Inflammation

According to this inflammatory hypothesis of alcoholism, the detrimental effect of excessive alcohol begins when heavy drinking changes the intestinal microbiome and increases gut permeability, causing a leaky gut. This allows endotoxin, the debris from dead bacteria in the gut to enter the blood stream.  This can cause liver inflammation and cirrhosis.  Sometimes this can also cause inflammation of the brain, called neuro-inflammation. A lousy diet may exacerbate this process. Such a diet, which often contains excessive omega-6 fat (the kind of fat in corn, soy, and peanut oils),  and also processed food with no fiber — can inhibit healthy bacterial diversity and promote overgrowth of bacteria that give more endotoxin. High fructose corn syrup also promotes increased inflammation from endotoxins.  Our brain, and therefore our mood, can be affected by inflammation and by the brain repair stress signals such as Corticotropin-releasing hormone (CRH), cortisol, and inflammation messenger molecules called cytokines. 

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The term “cytokine” is a generic name for a diverse group of signaling molecules which influence cells throughout the body. Inflammation promoting cytokines are part of the normal response to germs in the body. Inflammatory cytokines make us feel sick, and the inflammatory response they cause is sometimes called the "sickness response".  We all know what it feels like when we get sick; there are common features of many illnesses including a lack of appetite, body aches, and depressed mood.  Inflammatory cytokines cause these symptoms when we get the flu or even after we get vaccinated. Cytokines can also reduce the production of brain signaling molecules, i.e. neurotransmitters such as serotonin. This contributes to the growing evidence that depression can be thought of as a form of brain inflammation.

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Our diet can influence this process by changing the bacteria which normally live in our gut, or by causing a “leaky gut”.  A leaky gut can increase inflammatory cytokines in the blood and can encourage a generalized inflammatory response.  This an area of active research, and it is clear that as scientists learn more, we will need to re-think many traditional beliefs about what constitutes a healthy diet.
 

The most current scientific hypothesis of alcohol use disorder appreciates that the inflammatory process is key to understanding why people with alcohol use disorder lose their control over alcohol. 

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This diagram summarizes the "inflammatory hypothesis" of Alcoholism: