Mr. Wilko is a 40-year-old salesperson with a wife and three teenage children. He has recently begun to have a beer at lunch and a few drinks after work to reduce his work-related stress. An economic downturn in the housing industry has reduced the need for new home appliances and his income and sales record has been affected. Several other salespeople have been laid off at his firm. He has been told that if his sales and attendance records do not improve he will be fired. He and his wife are constantly arguing about finances and the children’s increasing demands for money. His drinking has increased to several beers at lunch and continued drinking after dinner. When he returns to work with alcohol on his breath, he is dismissed from his job. He continues to consume alcohol during the day as he attempts a job search. His wife is very concerned, as are his teenage children. Mr. Wilko states he is a social drinker and “can stop at any time.” How accurate is his self-assessment? What stressors are present in Mr. Wilko’s case? Why does Mr. Wilko continue to increase his alcohol intake? What changes in liver function can Mr. Wilko expect if he continues to drink large amounts of alcohol? Mr. Wilko complains to his wife that all the stress is causing “indigestion.” How do stress and alcohol consumption affect GI function? Why is Mr. Wilko at greater risk of trauma?
Expert Solution Preview
Introduction:
Mr. Wilko, a 40-year-old salesperson, is currently facing numerous stressors in his life such as financial troubles, job insecurity, and family conflicts. As a result, he has turned to alcohol as a coping mechanism to relieve his work-related stress. However, his drinking has escalated to the point where it is negatively impacting his career, relationships, and health. In this response, we will address various aspects of Mr. Wilko’s situation, including the accuracy of his self-assessment regarding his drinking, the stressors contributing to his behavior, the effects of alcohol on liver function, the impact of stress and alcohol on gastrointestinal (GI) function, and his increased risk of trauma.
1. How accurate is Mr. Wilko’s self-assessment of being a social drinker who can stop at any time?
Mr. Wilko’s self-assessment of being a social drinker who can stop at any time is likely not accurate. His increased alcohol consumption, especially during the daytime and in larger amounts, suggests problematic drinking behavior. Furthermore, his inability to stop drinking even when it negatively impacts his work and family life indicates a loss of control over his alcohol intake. This suggests that Mr. Wilko may be developing an alcohol use disorder rather than being a social drinker.
2. What stressors are present in Mr. Wilko’s case?
Mr. Wilko is facing multiple stressors in his life. These include the economic downturn in the housing industry leading to financial difficulties and job insecurity. The pressure to improve his sales and attendance records to avoid being fired adds to his stress. Family conflicts revolving around financial issues and increasing demands from his teenage children also contribute to his stress levels.
3. Why does Mr. Wilko continue to increase his alcohol intake?
Mr. Wilko may be increasing his alcohol intake as a maladaptive coping mechanism to deal with the stressors in his life. Alcohol initially provides him with temporary relief and relaxation. However, due to the addictive nature of alcohol and its impact on brain chemistry, he may develop a tolerance, requiring increased amounts to achieve the same level of desired effects. Additionally, alcohol can act as a form of self-medication to numb emotional pain and escape from his problems temporarily.
4. What changes in liver function can Mr. Wilko expect if he continues to drink large amounts of alcohol?
Continued heavy alcohol consumption can lead to liver damage, including fatty liver, alcoholic hepatitis, and eventually, alcoholic cirrhosis. These conditions involve inflammation, scarring, and irreversible damage to liver cells. Liver function tests may reveal elevated liver enzymes, indicating liver dysfunction. Additionally, alcohol-related liver disease can impair the liver’s ability to detoxify harmful substances, leading to a higher risk of metabolic disturbances and compromised overall health.
5. How do stress and alcohol consumption affect GI function?
Both stress and alcohol consumption can adversely affect GI function. Stress triggers the release of stress hormones, such as cortisol, which can alter GI motility, increase acid production, and lead to conditions like irritable bowel syndrome (IBS) and acid reflux. Alcohol, on the other hand, irritates the GI tract lining, disrupts the balance of gut bacteria, and impairs the absorption of nutrients. Chronic alcohol use can also contribute to the development of gastritis, ulcers, and digestive disorders.
6. Why is Mr. Wilko at greater risk of trauma?
Mr. Wilko is at a greater risk of trauma due to the combination of increased alcohol consumption and his likely impaired judgment and coordination while under the influence. Alcohol impairs cognitive and motor functions, which can result in accidents and injuries, especially when undertaking tasks that require precision and attention. The presence of alcohol in his system during job searches and activities throughout the day further increases the risk of accidents and potential harm to himself and others.
In conclusion, Mr. Wilko’s self-assessment regarding his drinking is likely inaccurate, and his increased alcohol consumption can be attributed to his attempt to cope with various stressors in his life. Continued heavy alcohol intake can result in liver damage, while stress and alcohol can both disrupt GI function. Furthermore, Mr. Wilko’s increased risk of trauma is due to impaired judgment and coordination resulting from alcohol use.
