Twenty-nine-year-old Abhishek (name changed), an IT engineer from Chennai, didn’t think of himself as having an alcohol problem. While he never touched a drink during the week, he liked to cut loose on weekends with his gang of old schoolmates. Still, the worst trouble he had faced in the past was having to go to work on a Monday morning with a massive hangover.
That was until one fateful morning when he awoke curled up in pain. His abdomen felt bloated, and the pain started near his gut and radiated out towards his back, making it impossible to move. When he arrived at the hospital, he was diagnosed with acute pancreatitis, brought on by the binge drinking the previous evening. Abhishek’s doctor also warned him that if the drinking continued, he was at risk of the problem becoming chronic.
While we are all aware of the risks of heavy alcohol consumption, Dr Piramanayagam, Gastroenterologist at Apollo Hospitals in Chennai, says that we tend to think of the problem in terms of daily drinking. But it’s just as important to be moderate on weekly or occasional drinking outings, he explains. Reason? There is no “right” amount of drinking. For some, even a couple of drinks once in a while could lead to serious health issues.
What is binge drinking and why does it affect us?
Binge drinking refers to the consumption of a large amount of alcohol during a short period of time. A widely accepted definition pegs this limit at five or more drinks within a couple of hours for men, and four or more drinks for women. But this is an average limit, and the number would vary depending on each person’s body composition.
Binge drinking affects our bodies because the digestive system is only able to metabolise a small quantity of alcohol at a given time. The presence of excess alcohol in the system is what gives the feeling of intoxication. But this excess alcohol also stresses out the digestive system, putting a strain on various organs as they struggle to metabolise the rest of it.
Binge drinking and pancreatitis
One of the big risks of binge drinking is the possibility of developing acute pancreatitis, says Dr Piramanayagam. “The secretions in the pancreas essentially digest the protein and fat in the food that we intake. These secretions have to do their duty inside the intestine,” he explains. However, in some instances, binge drinking can affect the hormonal balance in the pancreas, leading to the pancreatic secretions auto-digesting or eating away the fat cells around the pancreas itself.
Dr Piramanayagam, Gastroenterologist at Apollo Hospitals
This sets off the waves of pain, swollen abdomen, and sometimes nausea and vomiting that are the characteristic symptoms of pancreatitis. Mild cases of acute pancreatitis may pass after some time. In some cases, however, the inflamed pancreas may become infected. In very severe cases, called necrotising pancreatitis, parts of the pancreas may die, leaking body fluid into the abdominal cavity, which could cause shock and organ failure. Severe acute pancreatitis can be life-threatening.
If properly treated, most patients with acute pancreatitis can return to normal soon. “If acute pancreatitis runs its course and it settles down, the pancreas goes back to being nearly normal again,” says Dr Piramanayagam. However, some research points to the possibility of episodes of acute pancreatitis becoming chronic as well.
Not just the pancreas at risk
Dr Piramanayagam points out that higher levels of alcohol consumption also stress many other parts of the digestive system including the liver, the stomach and the intestines. While these conditions do not result from occasional heavy drinking episodes, repeated binges can cause serious problems even if one stays sober between episodes.
With the liver, binge drinking episodes have been found to increase the risk of alcoholic liver disease. While chronic drinkers are more prone to liver disease, the effects of binge drinking cannot be underestimated either. Such episodes lead to the deposit of fatty tissue in the liver, which can progressively turn into inflammation and then scarring and cirrhosis, says Dr Piramanayagam. Similarly, over the long-term, alcohol can affect the tissue lining of the stomach or intestines, leading to problems such as gastritis and stomach or intestinal ulcers.
How much is too much?
All of this raises serious questions in the wake of studies showing that alcohol consumption levels are rising in India. What’s more, the general tendency is for alcohol consumption to tend upwards with rising incomes. Further, according to the 2019 survey of “Magnitude of Substance Use in India” released by the Ministry of Social Justice, binge drinking or episodic heavy drinking is common among Indians. Nearly half (43%) of alcohol users, says the survey consume more than four drinks on a single occasion.
What confused Abhishek about his situation was that he didn’t drink nearly as much as his friends did. So, why was he stuck in the hospital, and not them? That is a faulty way of thinking that often leads people to underestimate the effects alcohol is having on their body, says Dr Piramanayagam. “When we take the personal history of patients, we find that they often compare themselves to other people who drink more and appear apparently well. So, they raise the question, saying ‘Why me?’”
The difficulty of such thinking, explains the doctor, is that different people’s bodies respond differently to alcohol. While there are nationally and globally recommended guidelines for alcohol consumption, even the medical literature is still in doubt about a definite safe level of alcohol consumption. Further, says the doctor, “What we have to understand about these cut-offs is that they are developed on a population basis. This gives us a broad idea about what is the average alcohol intake likely to cause a disease. But, in a given patient, it doesn't necessarily have to cross that amount to cause a disease.”
This article was created in association with TNM Brand Studio and not by TNM Editorial.