Alcohol disease 'hits young hard'

By Branwen Jeffreys, Health correspondent, BBC News

Doctors are seeing rising numbers of patients in their late teens and early twenties with severe alcohol-related disease, many of them women.

Of 115 specialists who replied to a BBC questionnaire, 77 said they had treated at least one patient aged under 25.

Many said the social acceptability of heavy drinking was the most important influence on young people.

The warning comes as a new alliance calls for a rise in alcohol taxes, and a bar on TV advertising before 9pm.

Twenty-four organisations, representing doctors and charities, have joined together to form the Alcohol Health Alliance.

It wants the government to make alcohol misuse a higher priority.

Public health minister Dawn Primarolo said the government had already drawn up a plan for concerted action.

The drink industry says alcohol consumption is falling, and that increasing the cost would hit the majority of people who enjoy a drink in moderation.

Generational shift

The comments of the specialists who responded to the BBC reveal a generational shift on hospital wards around the UK.

Whereas before most hospital consultants would have seen patients in their fifties or sixties in the past, they now describe seeing patients in their early twenties with alcohol-related hepatitis, and women whose livers are permanently damaged with the scarring known as cirrhosis by the time they are 30.

Dr Jonathan Mitchell, a consultant hepatologist in Plymouth, is one of the specialists who contacted the BBC.

He said many of his patients did not realise the permanent damage to their health caused by regular heavy drinking.

Until it reaches a critical stage most liver disease is virtually without symptoms.

Dr Mitchell said: "I've seen patients who've been admitted with pretty catastrophic bleeding from stomach and oesophagus with no prior warning of a problem of their liver.

"Others may present with jaundice or swelling of the abdomen because there's a lot of fluid in the abdomen.

"All these three things are signs of quite advanced liver disease and can come out of the blue."

Heavy drinking 'normal'

Fatty deposits gradually build up on the liver as alcohol interferes with the way it would normally be processed.

What follows is an inflammation within the liver which often leads to low grade hepatitis.

Although the liver has a remarkable capacity to regenerate the damage eventually reaches the stage where the scarring permanently alters the structure of the liver.

For some patients this will lead to an agonising wait on the liver transplant waiting list before they are forty.

He is not alone in his concerns that the normalisation of heavy drinking is putting a generation at risk from a silent killer.

Of the 115 consultants who contacted the BBC 101 said there had been an increase in the number of patients they were seeing for alcohol-related disease.

The shift in the age profile of their patients is also very marked, with 77 saying they had treated a patient under the age of 25.

Worrying snapshot

The doctor's responses are a depressing snapshot of the ages and condition of the patients they see:

• 24-year-old woman with advanced cirrhosis who died
• 25-year-old with advanced alcoholic cirrhosis
• 19-year-old female with end stage liver disease
• 21-year-old who died from acute alcohol poisoning.
  
  

While attention is often focused on the social disorder caused by binge drinking, many doctors say the serious health effects are not given enough attention.

Professor Ian Gilmore, president of the Royal College of Physicians, is one of the leading figures in the new campaign.

He said: "If you look at the burden of damage to society, it's hugely greater for alcohol than for drugs, but the majority of money has always gone on drugs, partly because of the strong link to crime."

Government view

The government has recently beefed up its Home Office target for reducing harm from alcohol.

It has also introduced a cross-departmental Alcohol Strategy.

This includes a public information campaign to promote sensible drinking, an independent review of alcohol pricing and promotion, toughened enforcement of underage sales by retailers and plans to introduce more help for people who want to drink less.

Dawn Primarolo, the public health minister, said the government had introduced a comprehensive strategy to tackle problem drinking.

She said tax on alcohol in the UK was already the second highest in Europe, and only about 1% of pubs had extended opening hours since extended licensing laws were introduced.

A bigger problem was the discounting of prices by supermarkets and off licences.

She said: "We're looking at where it's available, who it's available to, how it's being marketed, what the targeting is and what we can do to give clear messages and to make those who are selling it responsible."