By Alex Paton; Robin Touquet
Even though medical professionals are in most cases inquisitive about the actual or mental difficulties of person drinkers, the broader social effects of alcohol misuse are only as vital. absolutely revised and up-to-date, this fourth version of the ABC of alcohol includes new sections at the influence of alcohol on coincidence and Emergency departments and surgical perform in addition to the capability hazards of the interplay of alcohol and felony and unlawful medications.
This functional, good illustrated consultant is a perfect reference for normal practitioners and all overall healthiness and social execs who take care of those who have alcohol difficulties
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Additional resources for ABC of alcohol
Circumstances in which index of suspicion for heavy drinking should be high ● ● ● ● ● ● ● ● ● ● ● ● Repeated attendances or admissions for relatively minor complaints that cannot be labelled readily Gastrointestinal symptoms with no established cause Chest pain mimicking angina or palpitations due to arrhythmias “Essential” hypertension in men, which may not be adequately controlled by drugs Mild glycosuria in young or middle aged people Gout, whatever the immediate precipitating cause Attacks of confusion, especially in strange surroundings or after stress such as illness, operation, or bereavement Fits for the first time in middle age “Turns,” falls, or incontinence in elderly people Unexplained anaemia or hepatomegaly Serious chest infections with poor response to treatment Endocrine features that mimic Cushing’s syndrome, thyrotoxicosis, phaeochromocytoma, or carcinoid syndrome Obesity, infertility, and poorly understood hormonal and metabolic changes may not always be recognised as the result of overindulgence Dyspepsia Jaundice Cirrhosis Years of drinking 0 5 Trauma 10 Withdrawal symptoms 15 Fits 20 Dementia Pattern of complications during a heavy drinker’s life 27 ABC of Alcohol Conditions associated with heavy drinking Gut and liver ● Morning anorexia ● Indigestion ● Heartburn ● Vomiting ● Bleeding ● Jaundice ● Oesophagitis ● Gastritis ● Mallory Weiss syndrome ● Aero-digestive cancers ● Diverticulitis ● Pancreatitis ● Hepatitis/cirrhosis/ liver cancer Gynaecological ● Irregular periods ● Premenstrual tension ● Infertility ● Miscarriage ● “Small for date” babies ● Fetal alcohol effects ● Fetal alcohol syndrome ● Breast cancer Chest and heart ● Palpitations ● Chest pain; can mimic angina ● Bronchitis ● “Asthma” ● Arrhythmias ● Hypertension ● Lobar pneumonia ● Tuberculosis ● Fractured ribs ● Heart failure from beri beri Hormones and metabolism Weight gain or weight loss ● “Sugar” ● Impotence ● Infertility ● Obesity ● Hyperglycaemia or hypoglycaemia (binge drinking) ● Pseudo-Cushing’s syndrome ● Malnutrition—deficiencies of thiamine, vitamin C (scurvy), folic acid ● Alcoholic ketoacidosis (binge drinking) Nervous system ● Tremor ● Sweating ● Flushing ● Insomnia ● Headache ● Blackouts ● Fits ● Confusion ● Inability to concentrate ● Problems with memory ● Anxiety or depression ● Hallucinations Skin, muscles, nerves and bones ● Bruises, scars ● Flushing ● Acne rosacea ● Psoriasis Renal Loin pain ● “Blood in urine” ● Pelvi-ureteric obstruction ● Chronic nephritis ● Myoglobinuria from rhabdomyolysis ● ● ● ● ● ● ● ● Weakness of thighs Myopathy Burning legs Peripheral neuropathy Saturday night palsy (binge drinking) Rhabdomyolysis (binge drinking) Dupuytren’s contracture ● ● ● ● ● ● ● Backache Osteoporosis Rheumatism Gout Repeated injuries Fractures Immune system Defective immunity ● Infections including AIDS ● Mortality Around 33 000 deaths a year in England and Wales are attributed to alcohol misuse.
Morbidity Intoxication, for example from bingeing, can be associated with serious metabolic disturbance (alcoholic ketoacidosis), cardiac arrhythmias, nerve palsies, stroke, and respiratory failure. The best known physical complication, used as a marker for alcohol damage, is cirrhosis of the liver, although fewer than 10% of heavy drinkers are affected. Numbers have been rising steadily, especially in women, which reflects the increase in misuse over the past 20 years. Other organs that are particularly sensitive have not been studied in such detail, but that constant exposure of the gastrointestinal tract to alcohol might lead to oesophagitis, gastritis, cancers of the mouth, oesophagus, and larynx (with heavy smoking), diarrhoea, and pancreatitis—one of the most unpleasant and painful consequences of misuse—is understandable.
Survival rates at one and five years after liver transplant are broadly similar for patients with alcoholic cirrhosis and other types of cirrhosis. ● Orthopaedic surgery Osteoporosis—Alcohol is held responsible as a major aetiological factor for osteoporosis, especially in men, but the evidence is equivocal. In vitro experiments show that alcohol is toxic to osteoblasts, but the situation seems to be different in vivo. Several epidemiological studies suggest that patients who abuse alcohol chronically have low bone mineral density and a high risk of fracture.