Functional and morphological alterations in small intestine mucosa of chronic alcoholics.
OBJECTIVE
Alcohol-related diseases constitute the third largest health problem after heart disease and cancer in the world. The objective was to study the effects of chronic alcohol intake on small bowel cellular functions with focus on brush border enzymes, membrane enzymes, cellular enzymes and their relationship with structural changes in small bowel mucosa of chronic alcoholics.


METHODS
Duodenal biopsies were obtained by upper gastrointestinal endoscopy of chronic alcoholics having alcoholic liver disease (ALD) with and without cirrhosis. The biopsies were then processed for enzymatic assays to analyze the status of cellular functions. Light microscopy, transmission electron microscopy, and scanning electron microscopy were done to study the morphological alterations. Control group consisted of nonalcoholic gastroesophageal reflux disease patients reporting for routine endoscopy.


RESULTS
The experimental group consisted of ALD patients which showed significant difference (P < 0.01) in cellular functions when compared with controls. The light microscopy showed partial villous atrophy, increase in lamina propria infiltrate, and intraepithelial lymphocytes as main findings in the alcoholic group. Ultrastructural evaluation revealed changes like widened intercellular junction, distorted microvilli, increased rough endoplasmic reticulum, and increased and dilated mitochondria. The enzyme parameters correlated positively with the mucosal morphology parameters indicating a direct relationship.


CONCLUSIONS
The study brought out the changes in small bowel of chronic alcoholics having ALD at both cellular and subcellular levels which correlated significantly.
Department of Superspeciality of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sbbhardwaj2002@yahoo.com
Sonia
S
Bhonchal
Chander K
CK
Nain
Kaushal K
KK
Prasad
Ritambhara
R
Nada
Arun K
AK
Sharma
Saroj K
SK
Sinha
Kartar
K
Singh
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000201:enzymology / Q000473:pathology*; D001284:Atrophy; D016022:Case-Control Studies; D004384:Duodenoscopy; D004386:Duodenum / Q000201:enzymology / Q000648:ultrastructure*; D020895:Enterocytes / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000201:enzymology / Q000648:ultrastructure*; D008108:Liver Diseases, Alcoholic / Q000201:enzymology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies