Yes, entero-hepatic circulation helps catch and detoxify compounds as they are absorbed through the upper GI tract. However, the liver processes ethanol through the alcohol dehydrogenase path at a rate of 0.015 %/hr. It doesn’t matter if the liver recieves the ethanol through the e-h circulation or through other arteries/veins. The rate of detox is limited by enzyme kinetics that can’t be changed by blood supply, coffee or exercise or any other “cure”. If the above quote was true, then the liver would clear ethanol very quickly, and we’d never get drunk. The enhanced effects of an alcoholic enema would be due to a bolus dosage of ethanol, not unlike the “beer bongs” I saw in college that allowed one to get roaring drunk on one or two beers, consumed within a, say, ten minute period.
Somehow, the mental picture of a few folks kneeling on a table, knickers to their knees, butts pointed towards a cluster of little glasses with colored umbrellas in them, straws in their sphincters, just doesn’t sound like a party to me. :eek:
You raise a good point Vlad/Igor, but the rate you cited (0.015%/hr) must be a (typical) maximum at saturation (the physiologic BAC analogue of Vmax). IIRC, there’s nothing quirky about the kinetics/control of alcohol dehydrogenase, or alcohol transport to vary it from the standard Michaelis Menton kinetics.
I do not know what BAC ([EtOH]) saturates hepatic alcohol dehydrogenase, but I suspect it’s well into the inebriation range. Since we’re talking about reaching inebriation, we should still be in the concentration-dependent regime. [EtOH] is significantly higher in the portal hepatic vein than in the systemic circulation (the blood already contains systemic levels before absorbing more) , so e-h absorption should clear faster (in absolute terms) than rectal absorption in the first pass.
“First pass” hepatic clearance (metabolism, conjugation, whatever) is a major issue in clinical pharmacology, specifically discussed for each drug/class in the more comprehensive references. It isn’t our friend when the “toxin” is a medical drug administered orally. Some drugs are administered IV instead of PO for precisely this reason (or because of the flipside: increased hepatotoxicity at the higher e-h concentration)
I’ll think about this a bit. I must have the Km for alcohol dehydrogenase around here somewhere. That will clear up a lot. Let me know if I missed anything.
That I don’t know, but I suspect that the saturation point is somewhere below “inebriation” (a relative term, as I’ve had perfectly lucid conversations with long-term alcoholics with a BAC of 0.1%). Saturation has to be measured as a function of organ mass; that is, the liver contains millions of these enzymatic pathways, not just one. You can clear one beer a bit faster than several beers, but probably not much faster.
I was going to disagree with this at first, but re-reading, I see what you’re saying. In absolute terms, yes, the concentration of ethanol in the portal vein is higher, but if the ADH system is already saturated, it doesn’t make any dofference. Alcohol has a very low volume of distribution, compared to digoxin, which I know from personal experience you have to pound with a sledghammer all day to get it into solution.
Yeah, if you infused a large enough volume with a large percentage of alcohol, you’d kill off your intestinal normal flora, and possibly wind up with the trots. I suppose you could try to make your own transdermal patch by soaking a band-aid ™ pad in pure-grain, and then putting the band-aid ™ on. Not that I’m suggesting anyone should try this, or condoning it, but it might work.
Author Tom Dorsey used rectal administration of alcohol to great effect in one of his Floride crime novels. Florida Roadkill, I believe. The “hero” of the novel deals with a violent homophobe by administering a massive vodka enema, then advising him that the only way he will live out the hour is if he can convince someone to give him an enema. In Key West. On New Year’s Eve. Drunk.
I can’t get the image of waitresses doing handstands out of my head.
"Pink lady in the front, mudslide in the backs. Straws have already been inserted for your convenience.’
Or worse
“Mudslide.”
“Be right up.” The bartender jumps up and down, and swivels his hips. He then holds a glass under his buttocks and------------- I can’t bring myself to type the rest.
BTW- Did anybody get the horrible pun in my Russian post?
Yesterday my friends and I were drinking, and my friend sat on a beer can by accident. I joked, “There are easier ways to get drunk.” Then I said, jokingly, “Imagine if it turned out that you could get drunk really easily by pouring it in your ass, and people did it just to get drunk for cheap?” I can’t believe that people actually do this, and that it works.
