Chronic alcoholics retain dyspeptic symptoms, pan-enteric dysmotility, and autonomic neuropathy before and after abstinence.
OBJECTIVE
To carry out a comprehensive study on gastrointestinal symptoms, motility and autonomic neuropathy in chronic alcoholics before and one year after abstinence.


METHODS
Dyspeptic symptoms (questionnaires), fasting and postprandial gallbladder and gastric motility (ultrasonography), oro-cecal transit time (lactulose H2-breath test), stool form score (indirect marker of colonic transit), and autonomic neuropathy (sweat spot test, R-R ratio) were assessed at baseline in 268 subjects (136 chronic alcoholics and 132 healthy controls). A subgroup of 39 patients was re-evaluated after 12 months of abstinence.


RESULTS
Chronic alcoholics had increased dyspepsia, delayed gastric emptying and oro-cecal transit time but faster gallbladder emptying, with slightly accelerated colonic transit. Sympathetic, but not parasympathetic, autonomic dysfunction was found. Dyspeptic symptoms and functional alterations of gastric emptying and oro-cecal transit tests were still present after 12-month abstinence, whereas gallbladder motility, stool form score and sympathetic function improved.


CONCLUSIONS
Chronic alcoholics exhibit combined and interdependent presence of dyspeptic symptoms, impaired motility at different levels of the gastrointestinal tract, with sympathetic dysfunction. Only a few of these abnormalities improve after one year of abstinence from alcohol.
Division of Internal Medicine, Hospital of Bisceglie, Italy.
Agostino
A
Di Ciaula
Italian College of General Practitioners, Florence, Italy.|Clinica Medica 'A. Murri', Department of Biomedical Sciences and Human Oncology, 'Aldo Moro' University Medical School, Bari, Italy.
Ignazio
I
Grattagliano
Clinica Medica 'A. Murri', Department of Biomedical Sciences and Human Oncology, 'Aldo Moro' University Medical School, Bari, Italy.
Piero
P
Portincasa
D000328:Adult; D064829:Alcohol Abstinence; D020269:Alcoholic Neuropathy / Q000209:etiology / Q000503:physiopathology; D057229:Alcoholics; D000437:Alcoholism / Q000150:complications / Q000503:physiopathology*; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D002908:Chronic Disease; D004415:Dyspepsia / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires
autonomic nervous system; dyspepsia; gallbladder; gastric emptying; small intestine