John was sitting in the waiting room. He was becoming impatient as he was looking at his red ,swollen and throbbing finger . Time was passing so slowly, minutes felt like eternity.
“John,” radiology tech called his name at long last. “Please follow me.”
John got up and followed the woman in green medical scrub.
“Your hand will go on this table “, she said, positioning his finger under the X ray machine.
“What happened? “, she went on with the small talk.
“Lots of mishap. It’s all my fault. I was just drinking too much,” he replied .
“Things happen. Don’t blame yourself,” the tech was sympathetic.
“Even if I won’t, my wife will. You see, last weekend I went fishing. I had to wait long for a catch to bite. I sat there and almost dozed off . Was not well, nauseous or what. Maybe because of those two vodkas on empty stomach . And than I felt the jerk. I pulled and there it was. A nice chunk of catch. Was too eager to go home, nausea and what not. So I rushed to get it off the hook. The fish hook poked me. Straight into this finger. Did’n think much of it. You know, some peroxide and stuff.”
“So it was a fishing accident,” radiology tech listened, as she checked on her screen that John’s hand and finger position were right.
“I wish. There is more. It started to hurt before I went to bed. Took another vodka or two. Maybe just go to sleep, thought to myself as I was closing the bedroom door. But, no! The door somehow slammed my finger. This same finger. Thought I was in hell.”
“You were right. Didn’t expect to hear this. Lots of mishap,” radiology tech commented.
“Yeah. But there is more.You know. I went to work the next morning. Damn finger was just throbbing. Could’t take it. Was not paying much attention to anything else. Hit my finger with the hammer. This same finger. They say all evil comes in threes. ”
“Oh, man. What a story”, radiology tech sighed as she was finishing the X ray. “I hope you get better. Doctor can look at your film now.Good luck.”
Alcohol abuse is very common practice.
It can damage the liver and cause chronic liver disease. There are different forms of this condition, from alcoholic hepatitis, to fibrosis to cirrhosis.
New scientific data are looking at association between the liver disease and disturbed microbiome .The role of microbiome is to live in symbiosis with the human host and assist in food digestion.Disruption of microbiome results in change in bacterial species represented, some species are represented in smaller or larger proportions than others.
In a mouse model of alcohol induced liver disease ,Lactobacillus, Pediococcus and Leuconostoc were detected in diminished quantities. In another study, administration of probiotic Lactobacillus reduced the severity of alcohol liver disease in animal model.
Alcoholic liver disease is also associated with intestinal permeability.As a result, via damaged intestinal barrier, bacteria and products of bacterial metabolism, bacterial metabolites, can migrate from intestinal lumen to blood and than further travel via portal vein to the liver .Those products may play a role in chronic liver inflammation in alcoholic liver disease.Metabolic product of alcohol, acetaldehyde can compromise the intestinal lining tight junctions .
Alcohol use is required but is not sufficient for development of alcoholic liver disease, since about 20-30% of alcoholics will develop it. Researchers have looked into other possible mechanisms ,including the role of bacterial metabolites driving liver inflammation. Alcohol and alcohol metabolites affect the intestinal barrier causing damage to the tight junctions and open the pathways for bacterial metabolites, LPS,lipopolysccharides and others, to penetrate into the blood and via blood stream arrive to the liver where they contribute to the inflammatory pathways.
In one study authors looked at diurnal variations of intestinal permeability in relation to alcohol intake in experimental animal model. Mice were given alcohol or saline liquids several times a day and markers of intestinal permeability were measured.
Daily variations in intestinal permeability were dependent on the time of the day when alcohol was given to the animals.Scientists are researching complex interplay between the circadian rhythms and alcohol induced effects and analyzing gene expressions under the experimental circumstances as well as microbiome disruption with disruptions of circadian rhythms.
1)Interactions Between the Intestinal Microbiome and Liver Disease
B Schanbl, D Brenner Gastroneterology 2014 May 146 (6) 1513-1524
2)Alcoholic Liver Disease: The Gut Microbiome and Liver Crosstalk
P Hartman et al Alcohol Clin Exp Res 2015 My 39(5) 763-775
3) Circadian clock period inversely correlates with illness severity in cells from patients with alcohol disorders
McCarthy et al alcohol Clin Exp Res 2013 37(8) 1304-10