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Alcoholic disease: liver and beyond.

Alba Rocco1, Debora Compare1, Debora Angrisani1

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Alcohol abuse significantly harms the digestive system, causing liver disease, pancreatitis, and gastrointestinal damage. Understanding these mechanisms is crucial for treating alcohol-related health issues.

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Area of Science:

  • Gastroenterology and Hepatology
  • Toxicology
  • Pathophysiology

Background:

  • Harmful alcohol use is a major global health concern, ranking as the third leading risk factor for disease and disability worldwide.
  • Ethanol and its metabolites are recognized hepatotoxins, directly and indirectly damaging the liver, the primary organ for alcohol metabolism.
  • Alcohol-related damage extends to the pancreas and the entire gastrointestinal tract, including the esophagus, stomach, and intestines.

Purpose of the Study:

  • To review the clinically relevant alcohol-related diseases affecting the digestive tract.
  • To elucidate the pathogenic mechanisms by which ethanol and its metabolites induce damage in the liver, pancreas, and gastrointestinal system.

Main Methods:

  • This review synthesizes existing clinical and experimental data on alcohol's effects on the digestive system.
  • Pathogenic mechanisms of ethanol-induced damage in the liver, pancreas, esophagus, stomach, and intestines are examined.

Main Results:

  • Ethanol causes direct mucosal damage in the esophagus and stomach, alters motility, and affects gastric acid output.
  • Alcohol-induced pancreatic damage involves acinar cell injury and stellate cell activation, leading to fibrosis and atrophy.
  • Disruption of the intestinal mucosal barrier by ethanol contributes significantly to liver damage.

Conclusions:

  • Alcoholic liver disease, pancreatitis, and gastrointestinal pathologies share common pathogenic pathways involving direct cellular injury and inflammatory responses.
  • Damage to the intestinal barrier is a critical factor linking alcohol consumption to systemic liver disease.
  • A comprehensive understanding of these mechanisms is essential for developing effective therapeutic strategies for alcohol-related digestive disorders.