{"id":17683,"date":"2018-08-30T12:37:45","date_gmt":"2018-08-30T17:37:45","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=17683"},"modified":"2023-03-22T14:49:43","modified_gmt":"2023-03-22T19:49:43","slug":"why-are-more-young-women-getting-cirrhosis","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/healthcare-trends\/why-are-more-young-women-getting-cirrhosis\/","title":{"rendered":"Why Are More Young Women Getting Cirrhosis?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">A divorce at 28 left Sara* in emotional turmoil. In search of a distraction from her personal life, she turned to Chicago\u2019s lively bar scene. Drinking holes were judgment-free zones, and Sara found a bar for every activity: \u201cYou could go to watch a football game, read a book, drink with friends.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Soon enough, imbibing became Sara\u2019s private pastime too. She\u2019d stock up on cheap grocery-store vodka, drinking up to a liter a day. At age 31, three years after ending her marriage, Sara was diagnosed with alcohol-related hepatitis and cirrhosis, according to Dr. Haripriya Maddur, her hepatologist at Northwestern Memorial Hospital.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The diagnosis came as a shock to Sara, who had no idea she\u2019d put herself at risk for such serious diseases. \u201cYou don\u2019t think it will happen to you,\u201d she said. \u201cYou don\u2019t realize the liver doesn\u2019t flush everything out.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In recent years, the same diagnosis has come as a shock to a growing number of patients in their 20s and 30s, as cases of alcohol-related cirrhosis rise among millennials. This alarming trend caught the attention of Dr. Elliot Tapper and Dr. Neehar Parikh, both hepatologists at the University of Michigan, in 2017. Given that alcohol-related liver disease has traditionally been concentrated in people over 65, the two doctors decided to investigate further. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Their subsequent study findings, published in<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><em><a href=\"https:\/\/www.bmj.com\/content\/362\/bmj.k2817\"><span style=\"font-weight: 400;\">BMJ<\/span><\/a><\/em><span style=\"font-weight: 400;\"> in July, were surprising enough to garner <\/span><a href=\"https:\/\/www.nbcnews.com\/health\/health-news\/deaths-liver-disease-are-surging-drinking-blame-n892521\"><span style=\"font-weight: 400;\">national coverage<\/span><\/a><span style=\"font-weight: 400;\">: The greatest increase in deaths from alcohol-related cirrhosis between 2009 and 2016 was found in people aged 25 to 34. Within that age group, the rate of death had risen 13 percent in women, compared to 9 percent in men. In 2016, 209 millennial women died from cirrhosis, compared to 66 in 2008. Although we assume that those assigned female at birth have similar risks, we have no cirrhosis data about transgender men. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cMore men are dying, but the increases are faster for women,\u201d Tapper said, noting that the absolute number of cirrhosis deaths doesn\u2019t reveal the full scope of the situation. While he and Parikh focused on cirrhosis in their study, a growing number of millennial women are also incurring other <a href=\"https:\/\/www.cdc.gov\/alcohol\/fact-sheets\/alcohol-use.htm\">alcohol-related diseases<\/a>.\u00a0<\/span>Alcohol consumption can cause a range of health problems, including pancreatitis, heart disease and three types of liver disease:<\/p>\n<ul>\n<li><em>Fatty liver disease<\/em> is marked by a build up of fat cells in the liver. It&#8217;s an acute condition, meaning it can develop after days, weeks or months of heavy drinking. The damage is reversible with abstinence.<\/li>\n<li><em>Alcoholic hepatitis<\/em> (unrelated to infectious hepatitis) is most often caused by prolonged alcohol misuse. Less commonly, it develops after a short period of extreme binge drinking. The severity of liver damage varies, but is usually reversible with permanent abstinence.<\/li>\n<li><em>Cirrhosis<\/em> is severe scarring of the liver caused by conditions including hepatitis and chronic alcoholism. The liver becomes impaired while processing toxins like alcohol, but it can usually repair itself. When it has to process more alcohol than it can handle, however, it begins to scar, a process known as fibrosis. As hard scar tissue replaces healthy tissue, organ function is lost. The damage isn&#8217;t fully reversible.