Common Health Issues Associated With End-Stage Alcoholism

Alcoholism kills you by attacking key organs of the body until they stop working. Learn why immediate intervention with any drinking problem is an urgent priority:

Alcoholism is a disease characterized by stages of progression. The last of these stages, sometimes called “late-stage” or “end-stage” alcoholism, is when certain health issues like advanced liver disease or heart problems are more likely to surface. These common health issues during late-stage alcoholism are often incurable and inevitable precursors to death. This article will provide a firsthand look at these physical effects of late-stage alcoholism, with a view to educating readers about the dangers of untreated alcoholism and why immediate intervention for a drinking problem is always urgently advisable.

Phases of Alcohol Addiction and Late-Stage Alcoholism

There is widespread agreement within the scientific community that alcoholism is a progressive disease, in good part thanks to the work of the alcoholism researcher, E.M. Jellinek. (It was Jellinek, in fact, who was largely responsible for the evolution of the disease concept of alcoholism, which was officially adopted by the American Medical Association in 1956.) Jellinek was the first to identify stages of addiction from observations of problem drinkers: he noticed that over time alcohol use disorders exhibited certain symptoms that could be lumped into four distinct stages of dependency:

• Phase 1/Pre-alcoholic phase – is when an alcoholic drink socially and occasionally to relieve stress, but has control over their drinking behavior; in the later stages of this phase, the alcoholic is drinking more frequently in order to reduce stress.
• Phase 2/Early alcoholic phase – begins with a first blackout and involves a growing preoccupation with drinking, sneaking and gulping drinks, frequent blackouts and a loss of control of drinking.
• Phase 3/Middle alcoholic phase – is defined by a total inability to stop drinking after one drink, and can be characterized by dramatic physical and psychological changes, unsuccessful efforts to stop drinking, attempts to get help, problems at work and at home, alibis to conceal drinking, and chain drinking. In this stage, alcohol has become an all–consuming obsession and compulsion.
• Late or end-stage alcoholism – is when drinking escalates to an all-day habit, starting in the morning and continuing throughout the day; “benders” (the slang term for multiple-day binge drinking episodes in which the alcoholic neglects eating or sleeping in order to drink non-stop) can be a feature of this phase; severe liver and brain damage and other serious physical and psychological issues associated with end-stage alcoholism now set in.

Physical Effects of Late-Stage Alcoholism

During this last stage of alcoholism, the serious and life-threatening physical effects of a severe drinking problem are virtually unavoidable. These can vary depending on the individual, and can involve one or multiple organs, according to Dr. Edward Zawadzski. As an addiction-certified psychiatrist, Dr. Zawadzski is the medical director of Beach House Center for Recovery. He says severe alcoholism “creates an end-stage condition for whatever organ(s) it decides to attack.” His observation comes from years of experience treating late-stage alcoholics suffering from one or more of the following health issues as the result of their addiction:

Liver Disease and Failure – One of the more common health issues manifesting in end-stage alcoholism is alcoholic liver disease, which reportedly accounts for roughly 20 percent of the 100,000 deaths from alcohol each year. Excess alcohol consumption can damage and destroy liver cells, impairing their ability to do their job (metabolizing fats and protein and processing and flushing out incoming toxins).

Alcohol-related liver disease may begin as fatty liver disease and progress to the most severe stage of liver damage known as cirrhosis. A diagnosis of cirrhosis, characterized by irreversible scarring of the liver, means liver failure (in the absence of an organ transplant) — and in turn death—is inevitable.

A distended abdomen is one common complication that Dr. Zawadzski has seen in cases of alcohol-related liver damage. He often saw patients who would come in with “incredibly distended bellies” because of a build-up of fluid caused by liver dysfunction. In order to get relief from the resulting pain and discomfort, these patients would have to come in to the hospital once or twice monthly to have their abdomen drained of .5 to 1 liters of extra fluid. “Ascites” (the medical term for this health issue) refers to the abnormal accumulation of fluid in the abdominal cavity. Cirrhosis is reportedly the most common cause.

Chronic Pancreatitis – This condition that can occur in end-stage alcoholism is characterized by painful inflammation of the pancreas (which produces enzymes and hormones that aid in digestion). The ensuing pain, which radiates out from the center of one’s abdomen, can be so excruciating that it is crippling. Dr. Zawadzski recalled one especially heartbreaking case in which a patient with alcohol-induced chronic pancreatitis had to be in the hospital on a feeding tube for two years and could not eat because eating would upset their pancreas.

Wernicke-Korsakoff Syndrome (WKS, also known as Wernicke disease) – is a brain disorder resulting from lack of thiamine (vitamin B1) that is usually secondary to advanced alcoholism. WKS is a manifestation of chronic brain damage resembling dementia. Dr. Zawadzski estimated that roughly one third of the patients he once treated in a dementia unit suffered from alcohol-induced WKS. Depending on the severity of their syndrome, they had virtually no appreciable memory and would “confabulate” when you asked them a simple question. For example, “you would ask them, ‘How old are you?’ They would answer by neurologically dancing around the question, because they didn’t know the answer.”

WKS can also entail symptoms of alcohol-related psychosis, although these hallucinations and expressions of paranoia are a less common occurrence and typically only occur in clients with the most severe addiction.

Chronic Brain Damage – Chronic brain damage from problem drinking does not only take the form of WKS, however. A study of late-stage alcoholics showed significant impairment to the cognitive functioning of both the right and left hemispheres of the brain.

Barrett’s Esophagus and Esophageal Cancer – Research has found that heavy alcohol drinking puts alcoholics at greater risk of developing Barrett’s esophagus, a precancerous condition in which the cells lining the throat change into intestinal cells, impairing the ability to swallow. Those afflicted with this painful condition are prone to choking, aspirating, and getting pneumonia. They are also at greater risk of developing esophageal cancer.

Alcoholic Cardiomyopathy – Heavy drinking over a prolonged duration of time is known to cause heart disease in the form of alcoholic cardiomyopathy. This condition entails a progressive thinning and weakening of the heart muscle, which in turns disrupts the pumping of blood to key organs like the lungs. A high prevalence of patients with this disorder (as many as 40 percent in one study) also engage in heavier drinking, so the correlation appears to be causal and is one reason patients with this diagnosis are advised to cease all drinking as part of their treatment.

Long-Term Health Damages From Alcohol – Can They Be Reversed?

Each of the above health conditions associated with end-stage alcoholism is a serious and potentially life-threatening issue requiring immediate medical intervention … but can any of these problems be reversed? In some cases, yes, and in others, no, according to Dr. Zawadzski:

• WKS is almost always a permanent diagnosis, with very few exceptions.
• Chronic pancreatitis can resolve itself for a lucky few, but in many cases the condition is permanent and fatal.
• Where liver or heart disease is concerned, the prospects of reversal can also be dim, depending on the severity of the condition and its progression. Those with cirrhosis require a liver transplant to have any chance of survival. If alcoholic cardiomyopathy is caught soon enough, sometimes a biventricular pacemaker can help—but when the condition is not reversible, a heart transplant is the only life-saving option.

In each of these cases, then, getting help for alcoholism during its earlier stages is the best form of prevention. Consulting the advice of an addiction professional is the first step. If you’re worried about a drinking problem or about developing any of the above health issues associated with late-stage alcoholism, seek the help of a medical professional immediately.