Alcohol, Gut Leakiness, & Liver Disease

Inclusion Criteria: There are 4 different categories of participants that were used for recruitment: Healthy controls * Subjects must have a normal physical exam * No GI complaints * No known liver disease * Normal liver function tests (ALT, AST, bilirubin, alkaline phosphatase, serum albumin) * Consume no more than a moderate amount of alcohol (NIAAA definition \[1 \]). * These subjects should not be daily drinkers (\< 3x / week) and should typically drink \< 3 drinks per occasion. Alcoholics * Subjects should fulfill NIAAA criteria for at-risk drinking \& alcohol abuse or dependence \& DSM-IV criteria for alcoholism * Each must have consumed alcohol regularly for at least the past 3 mos but must be sober for 3-7 day post-binge at the time of sugar test (except for group 7) * Have a total regular heavy drinking history of at least 10 y (except for Group 6) the minimal period of time required for the development of ALD. These are the different alcoholic groups and their specific inclusion criteria: ALCOHOLICS WITHOUT LIVER DISEASE * no clinical evidence of ALD on physical examination * serum bilirubin or ALT or AST less than 1.25X normal * sobriety must be \<7 days at the time of sugar test. ALCOHOLICS WITH LIVER DISEASE * These subjects will have 1 of 3 possible grades of LD severity (mild, moderate, severe) \& have either clinical evidence of LD (hepatomegaly, splenomegaly, and esophageal varices), or serum bilirubin or ALT or AST more than 1.5X normal. * If liver biopsy or CT or ultrasound is available, there should be histological evidence of LD (alcoholic hepatitis or cirrhosis) or radiological evidence of LD (cirrhotic liver, splenomegaly, varices) * Their sobriety must be \<7 days at the time of the sugar test. ALCOHOLICS WITH SHORT-TERM Drinking * These subjects should fulfill the criteria of alcohol abuse * have sobriety \<7 days at the time of urine collection, but the duration of their heavy drinking must be \<5 years * They must not have any liver disease (negative serology) due to non-EtOH causes or clinical evidence of * cirrhosis. Here, liver enzyme levels are not inclusion/exclusion criteria; but since the duration of EtOH abuse (\<5 y) is too short for the development of cirrhosis, it is expected that none will have sustained elevated liver enzymes. SOBER ALCOHOLICS WITH LD . * Criteria is the same as Alcholics with liver disease but last drink was \>7 days from the study enrollment. Subjects with Non-alcoholic liver disease * Criteria for LD are similar to those outlined for alcoholics with liver disease subjects except that drinking history should be similar to that of healthy volunteers. Subjects after liver transplant. * These subjects must have successful liver transplantation at least 6 mos prior to the study and are on stable doses of immunosuppression for 3 mos. Exclusion Criteria: * Unreliable drinking history (to rule out closet drinkers or pretenders). * Subjects must clearly fulfill the criteria either of "alcoholism" or of "on-drinker". * Subjects with a drinking history of 5-9 years duration are excluded since this period is not short enough to preclude cirrhosis nor long enough to cause ALD in most subjects. * Significant renal impairment (creatinine\>l.2 mg/dL * Diseases that affect GI motility such as scleroderma. * insulin-requiring diabetes \&/or uncontrolled diabetes (Hgb-Alc\>8%) * Clinically significant dehydration. * clinically detectable ascites * Significant peripheral edema * Sepsis * Clinically significant cardiac failure * Regular daily use of medications that may affect intestinal permeability such as NSAIDS or intestinal motility (e.g. metoclopramide). * Alcoholics positive for other markers of LD such as smooth muscle antibody, hepatitis B surface antigen, hepatitis C antibody or hemochromatosis * Inability to sign an informed consent form * Patients with low platelet count (\<80k), uncorrectable prolonged PT (\>15 sec), history of bleeding will be excluded from aspirin tests