Alcohol-induced gastric and duodenal lesions in man

To determine the effect of an acute dose of ethanol on the stomach and duodenum, seven alcoholic subjects with previously normal upper gastrointestinal endoscopy were reevaluated with endoscopy and directed biopsy three hours after the oral ingestion of ethanol (1 gm./kg. body weight) as a 35 gm./100 ml. solution. After ingestion of alcohol, all seven subjects had moderate to severe antral erythema and friability and two had patchy erosions and hemorrhage in the antrum and fundus of the stomach. Five of seven subjects had changes in the duodenal bulb consisting of erythema similar to that in the antrum of the stomach. Microscopically after alcohol, four of seven demonstrated focal subepithelial hemorrhage and another had frank mucosal hemorrhage in the antrum. In the duodenal bulb, four of seven subjects demonstrated focal subepithelial hemorrhage in the tips of bulbar villi and four of seven had striking infiltration of eosinophils in the subepithelial stroma. These histologic alterations were not present in prealcohol biopsies or in biopsies in two additional subjects given club soda alone or beef bouillon, or in repeat biopsies in two subjects re-endoscoped three days after the ingestion of alcohol when the endoscopic findings were again normal. It is concluded that a single dose of alcohol consistently causes macroscopic and microscopic antral and duodenal alterations.