How much is too Much: The Definition of Excessive Drinking and Risks

Alcohol beverages is very common in our popular, most of the common beverages are – beers, wines and spirits. Studies shows that limited alcohol consumption usually do not pose any harm to body. However, to much alcohol can cause significant health risks. In general, more than or equal to 3 units for a male and 2 units for a female (a day) is too much on a long-term basis. Binge drinking is also not recommended due to high risk of alcoholic intoxication.

How many alcohol units are in each drink?

A shot of spirits (25ml): 1 unit

A standard glass of wine (175ml): 2.1 units

A large glass of wine (250ml): 3 units

A pint of 4% beer: 2.3 units

A pint of 8% strong cider: 4.5 units

What are the health risks?

Our liver is the main organ that metabolise the alcohol consumed. Under certain limit, our liver may be able to metabolise the alcohol. However, in the event of excessive drinking, the liver may not able to cope and this can lead to liver cell damage. Binge drinking can be defined as consuming 5 or more drinks within 2 hours for men, and 4 or more drinks within 2 hours for women.

Too much alcohol consumption also associated with other health issues such as:

  • Obesity
  • High blood pressure and diabetes
  • Cancers of the mouth, throat and esophagus, liver, colon, and breast
  • Digestive problems
  • Liver disease

Health impacts on different organs of our body

  • Pancreas

Heavy alcohol drinking is another big cause to chronic pancreatitis, a condition where the pancreases is severely inflammed. It occurs mostly after an episode of acute pancreatitis. The damage from heavy alcohol use to the pancreas may not develop symptoms for many years and one day, suddenly develop severe pancreatitis symptoms such as diarrhoea, constant upper abdominal pain, and weight loss caused by malabsorption of food. 

  • Brain

Chronic alcoholic consumption also cause neurological problem such as tremors and numbness of limbs. However, heavy drinkers may develop deficits in brain functioning and shrinkage of the frontal lobes of your brain over an extended period of time, that continue despite attaining sobriety.  Cognitive problems can persist due to the long-term alcohol abuse that negatively impact the brain’s “hard wiring”, such as poor decision-making, mild to moderate impairment of intellectual functioning, confused or abnormal thinking and loss of inhibitions.

  • Heart

Chronic alcohol consumption also increase cardiovascular risk. It can trigger arrhythmias (irregular heartbeats). Regularly drinking too much alcohol also raises your blood cholesterol level, this increase the chance of cholesterol plaque formation in blood vessels, thus increases your blood pressure, and over time high blood pressure (hypertension) can place a strain on the heart muscle, increasing your risk of heart attack, stroke and heart failure.

  • Stomach

Too much alcohol consumption can irritate your digestive system and over time, damage your intestines leading to bouts of diarrhoea or stomach pain. It can also cause stomach distress with symptoms like nausea, vomitting, bloating, gas and painful ulcers.

  • Liver

Chronic heavy drinking of alcohol can also lead to alcohol-related liver diseases such as fatty liver, cirrhosis and hepatitis. A person can have any of the conditions at a time, or all, if the disease is part of a progression.

Alcoholic fatty liver disease occurs as the early stage of liver damage induced by alcohol. It develops over time when too much alcohol consumption leads to a build-up of fat in the body’s liver cells, thus hindering liver function. This condition can be followed by inflammation in the liver (alcoholic hepatitis) and may progress to a build-up of scar tissues in the liver, leading to alcoholic cirrhosis.

Symptoms may not be present in the early stages. As you continue drinking alcohol over time, the performance and health of your liver declines and symptoms may begin to appear, which often can be too late.

They may develop gradually and include:

  • Jaundice
  • Abdominal pain and swelling
  • Encephalopathy or confusion
  • Severe itching of the skin
  • Wasting of muscles
  • Gastrointestinal bleeding

Moderation drinking habit

By drinking lightly and periodically, you can continue your drinking habits responsibly. It is also important to note long term alcohol is not recommended due to long term health risks.

For those taking prescription and medication, they should also ask their doctor if they can drink alcohol while taking them. Individuals with health conditions like heart failure, liver or pancreatic disease and uncontrolled high blood pressure should also check with their doctor about drinking as alcohol can worsen pre-existing health conditions.

Diagnosis and treatment

 Alcoholic liver cirrhosis can be diagnosed by gastroenterology specialists in singapore using blood tests and imaging procedures, including Fibroscan that will give a comprehensive assessment of a person’s liver health and determine disease severity. Patients in early stages of alcoholic hepatitis and fatty liver can reverse the condition, however, cirrhosis damage is irreversible and might require a liver transplant to survive.

You will need to abstain from drinking completely or gradually reduce your alcohol intake to see an improvement in your liver over time. Dietary and lifestyle modifications will be recommended to improve your well-being, and you can seek advice from a dietician for a balanced diet.