Critical Thinking Essay

Why alcoholics with liver disease are at a higher risk of bleeding

Close to two-thirds of Americans consume alcohol and alcohol abuse related costs are around $185 billion.1 Alcohol consumption is linearly correlated with liver disease, in which is a prevalent problem in the United States and gives rise to many questions. How is an alcoholic defined? How much alcohol being consumed puts a person at risk for liver disease? What are the detrimental effects of chronic alcohol consumption on the person’s body? And finally, how does the obtained liver disease contribute to the person’s elevated risk of bleeding? These are all very important questions to be asked and answered in the following paragraphs. Ethanol is the form of alcohol that is found in typical alcoholic beverages. It has good and bad effects on the body. In this article, the only consideration is put on the negative effects. It can become very addicting to certain individuals, alcoholics. The term alcoholic is used to describe an individual that has a problem with alcohol. This problem, due to chronic over consumption, can be attributed to physical and psychological factors. Males consuming 40 - 80 grams (or more) of ethanol a day for 10 years or more and females consuming 20 – 40 grams (or more) of ethanol a day for 10 years or more, are at greater risk of developing alcohol related liver disease. For the purposes of this article, the physical factors will be only considered. Chronic overconsumption of ethanol leads to the body increasing its tolerance of it and increasing its dependence on the ethanol to function. The dependence and increased tolerance will lead to more consumption to obtain desired effects or keeping the body from going through withdrawal. 2
Once ethanol is consumed, some of it is absorbed through the stomach and small intestine and then enters the blood stream. Most of the ethanol, however, is catabolized in the liver by the enzyme alcohol dehydrogenase. The catabolism of ethanol produces reactive oxygen species, also known as free radicals, causing oxidative stress. Oxidative stress in the liver is also caused by: liver hyper-metabolism, caused by alcohol consumption, free radical–induced lipid per oxidative damage, reduction in protective antioxidants, glutathione, vitamins A and E, caused by alcohol-related under nutrition, binding of alcohol oxidation products, such as acetaldehyde, to liver cell proteins, forming neo-antigens and resulting in inflammation, accumulation of neutrophils and other WBCs, which are attracted by lipid per oxidative damage and neo-antigens, and inflammatory cytokines secreted by WBCs.3 Along with ethanol causing oxidative stress it leads to fat accumulation in the liver. The fat accumulation leads to fatty liver disease, alcoholic hepatitis and cirrhosis of the liver. Hepatitis is the combination of fat accumulation, inflammation of the liver and necrosis of the liver tissue. Cirrhosis is an escalated stage of alcoholic hepatitis including scarring of liver tissue. 3 These diseases lead to the dysfunction of the liver.
The normal, healthy liver does the following; stores glycogen, helps process fats and proteins, produces bile which is passed into the intestines to help break down fats, processing a great amount of medications, detoxifies blood, removes alcohol from blood, and makes proteins that are essential for blood to clot.4 Alcohol has hematological complications including the production of defective red blood cells, damaged white blood cells and unfavorably effects the production of platelets which aid in the blood clotting system.5 For this article, the disruption of the blood clotting system is going to be limited to the function of the liver. The liver produces these six factors that enable blood to clot: I (fibrinogen), II (Prothrombin), IV, V, VI, and VII. 6 When the liver is damaged,

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