What Has The Primary Responsibility For Eliminating Alcohol?

Alcohol Metabolism – Alcohol is a toxin that must be neutralized or eliminated from the body. Ten percent of alcohol is eliminated through sweat, breath, and urine. Alcohol is volatile (will evaporate in air), so when alcohol in the blood comes in contact with air in the alveoli of the lungs, it can be transferred out of the body through breath.

• The liver is the primary organ responsible for the detoxification of alcohol.
• Liver cells produce the enzyme alcohol dehydrogenase which breaks alcohol into ketones at a rate of about 0.015 g/100mL/hour (reduces BAC by 0.015 per hour).
• Nothing will speed up the rate of detoxification, but the effective metabolism of alcohol can be limited by medications and liver damage.

When the rate of consumption exceeds the rate of detoxification, BAC will continue to rise.

How does the body process alcohol?

Abstract – Alcohol is eliminated from the body by various metabolic mechanisms. The primary enzymes involved are aldehyde dehydrogenase (ALDH), alcohol dehydrogenase (ADH), cytochrome P450 (CYP2E1), and catalase. Variations in the genes for these enzymes have been found to influence alcohol consumption, alcohol-related tissue damage, and alcohol dependence.

The consequences of alcohol metabolism include oxygen deficits (i.e., hypoxia) in the liver; interaction between alcohol metabolism byproducts and other cell components, resulting in the formation of harmful compounds (i.e., adducts); formation of highly reactive oxygen-containing molecules (i.e., reactive oxygen species ) that can damage other cell components; changes in the ratio of NADH to NAD + (i.e., the cell’s redox state); tissue damage; fetal damage; impairment of other metabolic processes; cancer; and medication interactions.

Several issues related to alcohol metabolism require further research. Keywords: Ethanol-toacetaldehyde metabolism, alcohol dehydrogenase (ADH), aldehyde dehydrogenase (ALDH), acetaldehyde, acetate, cytochrome P450 2E1 (CYP2E1), catalase, reactive oxygen species (ROS), blood alcohol concentration (BAC), liver, stomach, brain, fetal alcohol effects, genetics and heredity, ethnic group, hypoxia The effects of alcohol (i.e., ethanol) on various tissues depend on its concentration in the blood (blood alcohol concentration ) over time.

• BAC is determined by how quickly alcohol is absorbed, distributed, metabolized, and excreted.
• After alcohol is swallowed, it is absorbed primarily from the small intestine into the veins that collect blood from the stomach and bowels and from the portal vein, which leads to the liver.
• From there it is carried to the liver, where it is exposed to enzymes and metabolized.

The rate of the rise of BAC is influenced by how quickly alcohol is emptied from the stomach and the extent of metabolism during this first pass through the stomach and liver (i.e., first-pass metabolism ). BAC is influenced by environmental factors (such as the rate of alcohol drinking, the presence of food in the stomach, and the type of alcoholic beverage) and genetic factors (variations in the principal alcohol-metabolizing enzymes alcohol dehydrogenase and aldehyde dehydrogenase ).

1. The alcohol elimination rate varies widely (i.e., three-fold) among individuals and is influenced by factors such as chronic alcohol consumption, diet, age, smoking, and time of day ( Bennion and Li 1976 ; Kopun and Propping 1977 ).
2. The consequent deleterious effects caused by equivalent amounts of alcohol also vary among individuals.

Even after moderate alcohol consumption, BAC can be considerable (0.046 to 0.092 gram-percent ; in the 10- to 20-millimolar 1 range). Alcoholreadily diffuses across membranes and distributes through all cells and tissues, and at these concentrations, it can acutelyaffect cell function by interacting with certain proteins and cell membranes.

As explained in this article, alcohol metabolism also results in the generation of acetaldehyde, a highly reactive and toxic byproduct that may contribute to tissue damage, the formation ofdamaging molecules known as reactive oxygen species (ROS), and a change in the reduction–oxidation (or redox) state of liver cells.

Chronic alcohol consumption and alcohol metabolism are strongly linked to several pathological consequences and tissue damage. Understanding the balance of alcohol’s removal and the accumulation of potentially damaging metabolic byproducts, as well as how alcohol metabolism affects other metabolic pathways, is essentialfor appreciating both the short-term and long-term effects of the body’s response to alcohol intake.

Which of the following can be affected by alcohol consumption?

High blood pressure, heart disease, stroke, liver disease, and digestive problems. Cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum. Weakening of the immune system, increasing the chances of getting sick. Learning and memory problems, including dementia and poor school performance.

What is the only thing that eliminates alcohol from the body?

