Cirrhosis of the liver was the twelfth leading cause of death in the United States in 2005 and developed as a consequence of alcoholism in over 45 percent of cases, the National Institute on Alcohol Abuse and Alcoholism reports. Alcoholics often develop problems with the esophagus, which is the tube that leads from the mouth to the stomach, as a consequence of cirrhosis or in addition to the disease. Alcohol damages the cells lining the esophagus and can cause life threatening complications.
Gastrointestinal Esophageal Reflux
Because even one drinking episode weakens the lower esophageal sphincter, according to Montana State University, gastrointestinal reflux disease, often called GERD, often affects alcoholics. Incompetence of the sphincter allows stomach acid to back up into the esophagus, burning and irritating the tissues. Untreated reflux eventually causes the cells of the esophagus to look more like stomach or intestinal cells than esophageal cells, a condition called Barrett’s esophagus, the University of Pennsylvania explains. These cells can secrete acid directly into the esophagus. Barrett’s esophagus increases the risk of developing cancer of the esophagus, even if medical or surgical treatments are done. Frequent medical checkups and testing to detect abnormal cells early may help prevent cancer.
In alcoholics, esophageal varices develop when scarring in the liver, called cirrhosis, slows the flow of blood into the liver. Blood backs up into the portal vein that leads into the liver and into the smaller veins leading into it. The enlarged blood vessels rupture, causing bleeding, in around one-third of people with varices, MayoClinic.com reports. Vomiting of blood, black, tarry stools, lightheadness, fainting, low blood pressure, a decrease in urine output and shock an occur. Surgical banding of the varices closes off the dilated blood vessels.
Esophageal strictures occur when damage to the cells lining the esophagus causes scarring and narrowing of the opening over time. Strictures may become cancerous, especially in smokers and alcoholics, the University of Pennsylvania warns. Esophageal strictures make it difficult to swallow. Dilating the stricture relieves symptoms.
There are two types of esophageal cancer, both of which are associated with alcohol abuse. Squamous cell cancer is related to smoking and alcohol, while adenocarcinoma is much more common in people with Barrett’s esophagus, which complicates GERD, according to MedlinePlus. Heartburn, chest pain, vomiting and difficulty swallowing are warning signs of esophageal cancer, which is surgically removed if the cancer hasn’t spread beyond the esophagus.