of plasma proteins. Furthermore, the liver supports blood homeostasis due to functioning as “a storage depot” for Vitamin B12, folic acid, and iron (Behera & Dash, 2020, p. 149). Finally, the liver secretes inhibitors and clotting factors in people’s organisms. Therefore, when one has liver disease, a variety of hematological abnormalities can be observed. Research indicates that over 50 million individuals have chronic liver disease, which indicates a high prevalence of cirrhosis (Behera & Dash, 2020). Alcohol abuse is one of the most prevalent causes of liver disease. Meanwhile, the incidence of cirrhosis is largely underestimated in about one-third of patients do not demonstrate any symptoms.
Two of the most dangerous hematologic disorders related to alcoholic liver disease are anemia and clotting. Anemia of diverse etiology is reported to occur in three-thirds of patients with liver disease. Scholars note that the major factors responsible for the development of anemia in liver disease patients are anemia due to chronic disease, hypersplenism, iron deficiency, folic acid deficiency, aplastic anemia, autoimmune hemolytic anemia, and as an effect of the antiviral drug (Behera & Dash, 2020). Alcohol is the most typically used drug, the aftermath of which includes the destruction of hematopoiesis, the process of manufacturing blood cells in the body. Hence, patients suffering from alcoholism can experience nutritional deficiencies of vitamins (such as folic acid) because of malnutrition, malabsorption, or explicit toxic effect participating in hematopoiesis. Consequently, alcohol abusers cam suffer from moderate or severe anemia, which is characterized by “enlarged, structurally abnormal red blood cells, mildly reduced numbers leukocytes and neutrophils, and moderately to severely reduced numbers of platelets” (Behera & Dash, 2020). Therefore, anemia in chronic alcoholics is associated with the irreversible effect on hematopoiesis and impaired platelet production.
Clotting disorder is another problem commonly related to alcoholic liver disease. The mechanism of this condition is similar to that of anemia. Namely, platelet defects and coagulation issues, which are driven by alcohol abuse, are responsible for developing a clotting disorder in one’s organism (Behera & Dash, 2020; Gkamprela et al., 2017). Liver plays the most significant role in the clotting process, and on the bodies of people whose liver has been damaged by excessive alcohol consumption, this process is considerably obstructed.
Apart from dangerous hematologic disorders caused by alcohol abuse, there may also develop severe gastrointestinal bleedings. The one having the highest mortality rates in those with advanced cirrhosis is the variceal bleeding (Mallet et al., 2017). Acute variceal bleeding is one of the principal causes of high death rates among alcohol abusers. Additionally, this health problem is the main reason for upper gastrointestinal bleeding, accountable for about 70% of incidents (Mallet et al., 2017). During the first episode of variceal bleeding, the mortality rate is 15-20%, but it tends to increase with the severity of alcohol addiction level. Meanwhile, mortality is rather low in individuals with compensated cirrhosis (Mallet et al., 2017). The pathophysiology of variceal bleeding is manifested through portal hypertension, which derives from portal flow increases and portal vascular resistance. Such resistance appears when the vasculature is distorted by cirrhotic nodules.
The main resistance site is at the sinusoid level, and it is composed of two elements: a fixed one (associated with the vessels’ distortion by cirrhotic nodules) and a variable one (linked to vasoactive substances). The main predictors of variceal bleeding are red wale marks and large versus small varices (Mallet et al., 2017). In the past few years, researchers have gained significant progress in the management of variceal bleeding. Still, this condition is highly dangerous and affects a large number of people.
Acute pancreatitis is another common disease occurring in alcoholic abusers. This condition is the principal cause of hospitalization among gastrointestinal disorders in the USA (Gapp & Chandra, 2020). Some of the indications of acute pancreatitis are tachycardia and hypotension. The cardiovascular system is particularly affected in individuals suffering from acute pancreatitis. The reason why many patients present with hypotension and tachycardia is that the acute inflammatory process of pancreas is linked to the involvement of pancreatic and peripancreatic tissue in the cardiovascular system. Furthermore, the two mentioned conditions can manifest as additional symptoms of acute pancreatitis since they are associated with low to moderate fever and respiratory failure.
When analyzing individuals’ predisposition to alcoholic liver disease, one cannot but mention the gender differences. Females are more predisposed to alcoholic liver disease due to composition and body size. Specifically, women have less body water and are typically smaller than men in size. However, not only physical composition divergences affect females’ susceptibility to alcoholic liver disease but also varieties in immune reactivity do (Sookoian & Pirola, 2017). Research indicates that alcohol abuse is accountable for one in seven deaths in males and one in thirteen – in females (Stickel et al., 2017). However, concerning liver disease, women are more vulnerable due to varieties in expression patterns of alcohol-metabolizing enzymes, higher tissue levels of alcohol exposure, and a smaller distribution volume of alcohol in the body (Stickel et al., 2017). These factors signify a higher predisposition to alcoholic liver disease in women as compared to men.
Consuming alcohol in large quantities can have both direct and indirect effects on the human body and psyche. Direct ones can be observed comparatively early, which makes it possible to seek solutions for them. Meanwhile, indirect complications of the main problem – alcoholic liver disease – can remain unnoticed or neglected for many years, which significantly reduces the quality and duration of people’s lives. Hematologic disorders, such as anemia and clotting ones, gastrointestinal bleeds, such as variceal one, and acute pancreatitis are only some of the features manifesting alcoholic liver disease. The predisposition to alcoholic liver disease differs in patients depending on their age and gender. In order to avoid chronic conditions related to alcohol abuse, it is necessary to evaluate patients for adverse effects and suggest viable solutions to health problems associated with alcoholic liver disease as soon as they are suspected.
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Gkamprela, E., Deutsch, M., & Pectasides, D. (2017). Iron deficiency anemia in chronic liver disease: Etiopathogenesis, diagnosis and treatment. Annals of Gastroenterology, 30, 405-413. Web.
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