Alcohol’s Path Through the Body – About five percent of the alcohol consumed leaves the body through urine, sweat glands, and breathing. Most of the alcohol must be broken down (metabolized) by the liver to remove it from the system. The liver metabolizes alcohol at a very constant rate, approximately one drink per hour.

1. If there is excessive alcohol in the blood, the liver cannot speed up the detoxification process.
2. The unmetabolized alcohol just continues to circulate in the bloodstream.
3. This is intoxication – when there is a buildup of alcohol in the system.
4. Allowing the liver enough time to metabolize the alcohol is the only way to remove alcohol from the body.

A cold shower, fresh air, exercise, or black coffee will not help sober a person up. Time is the only thing that will remove alcohol from the system (about an hour per standard drink). Alcohol does not require digestion. Most passes into the stomach. About 20 percent is absorbed into the bloodstream through the stomach.

Is the pancreas responsible for elimination of alcohol?

POTENTIAL MECHANISMS OF ALCOHOL CONSUMPTION AND PANCREATIC DISEASES – Over the last decades there have been numerous efforts to elucidate the mechanisms by which alcohol damages the pancreas. The injurious effects of ethanol on the pancreas are mediated through different mechanisms as (1) sensitization of acinar cells to cholecystokinin (CCK) inducing premature activation of zymogens; (2) potentiation of the effect of CCK on the activation of transcription factors, nuclear factor-ĸB and activating protein-1; (3) generation of toxic metabolites such as acetaldehyde and fatty acid ethyl esters; (4) sensitization of the pancreas to the toxic effects of coxsackievirus B3; and (5) activation of pancreatic stellate cells by acetaldehyde and oxidative stress and subsequent increased production of collagen and other matrix proteins.

1. Chronic alcohol exposure leads to impaired exocytosis mediated by acetaldehyde-induced microtubular dysfunction and apical cytoskeleton reorganization in acinar cells, with a subsequent accumulation of intracellular enzymes.
2. In addition, alcohol decreases the stability of zymogen and lysosomal membranes and enhancers acinar cell sensibility to CCK further increasing susceptibility to pathological enzyme activation.

Some theories also show that physiologically ethanol leads to the formation of protein secretory plugs that obstruct pancreatic ducts, spam of the sphincter of Oddi or decreased tone of the sphincter causing reflux. Ethanol and its major metabolite, acetaldehyde, are classified by the International Agency for Research on Cancer as group 1 carcinogens.

1. Alcohol metabolism depends on enzymes that transform ethanol.
2. Genes for these modifying enzymes have specific polymorphisms that differ between subjects and races leading to differences in susceptibility to alcohol effects and alcohol dependence.
3. Although the liver is the major ethanol-metabolizing organ in the body, the pancreas can metabolize alcohol both via oxidative and non-oxidative pathways.

The oxidative pathway is catalyzed by the enzyme alcohol dehydrogenase (ADH) and the cytochrome P450 and produces the metabolite acetaldehyde. Finally, the oxidative alcohol metabolism results in the generation of oxygen species (ROS) and a depletion of the ROS scavenger glutathione.

The increased ROS production (which damage DNA and proteins) and a reduction of proteins that eliminate this ROS (glutathione and enzymes related) lead to oxidant stress and resultant damage in tissue. This stress could be responsible for induce alcoholic pancreatitis as has been demonstrated by several models.

But in pancreas, the non-oxidative pathways may be more important than oxidative metabolism, generating fatty acid ethyl esters (FAEE) by fatty acid ethyl ester synthases (FAEE synthases). It has been shown that pancreas exhibits higher FAEE synthase activity than liver and FAEEs accumulation have been observed in human and rat pancreas after alcohol intake.

• The products of alcohol oxidation (acetaldehyde and ROS) and of non-oxidative metabolism have been reported to cause acinar cell injury.
• Acetaldehyde cause morphological changes in rat and dog’s pancreas and it has been showed that inhibits CKK-simululated cinar cell secretion.
• Also, several studies have demonstrated that alcohol intake causes oxidant stress within the pancreas which may play a role in the alcohol-induced destabilization of zymogen granules and lysosomes.

In addition, alcohol oxidation contributes to acinar damage altering the intracellular redox state (a reduced NAD/NADH ratio and increased lactate/piruvate ratio). Other results obtained in isolated mouse pancreatic acinar cells suggest that FAEEs leads to mitochondrial damage, loss of ATP and rise in cytosolic free calcium, which leads to acinar cell toxicity.

1. Other authors have shown that acute application of ethanol at clinically relevant concentrations (1-50 nmol/L) of isolated acinar cells resulted in calcium influx due to the production of oxidative metabolites of alcohol.
2. Together, these data show that the role of alcohol metabolites in acinar cell damage could be due to aberrant calcium signals.

