Although two-thirds of American adults drink alcohol at least occasionally, fewer than 10 percent become “problem drinkers,” and only 25 percent of drinkers experience serious consequences from alcohol use. Heavy alcohol use negatively affects every organ system in your body, and alcohol consumption can aggravate many other medical conditions, such as diabetes or high blood pressure. Both the acute and chronic effects of alcohol can affect your gastrointestinal tract and cause stomach bleeding.
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Acute intake of large amounts of alcohol – so-called binge drinking – irritates your stomach wall and sometimes initiates bleeding. If alcohol overuse leads to vomiting, you could tear the lining of your esophagus, an injury that usually bleeds quite briskly. Long-term, heavy alcohol use sets the stage for alcoholic gastritis, a condition characterized by inflammation and erosion of your stomach lining. Alcoholic gastritis often “oozes” blood, which can lead to iron-deficiency anemia, but it can also cause sudden and dramatic blood loss, especially if the condition progresses to form open ulcers.
Cirrhosis, or liver scarring, is a well-known complication of chronic alcohol abuse. Under normal circumstances, the blood returning to your heart from your gastrointestinal tract and lower extremities first passes through your liver for filtering and detoxification. A cirrhotic liver acts like a dam, forcing this blood to find alternative routes back to your heart. These “back roads” include veins in the lining of your small intestine, stomach and esophagus. As these veins expand to accommodate the additional blood flow, they form “varices,” similar to hemorrhoids or varicose veins in your legs, which can break and bleed. Symptoms include vomiting blood, black stool, decreased blood pressure, increased heart rate and massive hemorrhage. Variceal bleeding, a common cause of death among alcoholics who have cirrhosis, carries a one-year mortality rate of almost 60 percent.
Your stomach lining and liver are endowed with an enzyme called alcohol dehydrogenase that metabolizes much of the alcohol you drink. The principal byproduct of this metabolism, acetaldehyde, is classified as a group 1 carcinogen in humans. An April 2011 review in “Journal of Digestive Diseases” noted that alcohol-derived acetaldehyde is indisputably linked to cancer of the stomach and esophagus. Although these cancers are unusual causes of bleeding in alcoholics – cancers are less common than gastritis or varices in this population – they do bleed readily once they establish a foothold in your gastrointestinal tract.
Stomach bleeding due to alcohol consumption is an ominous sign. On the one hand, it indicates the potential for serious underlying medical problems that must be aggressively investigated and treated. On the other, it serves as valid evidence for alcohol abuse, with its attendant psychological and social issues. Even if you are a recreational or social drinker, alcohol-related gastrointestinal hemorrhage sends the strong signal that you are drinking too much. If you cannot limit your drinking on your own, contact your physician.