ALCOHOLISM

Alcohol is the most commonly abused substance around the world. Alcoholism involves pattern of alcohol use that involves problems controlling drinking, being preoccupied with alcohol, continuing to use alcohol even it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when rapidly stopping drinking. Alcohol abuse plays role in many social and domestic problems.

Symptoms

Cannot quit or control drinking
Need to drink more for same effect
Withdrawal symptoms when one stop drinking
Spending lot of time drinking
Drinking in the morning
Feeling guilty for driking
Physical symptoms of drinking eg. Gastritis , gynecomastia etc

Symptoms of alcohol withdrawal:

Nausea
Vomiting
Excessive sweating
Agitation
Headache
Tremor
Seizure

Diagnosis

Screening: CAGE questionnaire

Felt need to Cut down?
People Annoyed you by criticizing your drinking?
Felt bad or Guilty about your drinking?
Need as an Eye opener
Investigation:
GGT (γ-glutyl-transferase)
MCV (mean corpuscular volume)
Alkaline phosphatase
AST, ALT, uric acid, blood triglyceride

Blood Alcohol Concentration

Complications

Social and Psychological problems

End stage liver damage
Peripheral neuropathy

Wernicke encephalopathy: ataxia, eye paralysis,confusion
Korsakoff syndrome: amnesia
Hepatic encephalopathy
Chronic gastritis, peptic ulcer
Malabsorption syndrome, Malnutrition
Pancreatitis
Damage to fetus in pregnant woman
Impotence in man

Treatment

Detoxification:

This is the treatment of alcohol withdrawal symptoms. The best way to stop alcohol is to stop suddenly unless there is high risk. Drugs are given to assist withdrawal symptoms. Benzodiazepam (diazepam, chlordiazepoxide), vitamins are used. Hospitalization may be necessary.