Patient: First of all, I’m asking this question for my girlfriend as she asked me to do a little research on the problem she has been having. I have personally seen what I assume is the cause and what I’m sure are the symptoms. This is only posted in Alcohol Abuse as it seemed to be the closest category to what I was looking for.Recently, she has experienced severe vomiting after having very few well-spaced drinks over the course of the night. For example, just last night we went out and she had one small margarita (I arrived after she had ordered, so I assume that’s what it was based on what it looked like) that she sipped over the course of about an hour before we went to a play (I don’t believe she even finished the drink). An hour to 90 minutes later at intermission, she had one small glass of white wine, and about another hour or so later she had one flavored vodka drink at the bar, which she sipped slowly over the course of about two hours (Again, I am not sure that she had even finished the drink before we left).After she arrived home about 90 minutes later, she began to violently vomit for the next 6-8 hours (not continuously, about once an hour). She said that on the way home she felt unusually intoxicated for the small amount she drank and the amount of time that had passed. I asked her if she had eaten anything before drinking and she said she had eaten dinner just before she went out and also had eaten a small sandwich and bread at the first restaurant where she ordered her first drink.The above is just one example of a number of times this has happened in the last six months to a year.I have known her for a long time, and this has not been a problem before the last year or so, and has been occurring more frequently as time has gone on. She was capable of drinking as much as she pleased for the last ten years or so that I’ve known her until recently. At the outset, it would only happen when she drank exceptionally heavily (which, again, is to be somewhat expected). She has never been a heavy drinker (maybe a beer, cocktail, or glass of wine every few days with a night out at the bar once or twice a month at the most, if at all).The symptoms seem to be hit-or-miss. About a month ago, we had some friends over and drank pretty consistently and heavily for a few hours with no issue later that night with the exception of her having a little bit of an “upset stomach feeling” and a hangover which I would think would be normal given that we had a good bit to drink that night and that we were drinking the type of alcohol that I would associate with hangovers: beer, wine, and brown liquor (although I think she just drank beer and wine). On the other hand, she has nights like the one I described before, where she had a total of two cocktails and a glass of wine over six hours and got sick. It seems to happen somewhat randomly.Some details about her:- 27 Years Old- Petite (Drinks appropriately for her size. Usually no more than 4-5 drinks in an entire night even when in a heavy-drinking situation like a party. Never what I would call “drunk” but certainly intoxicated.)- Biracial Asian-Caucasian (She does get the “Asian Glow”, but not severely nor regularly.)- Ovo-Lacto Vegetarian for about 15 years.- Generally in good health–not ill often and not over- or underweight.- Not on any medication (In fact, tries to abstain from even taking pain relievers or simple cold medicines unless absolutely necessary)Obviously, my question is “Why is this happening (now)?”Thank you in advance.
Doctor: Thank you for your question. Alcohol tolerance can change with age and the activity of the enzyme that metabolizes alcoh ol (Alcohol Dehydrogenase) is produced in less quantities in the liver of certain ethnic groups. For example, persons of asian decent, have less alcohol dehydrogenase in comparison to other ethnic groups. As a result, Asian persons may have a lower tolerance for alcohol. This could possibly be evident in your girlfriend, and also could possibly be the cause of her symptoms after drinking small quantities of alcohol. We recommend that she try to drink even smaller amounts of alcohol if she choose to drink. This would best assist in determining what is her tolerance and prevent her adverse effects of alcohol consumption.Thank you for consulting AskTheDoctor.com