Alcoholism - Diagnosis

A number of factors may lead a doctor to suspect that an individual is an alcoholic. First, a person may seem to be accident-prone because they repeatedly report unexplained accidents and injuries. In some cases, an alcoholic's family may intervene and alert a physician. In other instances, an individual may realize the need for medical attention. The problem rests not so much with the amount of alcohol a person consumes, but with how alcohol consumption affects the person's well-being, job, educational goals, relationships, and family life.

One technique used by some doctors is called the CAGE questionnaire. It consists of four questions about the patient's drinking patterns:

• Have you ever tried to C ut down on your drinking?
• Have you ever been A nnoyed by anyone's comments about your drinking?
• Have you ever felt G uilty about your drinking?
• Do you ever need an E ye-opener (a morning drink of alcohol) to start the day?

Based on personal interviews and family history, a doctor may diagnose one of two forms of alcoholism: alcohol dependence or alcohol abuse. In the case of alcohol dependence, a person literally seems to depend on alcohol consumption to get through a day. Some characteristics of alcohol dependence include the following:

• Increasing tolerance for alcohol, meaning that a person has become accustomed to consuming a certain amount of alcohol each day and must gradually increase that amount over time.
• Inability of a person to stop drinking without experiencing unpleasant physical and psychological effects.
• A tendency to over drink, meaning that a person consistently drinks more alcohol than he or she really intended or is unable to stop once he or she begins.
• Inappropriate drinking patterns, which include setting aside large blocks of time to drink, drinking instead of performing expected tasks such as attending school or work, or continuing to drink even when the person realizes that his or her job, education, or relationships are being affected.

Alcohol abuse leads to physical, medical, legal, or other kinds of problems as a result of alcohol consumption. A person who abuses alcohol may experience:

• Physical endangerment, such as driving while drunk
• Legal difficulties
• Problems in personal relationships or at work

Physical Signs of Alcoholism

Some surface signs of excessive alcohol consumption include broken capillaries (small blood vessels) on the face, a raspy voice, trembling hands, and chronic diarrhea. Upon further physical examination, a doctor may uncover some additional physical signs of alcoholism. Such signs include a visible network of enlarged veins just under the skin around the navel, fluid in the abdomen, a yellowish tone to the skin, decreased size of the testicles, and poor nutritional health. Laboratory studies may reveal an increase in the size of red blood cells, a reduced number of white blood cells, and an increase in the number of certain liver enzymes.