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Alcoholism and Esophagus Damage

Posted in Alcoholism

The esophagus is the hollow, muscular structure that extends from the bottom of the throat to the top of the stomach. It plays an absolutely essential role in human health by giving food and liquids access to the stomach and other digestive organs in the gastrointestinal (GI) tract. The types of heavy alcohol consumption associated with alcoholism can damage the tissues in the esophagus both directly and indirectly. Potential consequences of this damage include relatively minor problems such as heartburn and gastroesophageal reflux disease (GERD) and potentially fatal problems such as esophageal cancer and enlarged, bleeding veins known medically as esophageal varices.

Esophagus Basics

The esophagus sits in the space between the spine and the trachea (windpipe). In the average adult, it measures roughly 8 inches in length. At its upper end sit a ring of muscles known collectively as the upper esophageal sphincter, which opens and closes the esophagus’s link to the throat during such actions as eating, breathing, vomiting and burping. In addition, the muscles of this sphincter prevent food and other substances from accidentally entering the trachea. At the bottom end of the esophagus sits another ring of muscles known collectively as the lower esophageal sphincter, which is placed on a level with the diaphragm maintains the connection between the stomach esophagus and the. Under normal circumstances, the muscles in this sphincter close automatically during food digestion and prevent food and stomach acids from working their way back up the esophagus.

Heartburn and GERD

Alcohol is toxic to a wide variety of tissues throughout the body. In the lower esophageal sphincter, even isolated drinking sessions can weaken muscle function enough to allow the regurgitation of food and stomach acids, thereby triggering cases of heartburn and GERD, according to researchers at the University of Montana. Heartburn is a GERD symptom that typically occurs when stomach acids pass into the esophagus and irritate the esophageal lining; in addition to heartburn, GERD can produce nausea, an unusual sticking sensation in the esophagus, sore throat, a hoarse or altered voice, swallowing problems, wheezing and coughing. In alcoholics, heartburn and GERD can recur frequently or turn into chronic conditions.

Esophageal Cancer

Alcoholics with chronic cases of GERD develop increased risks for the onset of a disorder called Barrett’s esophagus, according to a study published in 2009 in the journal Gastroenterology. In people with this disorder, ongoing exposure to stomach acids triggers structural changes in the esophageal lining. In turn, these structural changes can eventually result in a precancerous condition called dysplasia, which occurs when damaged or altered tissues start to produce abnormally high numbers of immature cells. In alcoholics and anyone else affected by advanced cases of esophageal dysplasia, increased production of abnormal cells can lead to the onset of esophageal cancer. Doctors typically can’t cure this kind of cancer, the US National Library of Medicine reports. In some cases, surgical removal or radiation therapy can improve outcomes when the cancer has not yet spread (metastasized) to other parts of the body. However, there is no real remedy for metastasized esophageal cancer.

Esophageal Varices

While alcohol-related heartburn, GERD, Barrett’s esophagus and esophageal cancer all stem from the direct, localized effects of excessive alcohol consumption, esophageal varices appear as a secondary effect of scarring in the liver, also known as cirrhosis. In alcoholics, cirrhosis occurs when repeated, heavy alcohol exposure overwhelms the liver’s attempts to detoxify the body and triggers severe structural changes in the liver’s cells. The presence of cirrhosis reduces the liver’s ability to accommodate a normal blood flow; esophageal varices form when the body compensates for low blood flow in the liver by increasing blood flow in the veins found in the lower portion of the esophagus. Pressure caused by this increased blood flow can eventually burst the affected veins and trigger levels of bleeding that range from minor to severe. Alcoholics and other people with severe bleeding from esophageal varices can easily die without emergency medical intervention.


Other potential esophagus-related consequences of alcoholism include a bleeding rupture at the border of the esophagus and stomach called Mallory-Weiss syndrome (or a Mallory-Weiss tear), and a form of painful spasming inside the esophagus known as “nutcracker esophagus.” In some cases, alcoholics with liver scarring develop bleeding varices in the upper stomach rather than in the lower esophagus. Varices in the stomach can also lead to fatal outcomes when they trigger severe bleeding.