The pathological anatomy of alcoholic disease

The problem of alcohol abuse is high on the agenda for the whole world both medically and socially. However, the fight against this disease is less than effective, mostly due to the fact that its solution has been left to psychiatrists and experts in narcology. They are making attempts to treat alcoholism, a disease which results from long-term, chronic alcohol intoxication and alcohol dependence. What is missed here is a long period of excessive use of hard drinks characterized by alcohol cravings with no alcohol dependence; this period is called “excessive alcohol consumption”. Based on the results of 1113 autopsies of patients aged 18 to 73 years who died at home or in a hospital, the authors propose the concept of the alcohol disease, whose pathogenesis consists of 3 stages: stage 1, episodic alcohol intoxication, stage 2, excessive alcohol drinking, and stage 3, alcoholism and its complications. The article describes the changes over time that can be found in the liver, vessels and other organs. The authors emphasize that the formation of Mallory bodies (auto-antigens), mainly in the stage of alcoholism, triggers an irreversible autoimmune inflammatory reaction explaining an extremely poor effect of alcoholism treatment. In this regard, excessive alcohol drinking is being suggested as a separate stage, which should be treated by internists.