![]() ![]() Pathophysiology Alcohol flush reaction as a result of the accumulation of acetaldehyde, the first metabolite of alcoholĪfter being ingested, the ethanol in alcoholic beverages is first converted to acetaldehyde by the enzyme alcohol dehydrogenase and then to acetic acid by oxidation and egestion process. Some complex organic molecules found in alcoholic beverages known as congeners may play an important role in producing hangover effects because some, such as methanol, are metabolized to the notably toxic substances formaldehyde and formic acid. Additional associated phenomena are dehydration, metabolic acidosis, disturbed prostaglandin synthesis, increased cardiac output, vasodilation, sleep deprivation and insufficient eating. Several pathophysiological changes may give rise to the alcohol hangover including increased levels of acetaldehyde, hormonal alterations of the cytokine pathways and decrease of the availability of glucose. The processes which lead to hangovers are still poorly understood. Drowsiness and impaired cognitive function are the two dominant features of alcohol hangover. Some symptoms such as changes in sleep pattern and gastrointestinal distress are attributed to direct effects of the alcohol intoxication, or withdrawal symptoms. Hangover symptoms validated in controlled studies include general malaise, thirst, headache, feeling dizzy or faint, tiredness, loss of appetite, nausea, stomach ache, and feeling as though one's heart is racing. Alcohol hangover symptoms develop when blood alcohol concentration falls considerably and peak when it returns to almost zero. Signs and symptoms A painting from 1681 showing a person affected by vomiting, a typical symptom of alcohol hangoverĪn alcohol hangover is associated with a variety of symptoms that may include drowsiness, headache, concentration problems, dry mouth, dizziness, gastrointestinal complaints, fatigue, sweating, nausea, hyper-excitability, anxiety, and a feeling of general discomfort that may last more than 24 hours. ![]() A hangover may also impair performance during potentially dangerous daily activities such as driving a car or operating heavy machinery. The socioeconomic consequences of hangovers include workplace absenteeism, impaired job performance, reduced productivity and poor academic achievement. Avoiding alcohol or drinking in moderation are the most effective ways to avoid a hangover. Though many possible remedies and folk cures have been suggested, there is no compelling evidence to suggest that any are effective for preventing or treating hangovers. The symptoms usually occur after the intoxicating effect of the alcohol begins to wear off, generally the morning after a night of heavy drinking. Beverage-specific effects of additives or by-products such as congeners in alcoholic beverages also play an important role. While the causes of a hangover are still poorly understood, several factors are known to be involved including acetaldehyde accumulation, changes in the immune system and glucose metabolism, dehydration, metabolic acidosis, disturbed prostaglandin synthesis, increased cardiac output, vasodilation, sleep deprivation, and malnutrition. Typical symptoms of a hangover may include headache, drowsiness, concentration problems, dry mouth, dizziness, fatigue, gastrointestinal distress (e.g., nausea, vomiting, diarrhea), absence of hunger, light sensitivity, depression, sweating, hyper-excitability, irritability, and anxiety. ![]() Hangovers can last for several hours or for more than 24 hours. A hangover is the experience of various unpleasant physiological and psychological effects usually following the consumption of alcohol, such as wine, beer, and liquor. ![]()
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