Siegmund S V, Singer M V
II. Medizinische Universitätsklinik, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg, Universitätsklinikum Mannheim.
Z Gastroenterol. 2005 Aug;43(8):723-36. doi: 10.1055/s-2005-858257.
The oesophagus, stomach and pancreas are primary target organs for ethanol-related diseases. In the oesophagus and stomach, ethanol induces motility disorders and mucosal lesions that are dose-dependent and reversible under acute conditions. Chronic consumption of alcohol causes a significant increase in the risk for squamous carcinoma of the oesophagus. All of these effects are mainly caused by direct contact of alcohol or its metabolite acetaldehyde with the mucosa. Non-alcoholic components are responsible for many effects of alcoholic beverages, including the powerful stimulation of gastric acid secretion by beverages that are produced by fermentation. In the exocrine pancreas, alcohol induces secretory alterations that are mainly affected by the manner and duration of alcohol exposure, the additional administration of food, the type of beverage or the basal secretory state of the gland. Because the pancreas is not topically exposed to ethanol, these ethanol effects on pancreatic secretion are primarily caused by systemic cholinergic mechanisms of the vagus nerve. Chronic alcohol abuse may cause chronic alcoholic pancreatitis after recurrent subclinical inflammatory episodes. Genetic predispositions are believed to play an additional role in the pathomechanism of the disease. In contrast to the cardiovascular system, moderate consumption of alcoholic beverages does not have any beneficial health effects on the oesophagus, stomach or pancreas. Future research needs to define the exact molecular mechanisms and the role of different genetic predispositions for alcohol-induced diseases as well as the effects of the non-alcoholic components of alcoholic beverages.
食管、胃和胰腺是与乙醇相关疾病的主要靶器官。在食管和胃中，乙醇会引发运动障碍和黏膜损伤，这些在急性情况下是剂量依赖性且可逆的。长期饮酒会显著增加患食管鳞状细胞癌的风险。所有这些影响主要是由酒精或其代谢产物乙醛与黏膜的直接接触引起的。酒精饮料的许多作用是由非酒精成分导致的，包括发酵产生的饮料对胃酸分泌的强烈刺激。在外分泌胰腺中，酒精会引发分泌改变，这主要受酒精接触的方式和持续时间、食物的额外摄入、饮料类型或腺体的基础分泌状态影响。由于胰腺并非局部暴露于乙醇，这些乙醇对胰腺分泌的影响主要是由迷走神经的全身性胆碱能机制引起的。长期酗酒在反复出现亚临床炎症发作后可能导致慢性酒精性胰腺炎。遗传易感性被认为在该疾病的发病机制中起额外作用。与心血管系统不同，适量饮用酒精饮料对食管、胃或胰腺没有任何有益的健康影响。未来的研究需要确定酒精诱导疾病的确切分子机制以及不同遗传易感性的作用，以及酒精饮料中非酒精成分的影响。
