PART 11. THE GASTROINTESTINAL SYSTEM

C. The Small Intestine

INTRODUCTION

Kenneth Williams

The second part of the monograph ends with a consideration of the effect of alcohol on small-intestinal function. These papers are helpful in understanding the complex interplay between alcohol consumption and malnutrition, for it can be now shown that even if the alcoholic consumes a nutritionally adequate diet, the effect of large amounts of alcohol on intestinal absorption of nutrients can produce malnutrition.

Dr. Mezey’s paper outlines the importance of alcohol and dietary deficiency in malabsorption, although large amounts of alcohol could be demonstrated to produce pathologic histological changes in the mucosa, deranged motility, and defective absorption.

Dr. Lindenbaum reports his experiments in which ingestion of large amounts of alcohol (representing approximately 50% of total caloric intake) produced malabsorption of vitamin BI2 in spite of a fully nutritious diet supplemented with vitamins.

This second section of the monograph, The Gastrointestinal System, does not consider the medical complications of alcoholism affecting the stomach, except for consideration given to cancer in this area (see Part VII, Cancer). Alcohol is known to be capable of producing acute superficial, hemorrhagic gastritis. Clinically this condition is considered to be common in alcoholics following a prolonged drinking bout. Whether or not the ingestion of large amounts of alcohol can be implicated in producing peptic ulcer disease appears not to be resolved at the present time.

The only lesion of the lower gastrointestinal tract known to be related to alcoholism is hemorrhoids. This condition frequently accompanies the portal hypertension found in patients with Laennec’s cirrhosis.

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