アルコール性胃病変

Acute Gastric Changes Due to Alcohol Beverages

　酒は古代より人類の信仰や日常生活と密接な結びっきをもっ飲料である．酒の害を説く声よりこれを称える讃歌が大きく響き，世間では二日酔いの苦しみもものかは懲りることなく飲み続ける人が多い．酒が胃に悪影響を及ぼす証拠を印象付ける報告も少く，一過性の異常があってもあまり害はないのではないかと錯覚を起すほどである．しかし，種々の臓器，とくに肝膵心にアルコールが関係して障害を与えることは明らかである．アルコールが胃にどのような変化を及ぼすか知るところは少ないが，アルコールの貯留，吸収の第一の関門となる胃に何らかの影響があろうとの推定は成立っであろう．ここに改めて日常のアルコール飲料飲用が胃粘膜に及ぼす影響や変化を協同研究者田中の報告を含めて検討報告する．

　A study has been made of the effects alcoholic intaken on the gastric mucosa. Also have been collected and tabulated 18 cases of erosion or ulcer in the stomach developing within 24 hours after alcoholic intake with chief complaints of hematemesis and epigastric pain. The effect of a single drink on the gastric mucosa has also been studied in 29 cases by endoscopy combined with biopsy both before and after drinking. The relationship between ingestion of alcoholic drink and atrophy of the gastric mucosa has been investigated too. A usual drink often causes acute changes in the stomach. Less frequently, but more severe symptoms may occur with resultant erosive ulcer. The amount of alcoholic intake and the level of alcohol in the blood were both seemingly related with the appearance of acute gastric changes, but no definite proof has been demonstrated. Changes in the tissue as revealed by biopsy included edema, exerosis, dilated capillary vessels, engorgement, accelerated mucus production, increased erosion in the “Leistenspitze”, swollen basal membrane, degeneration of glandular epithelium, inflammatory cellular infiltration, especially with xeudate of neutrophile cells.

Some relationship was seen between alcoholic intake and chronic gastritis. In a group of drinkers the degree and extent of mucosal atrophy were mostly extensive, while in a teetotalist group atrophy was at time slight, but still at present a definite conclusion can not be drawn.

　In order to study the behavior of the gastric mucosa on alcoholic intake, one should first investigate functional attitude of the mucosa toward alcohol, its biochemical aspects, changes to be seen on the cellular level, or even on molecular level, and only then should one retrospectively study the gastric mucosa on the macroscopic as well as on optical microscopic level.