Sometimes, when you're at a party, when you're with friends, and you drink a little wine or a beer, nothing happens to some people. But there are others, even if you drink a little, your whole face turns red and you feel uncomfortable. Has that happened to you? So, I'm going to talk about something that's very important to you. That's a condition called alcohol intolerance.
What is alcohol intolerance?
Simply put, this is a genetic condition that we inherit from our parents, related to our body's metabolism. Metabolism is the way our body turns food into energy. It is inherited, meaning that you have inherited a mutated gene from both of your parents. Your parents may not have the condition, but they can pass that gene on to you.
Our bodies have special proteins called enzymes . These are what help us digest the food we eat and create energy. Alcohol intolerance is a problem with a special enzyme that helps us digest alcohol.
This is why even after drinking a little alcohol (ethanol), the face turns red and feels hot. We call this an alcohol flush . This comes with a very uncomfortable feeling for the body.
Don't confuse this with an alcohol allergy!
Many people confuse these two conditions. But these two are two completely different things. It is very important to understand this correctly.
Alcohol intolerance is a genetic metabolic problem. An alcohol allergy is an immune system response.
You can easily understand this difference from the table below.
| Feature | Alcohol Intolerance | Alcohol Allergy |
|---|---|---|
| Reason | A genetic problem related to the digestive system. The body cannot properly digest alcohol. | An over-reaction of the immune system. The body reacts to something in the alcohol (grains, chemicals). |
| Main features | Flushing, nausea, and increased heart rate. | Skin rashes, severe itching, swelling, stomach pain. |
| Seriousness | It's uncomfortable, but usually not life-threatening. | It can be very serious and even life-threatening if left untreated. |
As you can see, the symptoms of an allergy can be very painful and uncomfortable. So if you feel anything unusual after drinking alcohol, don't ignore it. Be sure to see your doctor for advice.
Why is this happening? What is the reason?
To understand this, we need to know a little about how alcohol breaks down inside our bodies.
This is what usually happens when someone drinks alcohol (ethanol):
1. First step: An enzyme called `alcohol dehydrogenase (ADH)` breaks down alcohol.
2. Step 2: The liver converts alcohol into a chemical called acetaldehyde . This acetaldehyde is a toxic chemical that can damage our cells.
3. Third step: Another enzyme called `Aldehyde Dehydrogenase 2 (ALDH2)` comes in and converts that toxic acetaldehyde into harmless acetic acid (acetic acid - which is also found in vinegar).
Now let's see what happens to someone with alcohol intolerance.
They have a mutation in the gene that makes the enzyme ALDH2, which is in the third step. So this enzyme doesn't work properly. What happens then? That toxic acetaldehyde builds up in the body. That's the cause of all those unpleasant symptoms.
What are the main symptoms of this condition?
The main symptom is a reddening of the face called alcohol flushing, but there may be a number of other symptoms.
| Symptom | Description |
|---|---|
| Flushing | The face, neck, and chest become red and feel hot. |
| Nausea and vomiting | Nausea and vomiting with stomach discomfort. |
| Heart palpitations | Feeling like your heart is beating fast (tachycardia). |
| Low blood pressure | Low blood pressure (hypotension). |
| Headache | Severe, throbbing headache. |
| Nasal congestion | A feeling of stuffiness in the nose, like a cold. |
| Diarrhea | Bloating due to digestive problems. |
| Worsening of asthma | If you have asthma, your symptoms may worsen. |
How is this treated and managed?
As mentioned before, since this is a genetic condition, there is no cure for it. It is a lifelong condition. But don't worry. It can be managed.
The best and only way to do that is to completely abstain from alcohol. That's the simplest way to prevent symptoms from occurring.
In addition, you should also be aware of these things:
- Avoid smoking: Smoking can increase the level of acetaldehyde in the body, which further increases the risk of cancer.
- Be careful with certain medications: Alcohol can interact with other medications you are taking and worsen symptoms. So tell your doctor about all the medications you are taking.
- Don't take medication to suppress symptoms: Some people take antacids or antihistamines and then drink alcohol. This only suppresses the symptoms. Then, without you knowing, you drink more alcohol. This increases the damage to the body. This is a very dangerous habit.
What are the risks of drinking alcohol in this condition?
This is not just an inconvenience. If someone with this condition continues to drink alcohol, they are at greater risk of developing serious illnesses.
The body is giving us a warning through these symptoms. Ignoring that warning can lead to serious illnesses in the long run.
Research has found that people with this condition are at increased risk of the following if they drink alcohol:
- Cancer of the mouth and throat (head and neck cancer)
- Liver disease (liver disease such as cirrhosis)
- Late-onset Alzheimer's disease
So, don't dismiss your face turning red or your body getting hot after drinking a little alcohol as "oh, that's normal." It's an important signal your body is giving you.
Take-Home Message
- Alcohol intolerance is a genetic condition, not an allergy.
- This is due to a decrease in the activity of the enzyme ALDH2, which causes toxic acetaldehyde to accumulate in the body.
- The main symptom is a feeling of warmth and redness in the face, neck, and chest after drinking alcohol. In addition, symptoms such as nausea and headache may also occur.
- The best and safest way to manage this condition is to completely abstain from alcohol.
- Ignoring this situation and drinking alcohol significantly increases the risk of developing serious diseases such as oral cancer and liver disease.
- If you experience any of these discomforts when you drink alcohol, talk to your doctor about it.
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