Beer, wine and harmless-looking cocktails that are fuelled with alcohol are a common feature at celebrations in Singapore. And like a ritual of sorts, many working adults descend upon watering holes for drinks at the end of every work week. This prevalence of drinking as a social activity has increased with the country’s rising affluence. And it appears our appetite for booze is set to continue getting bigger.
According to the Yearbook of Statistics Singapore, 2019, private consumption expenditure on alcoholic beverages and tobacco is on the rise. In 2012, we spent S$2.73 billion. By 2018, this figure had increased to S$3.07 billion, at 2012 market prices. Meanwhile, the 2016/2017 National Population Health Survey revealed an uptrend in binge drinking, with figures standing at 9.0% in 2017, up from 2.2% in 2001, and the incidence is higher among males.
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 MHC Asia Group network. About one in 10 of his patients see him for alcohol-related liver and gastric problems.
Sobering truths
It’s a myth to think you’re less likely to develop alcohol-related gastric issues if you do not drink a lot of hard liquor like whiskey. What you should consider however is the alcohol content of your tipple of choice and the amount imbibed. One bottle of beer, containing 5 per cent of alcohol, has the same alcohol content as one shot of hard liquor containing 40 per cent of alcohol1.
Other factors like binge drinking or high-risk drinking may also complicate matters. The latest 2015 to 2020 Dietary Guidelines for Americans by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture defines high-risk drinking as consumption of four or more drinks on any day or eight or more drinks per week for women; or five or more drinks on any day or 15 or more drinks per week for men.
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.
Source:
U.S. Department of Health and Human Services and the U.S. Department of Agriculture, Dietary Guidelines for Americans 2015 - 2020
National Institute on Alcohol Abuse and Alcoholism, “What are the risks?”
Tips for cutting back on alcohol
If the thought of becoming a teetotaler conjures horrifying visions of a lonely life devoid of fun, withdrawal symptoms and losing your ability to do karaoke, then perhaps you’re not ready to part with your bottle just yet. But even minimising your alcohol intake can bring numerous benefits. Aside from reducing alcohol-related gastric issues, you’d be sparing yourself from a beer belly, two-day hangovers, puffiness in the face, and a declining bank balance.
• Drink in moderation. The latest guidelines by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture define moderate drinking as having up to one drink per day for women and up to two drinks a day for men. This refers to the amount consumed on any single day and is not intended as an average over several days.
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.
• Bite before you sip. Drinking alcohol after a meal slows down the absorption of alcohol, giving your body more time to metabolise the alcohol. Dr Yim says 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.
Routes to sobriety
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), the 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.
Dr Yim says, “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, vomiting, weight loss or anaemia.
“Vomiting 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 adds.
1National Institute on Alcohol Abuse, “What's a "standard" drink?”,
https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/what-counts-as-a-drink/whats-A-Standard-drink.aspx