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Study: Alcohol use may be behind pandemic’s impact on gastrointestinal, liver diseases

There has been no shortage of anecdotal evidence that drinking increased during lockdown, but now a documented surge in alcohol-related gastrointestinal and liver disease consultations suggest to Brown University researchers that heavy drinking occurred during the pandemic.

Doctor visits dropped during lockdown while consultations for alcohol-related gastrointestinal issues and liver disease soared according to Dr. Waihong Chung, lead researcher of the study and a research fellow for the Division of Gastroenterology at the Warren Alpert Medical School of Brown University in Providence, Rhode Island.

Chung presented his team’s finding during a Thursday briefing hosted by Digestive Disease Week (DDW) 2021.

During the pandemic lockdown, the total number of gastrointestinal, or GI, consults was down 27% compared to the previous year.

“But, the proportion of consults for alcohol related GI and liver disease increased sharply — by about 60%,” he said. “In particular, we saw about a 53% increase in acute alcohol hepatitis, which is a very serious condition with a very high short term mortality.”

Alcohol-related GI liver disease includes conditions such as acute alcohol pancreatitis, alcoholic cirrhosis, alcoholic gastritis and alcoholic esophagitis.

Chung believes the study is an accurate reflection of what also happened in other urban and suburban areas across the U.S., because it involved nearly 1,300 records from a systemwide audit of the largest health system in Rhode Island.

During the reopening phase, the number of GI consults returned to pre-pandemic levels and consults for alcohol-related GI and liver diseases remained highly elevated by about 80%.

“More impressively, the relative volume of patients presenting with acute alcoholic hepatitis has more than doubled compared to the prior year,” Chung said. Case counts were up 127.2% compared to 2019.

The number of people needing inpatient endoscopic procedures was considerably higher, 34% compared to 12.8% in 2019. There also were worse outcomes from blood count liver function tests.

“In further analysis, we noted that during the lockdown phase, the majority of admissions for alcohol-related GI and liver diseases clustered around weeks five, six and seven of lockdown,” Chung said. “This timeframe mirrors the length of time it takes for symptoms to appear for these diseases, suggesting the start of the pandemic may have had an impact on patients’ alcohol consumption.”

Because many people who have alcohol-related diseases aren’t admitted to a hospital right away or at all, researchers believe health problems related to increased alcohol use may be even higher in the community.

Chung said alcohol use often is a manifestation of other problems such as mental health issues, anxiety or depression. He believes all doctors should talk with patients about alcohol use much like they routinely do blood pressure checks.

“And, identify people who might need help — sooner rather than later,” Chung said.


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