alcohol

Question

How is it with alcohol use and cystic fibrosis ?

Answer

Thank you for this interesting question. Everybody knows that alcohol abuse can damage organs such as the brain, the liver, the heart, muscles, the intestines, the nerves and the pancreas. The damage to the pancreas can lead to diabetes and/or pancreatitis. On top of that you can get sick from lack of vitamins.
Compared to people who don’t abuse alcohol, people who are chronic drinkers more frequently get acute and chronic pancreatitis. Chronic alcohol abuse is considered if you consume more that 80g of alcohol/day for women or more than 100 g/day for men (one alcoholic drink contains about 10 gr of alcohol). Not everybody who drinks too much will get pancreatitis: only 5-10% of chronic drinkers will develop chronic pancreatitis. Other factors such as environmental and genetic ones –besides the alcohol (ab)use -will determine whether you get pancreatitis. It is for instance known that people who get pancreatits from excess alcohol use have more often minor changes in the CFTR gene, called polymorphisms (read more in ‘CFTR Polymorphisms in Patients with Alcoholic Chronic Pancreatitis, Pancreatology 2009;9:173–181’). This CFTR gene is the gene that is associated with cystic fibrosis. This means that people with changes in the CFTR gene are more prone to develop pancreatitis. In 2005 the use of alcohol was also examined in a group of CF patients before and after lung transplant (read more in ‘Tobacco and alcohol use in lung transplant candidates and recipients. Clin Transplant 2005: 19: 207–214’). Before transplant about 80% of patients said to have used alcohol in the past. After the lung transplant 30% of people consumed alcohol but ‘never excessively’. In some lung transplant programs one is advised not to use more than 2 alcoholic beverages a day. This is in agreement with the general health advice about alcohol use which states that you should not use more than 8-20 g alcohol per day i.e. one consumption per day for women and two consumptions per day for men. Additional concern in transplant patients is that apart from the use of alcohol, high dose steroids will increase the risk of osteoporosis. Research in patients before and after lung transplant and also in patients with other organ transplants has demonstrated that alcohol consumption can be problematic and that addiction also in these patients does occur. It wasn’t however specified ‘how much alcohol use’ was meant in this cohort of subjects.
A last point of advice concerns the use of alcohol when one takes medicines. Sometimes alcohol will inhibit the action of the drug and sometimes the action will be increased. The drug leaflet will always have information about this. This is of course very important in patients with CF because they use many medicines.
To conclude: it is important to warn against excessive alcohol use. In the majority of CF patients the pancreas is already damaged and one should prevent that the body is being stressed additionally by external factors such as alcohol abuse.
I. Bronsveld

13.07.2009