Recent aspects of alcoholism in Sri Lanka--an increasing health hazard

Eighty-five patients (81 males and 4 females) with significant alcoholic histories were studied. Alcohol misuse was directly or indirectly responsible for about 5-10% of hospital admissions in Sri Lanka. Prevalence of alcoholism in patients below 40 years (43% of cases) or with a strong family history (56% of cases) were demographic features simulating trends in developed nations. Although rarely an occupational hazard, the majority in this lower socio-economic group drank illicitly-manufactured brews with high alcohol content while many consumed a mixture of beverages. Lone drinkers were predominant (86%); features of psychological interest were sleep disturbance (64%), emotional problems (42%) and loneliness (34%); domestic problems (36%), social problems (24%) and financial problems (34%) were also noted. Many such factors, either singly or in combination, initiated or perpetuated the drinking habits of the patients. Drug misuse and suicidal tendencies were not observed. Severe hepatic damage was noted in 63% of 42 patients where the histology was demonstrated, and who usually presented with significant hepatomegaly; about 50% of patients below the age of 40 had hepatic damage of a serious or irreversible nature. Direct toxicity of ethanol, toxic contamination during the preparation of illicit brews and nutritional factors appear pertinent to hepatic damage in developing nations. Nutritional factors may cause variations in relation to abnormalities in liver function tests and also liver size among the population studied when compared to findings from the western world.(ABSTRACT TRUNCATED AT 250 WORDS)