A patient may have only one of the three alcohol-induced conditions or any combination of them. Traditionally, they have been considered sequentially related, progressing from fatty liver to alcoholic hepatitis to cirrhosis. However, some studies have demonstrated that alcoholics may progress to cirrhosis without passing through any visible stage resembling hepatitis. Thus, alcoholic cirrhosis can appear insidiously, with little warning. Trauma linked to alcohol is the fourth highest cause of death, after coronary disease, cerebro-vascular accidents and cancer (the two latter illnesses are also exacerbated by alcohol). It is the main cause of death before the age of 40 years.
Numerous studies suggest that consuming more than two drinks a day over the long term can raise blood pressure in some people and increase the risk for stroke and other diseases. Overconsumption of alcohol is linked to cancers of the oesophagus and liver. Chronic alcoholism increases the risk of cancer of the upper respiratory and digestive tracts (mouth, upper pharynx, larynx). The risk increases greatly with tobacco addiction. Alcohol is the main cause of inflammation in the stomach (acute erosive gastritis). Alcohol causes poor absorption of nutrients in the intestine, hence some nutritional deficiencies, such as vitamin A and C. Large quantities of alcohol can cause haemorrhagic lesions in the internal wall of the intestine. Chronic alcohol consumption can lead to cardiac rhythm problems (tachycardia, palpitations). Alcoholism is the main cause of late onset epilepsy in adults. One Danish study found that heavy drinkers, having more than 42 units a week had a significantly increased risk of premature death. (A unit is equivalent to an average glass of wine or a "stubby", or 0.3 litre, bottle of lager beer). Another, however, found the mortality rate for those who drink up to 69 units of alcohol a week was equal to the rate for teetotallers, and that gender makes no difference (unlike most previous research which sets a lower limit for women). Smoking is considered by most researchers to increase the health risk factor from alcohol.
Deficiency of vitamin B-1 (thiamine), caused by reduced digestive absorption of this essential nutient in alcoholics, causes Wernicke's encephalopathy, characterized by impaired memory, confusion and lack of coordination. Further deficiencies of thiamine can lead to Korsakoff's syndrome, characterized by amnesia, apathy and disorientation.