Question

Some alcoholics with liver cirrhosis can experience excessive bleeding, anemia, decreased appetite and abdominal pain.

a. What are the mechanisms that cause anemia and clotting disorders associated with alcoholic liver disease?

b. What gastrointestinal bleeding condition is associated with high mortality rates due to advanced cirrhosis? Describe the pathophysiology of the condition.

c. Why is tachycardia and hypotension associated with alcoholic-related acute pancreatitis, particularly after binge drinking?

d. Why are women more predisposed to alcoholic liver disease than men?

Answer 1

a).Multiple different types of aneamia are associated with liver disease.Portal hypertension related to chronic or acute liver disease may cause GI bleeding,which is predisposed by coagulopathy related to liver dysfunction.Acute blood loss anemia in these circumstances is often due to gastroesophageal varices,which may also lead to iron deficency anemia and also cause abnormalities in the composition of red blood cells membrines that finally cause hyperssplenisam.These include decreased hepatic synthesis of factor II,VII,IX and x. the presence of inhibitors of these factors decreased clearance of activated coagulation factors;Thrombo cytopenia ,impaired platelet function ;hyperfibrinolysis and disseminated intra vascular coagulation

b)Gastrointestinal hemorrhage is a major complication of cirrhosis and portal hypertension and is responsible for significant morbidity and mortality.Variceal bleeding is one of the major cause of upper GI bleeding in cirrhotic patients.

c)Acute pancreatitis  is an inflammatory condition of pancreas.organ failure can occure in acute pancreatitis because damage to the pancrease may permit activated enzymes and toxines such as cytokines to enter the blood stream and cause low blodd pressure and damage to other organs such as the lungs and kidneys.

d)women are more susceptible to the damaging effects of alcohol than mens because they are generally smaller in stature and have less body water than men. The female liver has no more sensitive than its male concentration of alcohol reaching the liver will be higher causing the liver to be damaged much faster