<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For alcohol-related cirrhosis to strike someone in their 20s or 30s, consumption has to be exceedingly high. Cirrhosis in young women tends to surprise both patients and doctors, says Dr. Jessica Mellinger, another hepatologist at the University of Michigan. \u201cThat demographic doesn\u2019t come to mind when you think of someone with alcoholism.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Often, changes in appearance are what motivate young women with early-stage cirrhosis to see a doctor. \u201cA lot of concern from the patient\u2019s standpoint,\u201d said Maddur, &#8220;is about why they&#8217;re\u00a0<\/span><span style=\"font-weight: 400;\">losing their hair and why they&#8217;re<\/span><span style=\"font-weight: 400;\">\u00a0getting skinnier.'&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Those were two of the symptoms Sara noticed before her diagnosis. She was also having<\/span> <span style=\"font-weight: 400;\">trouble with her memory and balance, and itching all over her body as a result of peripheral neuropathy (nerve damage). And she had severe pain in her belly from built-up abdominal fluid, called ascites. By the time Sara took herself to the emergency room, her stomach was distended to the point where she looked pregnant. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cMy symptoms built up,\u201d she said, \u201cand then overnight, my body just quit.\u201d<\/span><\/p>\n<h2>Why the uptick?<\/h2>\n<p><span style=\"font-weight: 400;\">Without a partner and with limited social support, Sara worried her future would be<\/span><span style=\"font-weight: 400;\"> a lonely and difficult road. Drinking eased the stress. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">She\u2019s far from the only 30-something feeling stressed about the future. <\/span><span style=\"font-weight: 400;\">According to a<\/span><a href=\"http:\/\/www.pewresearch.org\/fact-tank\/2017\/09\/06\/5-facts-about-millennial-households\/\"> <span style=\"font-weight: 400;\">Pew report<\/span><\/a><span style=\"font-weight: 400;\">, millennials have more student loan debt, higher poverty and unemployment levels, and lower income levels than any previous generation at the same stage of life. Generational stressors prompted by the recession, Parikh and Tapper surmise, may be a factor in climbing rates of deaths from cirrhosis. But they\u2019re reluctant to blame the rise solely on an economic downturn, particularly because their<\/span><span style=\"font-weight: 400;\"> patients vary in terms of income and education. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">In fact, according to data from the<\/span><a href=\"http:\/\/hcupnet.ahrq.gov\/\"> <span style=\"font-weight: 400;\">National Emergency Department Sample<\/span><\/a><span style=\"font-weight: 400;\">, the <\/span><i><span style=\"font-weight: 400;\">Washington Post<\/span><\/i><span style=\"font-weight: 400;\"> found that<\/span><a href=\"https:\/\/www.washingtonpost.com\/news\/national\/wp\/2016\/12\/23\/nine-charts-that-show-how-white-women-are-drinking-themselves-to-death\/?utm_term=.ee1b3f56f425\"> <span style=\"font-weight: 400;\">women from wealthier neighborhoods<\/span><\/a><span style=\"font-weight: 400;\"> are much more likely to show up at the hospital for alcohol intoxication than lower-income women. Additionally, 31 percent of the women with a college degree reported drinking multiple days a week, compared to 21 percent of women with some college and 14 percent of women with a high school education or less. \u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A contributing factor, experts speculate, might be a lack of awareness around healthy consumption limits. \u201cMaybe they don\u2019t know what a glass of wine really means,\u201d says Mellinger. \u201cAnd if they have one drink a day, how big is that one drink?\u201d <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Those recommended limits are lower than you might think: no more than eight drinks per week for women, per the\u00a0<a href=\"https:\/\/pubs.niaaa.nih.gov\/publications\/brochurewomen\/women.htm\">National Institute on Alcohol Abuse and Alcoholism<\/a>.\u00a0A<\/span> <a href=\"https:\/\/pubs.niaaa.nih.gov\/publications\/brochurewomen\/women.htm\"><span style=\"font-weight: 400;\">standard drink<\/span><\/a><span style=\"font-weight: 400;\"> contains 14 grams of alcohol, which is roughly equivalent to 12 ounces of beer with 5 percent alcohol, 5 ounces of wine with 12 percent alcohol and 1.5 ounces of liquor with 40 percent alcohol.