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Painkillers for that hangover headache may damage your liver

By Vision Reporter

Added 20th January 2008 03:00 AM

SWALLOWING medicine, with or after drinking alcohol is very dangerous. The most dangerous medicines to avoid taking with alcohol are sedatives (drugs that reduce anxiety and induce sleep), paracetamol (the most widely used pain killer), anticonvulsants (drugs that reduce/prevent convulsions) and ana

SWALLOWING medicine, with or after drinking alcohol is very dangerous. The most dangerous medicines to avoid taking with alcohol are sedatives (drugs that reduce anxiety and induce sleep), paracetamol (the most widely used pain killer), anticonvulsants (drugs that reduce/prevent convulsions) and ana

By Robert Zavuga

SWALLOWING medicine, with or after drinking alcohol is very dangerous. The most dangerous medicines to avoid taking with alcohol are sedatives (drugs that reduce anxiety and induce sleep), paracetamol (the most widely used pain killer), anticonvulsants (drugs that reduce/prevent convulsions) and anaesthetics (drugs that make you unconscious during operations).

Studies carried out on these drugs show that alcohol exaggerates the effects of sedatives. Paracetamol induces the liver to produce potentially toxic substances which may damage the liver. Ingestion of a few tablets of paracetamol after alcohol consumption may result in severe liver injury.

Therefore, it is a common finding that severe hepatitis may result in heavy drinkers who may have ingested paracetamol in order to treat their hangovers.

The condition is frequently not recognised as doctors do not usually elicit history of alcohol use with paracetamol. On the other hand, alcohol induces the liver to carry out an increased breakdown of anticonvulsants and general anaesthetics. This reduces the efficiency of these drugs.

Consequently; it will require prescription of higher doses to achieve therapeutic results.

Alcohol related liver disease is a common problem. In Uganda, it is estimated that fatal illnesses related to alcohol abuse account for about 4,860 deaths per year. Further still, approximately 100,000 and 280,000 people die per year in the US and the UK respectively due to alcohol related illnesses.

Susceptibility to liver disease
There is a threshold of alcohol consumption beyond which the incidence of liver disease increases. The threshold is 40g per day, which corresponds to about one litre of beer, half bottle of wine and four tots of spirits.

However, individual susceptibility varies. Even in heavy drinkers 15-20% are likely to develop cirrhosis irrespective of the amount they drink.

The incidence of chronic liver disease is also associated with:
Duration of consumption of alcohol: The risk of alcoholic liver disease increases when drinking is started early especially in adolescent years.

Drinking pattern: Regular drinking is more dangerous than binge drinking where periods of heavy drinking alternate with periods of abstinence.

Poor feeding and associated nutritional deficiencies

Gender: Women are more susceptible to alcoholic liver disease than men.

Symptoms of liver cirrhosis
It is possible to have a cirrhotic liver but not show any signs. This is called latent cirrhosis. The symptoms of active cirrhosis include;
lack of appetite
yellowing of eyes
general weakness
abdominal pain
itching of the skin
weight loss
liver tenderness

Treatment
The first step is diagnosing the condition through medical examination and laboratory tests.

However, this is challenging to doctors since many patients who seek health care deny the use of alcohol and a few who admit its use will give incorrect amounts they consume.

Recovery of damaged liver cells is impossible. However, since liver cells regenerate, it is possible for some degree of normal liver function to return. Abstinence from alcohol is fundamental during the treatment of liver cirrhosis.

There is no specific therapy for alcoholic liver cirrhosis. Treatment is directed at maintaining good health and at dealing with medical complications as they arise.

Liver transplantation is also possible where a liver of a person who has just died is removed and given to the patient. The donor should have been healthy. Though liver transplantation is not done in Uganda, it is possible abroad.

A word of caution
While alcohol caries connotations of pleasure to many, harmful consequences of its use are diverse. If you must drink, drink responsibly.

The writer is a final year medical student at Makerere University Medical School

Painkillers for that hangover headache may damage your liver

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