A toast to gastric health

That post-drinks feeling in the pit of your stomach may point to more serious, long-term health issues

It's a situation most of us are familiar with: After a long week at work, you head to the nearest watering hole to knock back a few drinks with friends or colleagues.

According to the Yearbook of Statistics Singapore, 2016, private consumption expenditure on alcoholic beverages and tobacco is on the rise. In 2010, the amount spent was S$2.46 billion. Last year, this figure had increased to S$2.82 billion, at 2010 market prices.

It's a trend that Dr Yim Heng Boon says is becoming more prevalent among younger people as well. "There is a worldwide trend of an increasing number of younger people suffering from alcohol-related abdominal pains as more people are starting to drink alcohol at a younger age," he said. Dr Yim is a gastroenterologist from Yim Gastroenterology Liver and Endoscopy Centre at Mount Elizabeth Novena Specialist Centre and is a member of the Alliance Healthcare network. 

Hard to stomach

It's common to share a few post-work drinks at the end of the week, but if you experience persistent post-drink gastric pains, you may want to consult a specialist.

Some people may think that they are less likely to develop alcohol-related gastric issues if they do not drink a lot of hard liquor like whiskey. However, according to the Health Promotion Board (HPB), two factors need to be taken into account: The alcoholic content of the drink and the amount consumed. One bottle of beer, containing 3.5 per cent of alcohol, has the same alcoholic content as one shot of hard liquor containing 40 per cent of alcohol.

Other factors like binge drinking may also complicate matters. The HPB defines this as consuming at least five alcoholic drinks for males or at least four alcoholic drinks for females, in one occasion.

According to Dr Yim, alcohol, if consumed over a long period of time and in high quantities, may even lead to more serious chronic health issues including hepatitis, liver cirrhosis (hardening of the liver), acute or chronic pancreatitis as well as cancer of the mouth and oesophagus.

In extreme cases, it can lead to alcohol poisoning, which affects vital bodily functions such as the brain and circulatory system. It also affects the pharyngeal reflex, which helps to prevent choking.

Limiting the effects of alcohol

One way to minimise the effects of alcohol is by drinking in moderation, which the HPB defines as drinking no more than two standard drinks a day for men, and no more than one standard drink a day for women. The recommended drinking limits are lower for women as their bodies usually have a smaller amount of blood as well as a different fat-to-muscle ratio compared to men. A standard alcoholic drink is defined as a 330ml can of regular beer, half a glass (175ml) of wine or one nip (35ml) of spirit.

Drinking alcohol after a meal also slows down the absorption of alcohol, giving a person more time to metabolise the alcohol. Dr Yim said that fatty food tends to stay in the stomach longer for digestion and may lead to relatively slower alcohol absorption, which may reduce the effects of intoxication. 

Treatment options

It's important to know if any gastric pains you feel after drinking are cause for concern.

"Abdominal pain associated with alcohol can be due to acid reflux disease, gastritis, peptic ulcer disease or alcohol hepatitis. If one has frequent pain with alcohol drinking, then it will be sensible to stop drinking and consult a gastroenterologist to evaluate the cause of the pain," said Dr Yim.

Symptoms including yellow eyes, dark urine, vomiting (including vomiting of blood), passage of black tarry stools and unintentional weight loss point to the possibility of more severe health complications. That's when you should definitely make an appointment to see a specialist for a more thorough review.

Said Dr Yim: "If one drinks a lot over a long term, we will do a detailed physical examination and then order blood tests as well as radiological imaging of the liver and pancreas."

An endoscopy is performed if the patient is experiencing recurring abdominal pains, vomitting , weight loss or anaemia. " Vomitting blood is a serious complication and can be caused by violent vomiting or oesophageal, gastric variceal bleeding.  If so, an urgent gastroscopy to stop the bleeding is needed," he added.

According to Dr Yim, patients with serious alcohol-related medical problems would be advised to stop drinking alcohol, while those with mild issues would be asked to reduce their alcohol intake.

"However, those who have a serious alcohol addiction may experience serious withdrawal symptoms such as sweatiness, tremor of hands and feeling agitated during alcohol cessation. These patients might then have to be hospitalised in order for us to effectively manage their withdrawal symptoms," he added. 

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