<\/span><\/p>\n<h2>How to know if you\u2019re at risk<\/h2>\n<p><span style=\"font-weight: 400;\">The danger of alcohol-related liver disease is higher for women because of their heightened sensitivity to alcohol. A\u00a0<\/span><span style=\"font-weight: 400;\">woman\u2019s organs are exposed to more alcohol because, pound for pound, women have less water in their bodies than men. With higher alcohol levels in their blood, they are more vulnerable to resulting health problems.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The notion that drinking in moderation promotes heart health is only true for women over 55, according to the<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><a href=\"https:\/\/pubs.niaaa.nih.gov\/publications\/brochurewomen\/women.htm\"><span style=\"font-weight: 400;\">NIAAA<\/span><\/a><span style=\"font-weight: 400;\">. And a r<\/span><a href=\"https:\/\/www.nytimes.com\/2018\/08\/27\/health\/alcohol-drinking-health.html\"><span style=\"font-weight: 400;\">ecent meta-study<\/span><\/a><span style=\"font-weight: 400;\"> published in the <em>Lancet<\/em><\/span> <span style=\"font-weight: 400;\">linked alcohol consumption of any amount with health risks and no benefits.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unfortunately, patients can\u2019t assume that routine checkups will catch alcohol-related health issues. Currently there\u2019s no standard practice for screening people who toe the line of unhealthy drinking. If women regularly cross the eight-drinks-per-week threshold, they should tell a doctor. (And if they\u2019re having a hard time cutting back, there are <\/span><a href=\"https:\/\/www.zocdoc.com\/blog\/how-to-know-when-to-get-medical-help-for-drinking\/\"><span style=\"font-weight: 400;\">alcohol cessation tools and programs<\/span><\/a><span style=\"font-weight: 400;\"> to help.)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Maddur wishes doctors were more proactive. \u201cIt should start with first-line primary care doctors asking people how much they\u2019re drinking,\u201d she said. \u201cIf they\u2019re exceeding the recommended limit, doctors should give them tools with which to minimize their drinking.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Getting tested is smart even if you feel healthy; signs of cirrhosis often don\u2019t show up during the early stages of the disease. Early symptoms include yellowed skin (jaundice), itching, loss of appetite and a swollen abdomen. If drinking continues and the disease advances, symptoms can include degeneration of the brain, severe bleeding, kidney failure and weakness. Diagnosing cirrhosis involves some combination of blood tests, imaging and liver biopsies. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The good news is that the liver has a high capacity to regenerate compared to other organs. After a year of sobriety, Sara\u2019s liver is functioning again. Most of her hair is back, and she\u2019s put on weight and regained her ability to walk. But she can\u2019t resume drinking, ever, and must monitor everything that goes into her body. She also struggles with balance, takes medication for memory problems and sees a neurologist for peripheral neuropathy. Managing these issues, and protecting her liver from further damage, will be a lifelong effort.\u00a0<\/span><\/p>\n<hr \/>\n<p><i><span style=\"font-weight: 400;\">*Name changed by request<\/span><\/i><\/p>\n<hr \/>\n<h1 class=\"p1\" style=\"text-align: center;\"><span class=\"s1\">Ready to book a doctor&#8217;s appointment? Visit <a href=\"https:\/\/www.zocdoc.com\/\"><span class=\"s2\">Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"<p>The alcohol-related liver disease is on the rise among millennials. <\/p>\n","protected":false},"author":28,"featured_media":17532,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[229],"tags":[23,134,93],"class_list":["post-17683","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthcare-trends","tag-drugs-alcohol","tag-gender","tag-public-health","reviewer-dr-nassim-assefi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Why Are More Young Women Getting Cirrhosis? - Healthcare Trends<\/title>\n<meta name=\"description\" content=\"The alcohol-related liver disease, cirrhosis, is on the rise among millennials.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/healthcare-trends\/why-are-more-young-women-getting-cirrhosis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Why Are More Young Women Getting Cirrhosis? 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