April is National Alcohol Awareness Month.  Alcohol is the cause of many digestive issues for women yet many women are unaware of the dangers of drinking. At the same level of alcohol consumption, women become intoxicated faster, develop addiction earlier, and suffer health damage more rapidly. There are biological factors that cause women to be more vulnerable to the effects of alcohol than men.

These biological factors explain why women become intoxicated after drinking less and are more likely to suffer negative health consequences after drinking smaller quantities for less time than men.

Body fat. Women generally weigh less than men, and women’s bodies contain proportionately less water and more fatty tissue than a man’s. Because water dilutes alcohol and fat retains it, alcohol remains at higher concentrations for longer periods of time in a woman’s body, exposing her brain and other organs to more alcohol.

Enzymes. Women have lower levels of two enzymes—alcohol dehydrogenase and aldehyde dehydrogenase—that break down alcohol in the stomach and liver. As a result, women absorb more alcohol into their bloodstreams than men. The less alcohol dehydrogenase you produce, the more alcohol leaves your stomach in its original form, affecting the intestine, bloodstream and liver.

Hormones. Changes in hormone levels during the menstrual cycle is also thought to affect how a woman’ body processes alcohol.

Alcohol Related Liver Diseases:

The liver is the organ that is most affected by alcohol consumption.  The liver is responsible for metabolizing alcohol and therefore is the organ at the highest risk of damage from alcohol use. Liver scarring, called cirrhosis, from use of alcohol causes irreversible structural damage and there are few treatment options for the disease once it reaches an advanced stage.  The primary job of the liver is to filter and clean the blood. When this tissue is scarred by cirrhosis, it keeps blood from flowing normally causing a build-up of poisons and wastes in the body. Women have a two to three time greater risk of developing cirrhosis than men.  Women diagnosed with alcohol-related cirrhosis are at a higher risk of developing liver cancer.  Fatty liver disease is also a condition often caused by excessive alcohol consumption.  Fatty liver disease can sometimes be reversed and is always improved through alcohol abstinence. Alcoholic hepatitis is inflammation of the liver caused by alcohol consumption. Although only a low percentage of drinkers develop alcoholic hepatitis, the disease can occur in women who drink only moderately or binge infrequently.

Alcohol contributes to several other forms of liver disease. Women with alcohol-related cirrhosis are at a higher risk of developing liver cancer.  Regular alcohol consumption increases risk for cancers of the breast, mouth, larynx, colon, esophagus, stomach and liver.  Women with Hepatitis B or C who are drinkers are at a much higher risk of cirrhosis.  It can be compared to squirting lighter fluid onto smoldering coals - it really accelerates the damage.

This information does not mean that women should never have a drink, but it does suggest that women be aware of their alcohol consumption and the associated risks.  The U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015 recommends that women consume no more than one drink per day, and the serving size is surprisingly small - 12 oz beer, 5oz wine, or 1.5 oz hard liquor. This definition is referring to the amount consumed on any single day and is not intended as an average over several days.  So, that glass of wine with dinner is fine for those without any alcohol related diseases, but excessive drinking is a great risk for women’s health.

Drs. Miller and Scholl are very experienced with the diagnosis and treatment of women with alcohol related health issues.  They recognize the difficulty for many women to discuss these issues and are discrete and compassionate in their handling of these issues.