Alcohol consumption is a significant risk factor for gastrointestinal diseases, including cancer. Alcohol can damage the gastrointestinal tract in several ways. It can promote an impairment of several intestinal barrier functions, leading to leaky gut and dysbiosis. Ethanol metabolism can also produce toxic substances such as acetaldehyde and acetate, further damaging the gut and potentially promoting cancer.
, gut immune dysfunctions, and alterations in the intestinal microbiome. The pathophysiology of ABD has yet to be fully understood, but it is thought to involve the metabolism of ethanol and its principal metabolites, acetaldehyde and acetate. These metabolites can impair different functions in the digestive tract, leading to various GI diseases, including ABD.
One challenge in studying ABD is that studies are primarily descriptive. In addition, investigations of the intestinal barrier in humans often consider only advanced stages of alcohol-associated liver disease , in which additional factors such asor decompensation of liver function are influencing, per se, the digestive tract.
Ethanol, as well as acetaldehyde and acetate produced by ethanol metabolism in chronically alcohol abusers, may promote and/or contribute to bowel pathogenesis. Epithelial and non-epithelial cells and microbes along the different intestinal tract sites could be impacted by ethanol itself and by differential doses of acetaldehyde and acetate due to ethanol metabolism. However, the exact contribution of the digestive tract in ethanol metabolism remains to be elucidated.
More research is needed to understand ABD's mechanisms and develop effective treatments. There is some evidence to suggest that ABD may precede or contribute to ALD. For example, approximately 90% of alcohol user disorder patients present with mild liver disease. However, most will likely have certain degrees of bowel dysfunctions , suggesting that ABD may precede in certain patients and promote or contribute to ALD.
Future studies are needed to better understand the role of the intestine in ethanol metabolism and the impact of ethanol on the intestine. These studies could help identify new targets for preventing and treating ABD.Luca Maccioni et al, Alcohol-associated bowel disease: new insights into pathogenesis,
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