FAEEs can elevate Calcium greater that ethanol alone. In addition, FAEEs and their products, fatty acids induces necrosis in acinar cells and this process could be avoided by calcium chelation. These physiological changes leads to the pathobiology found in alcoholic pancreatitis including acute and chronic inflammation, elimination of parenchymal cells of the pancreas by a deregulation of apoptosis/necrosis and/or modification in cell proliferation.

• The hypothesis called ‘‘necrosis-fibrosis sequence” shows these pathological changes where in the early episodes of pancreatitis, patients present focal necrosis and mild fibrosis while patients evaluated years later of the onset of symptoms presents fibrosis and calcifications but not necrosis.
• But the fact that only a minority of heavily drinkers develops pancreatitis or PC indicates that other susceptibility factors as lipid tolerance, smoking or hereditary factors play an important role.

In the last decades, genetic susceptibility has been considered between the factors that contribute mainly to the development to alcoholic pancreatic diseases. One study showed an association between a polymorphism of the gene for one FAEE synthase enzymes, carboxylester lipase and risk of developing alcoholic pancreatitis.

In addition, the G191R variant in the anionic trypsinogen gene PRSS2, has been shown to result in a form of trypsin that is easily degraded, is more infrequent in alcoholic pancreatitis patients compared with healthy controls. Other studies have demonstrated that mutation N34S in SPINK1 gene is found in 5%-5.8% of patients with pancreatitis compared with 1% in healthy controls.

But still the functional consequences of this mutation are unknown. One of the enzymes that have been also related to alcoholism and drug dependence for decades is ADH. Li et al performed a recent meta-analyses and confirmed strong associations of the ADH1B and ALDH2 genes with alcoholism and alcohol-related medical diseases.

Recently, Celorrio et al demonstrated that some specific polymorphism in the genes TH, ADH1B increase the risk to develop diseases a consequence of excessive consumption of alcohol. Although it is clear that alcohol consumption is genetically influenced, but characterized by incomplete penetrance, phenocopies, heterogeneity, and polygenic inheritance.

In conclusion, nowadays it appears clear that alcohol consumption is the first or second most common cause of pancreatitis. Based on the different epidemiology studies published in the literature the percentage of pancreatitis cases attributable to alcohol abuse vary since 30% to 90% between countries.

A statistical association has been shown with a threshold of ≥ 5 drinks per day with a dose of alcohol ≥ 50 g/d. But despite that excessive alcohol consumption is primarily responsible for most cases of pancreatitis, alcohol intake alone is not sufficient to lead to this disease, as less than 10% of heavily drinkers develop pancreatitis.

Regarding to PC, the role of alcohol consumption remains less clear, and low to moderate alcohol consumption do not appear to be associated with PC risk, but only chronic heavy drinking increase the risk compared with lightly drinkers. Genetic variability and environmental exposures such as smoking and diet could act synergistically with regard to pancreatitis and PC and should be considered for further investigations.

Which organ is most responsible for the metabolism of alcohol?

Alcohol is metabolized in the body mainly by the liver.

Which organ of body is most affected by excessive intake of alcohol?

Fatty Liver Disease – A majority of heavy drinkers will develop some degree of fatty liver disease. Fatty liver disease is a condition in which the liver has an excess build-up of fat. While symptoms may not be present in the early stages, fatty liver disease can lead to cirrhosis (scarring of the liver) and liver cancer. Luckily, fatty liver disease may be reversible if you stop drinking.

How long does it take for alcohol to leave your liver?

How ARLD is treated – There’s currently no specific medical treatment for ARLD. The main treatment is to stop drinking, preferably for the rest of your life. This reduces the risk of further damage to your liver and gives it the best chance of recovering.

1. If a person is dependent on alcohol, stopping drinking can be very difficult.
2. However, support, advice and medical treatment may be available through local alcohol support services,
3. A liver transplant may be required in severe cases where the liver has stopped functioning and doesn’t improve when you stop drinking alcohol.

You’ll only be considered for a liver transplant if you’ve developed complications of cirrhosis, despite having stopped drinking. All liver transplant units require a person to not drink alcohol while awaiting the transplant, and for the rest of their life.

Do heavy drinkers metabolize faster?

Frequency Of Alcohol Use – In heavy drinkers, the average metabolic rate can be significantly faster than occasional drinkers. However, alcoholism damages the liver over time. As this damage becomes more severe, the ability to metabolize alcohol decreases significantly.

Why alcohol is a silent killer?

Excessive alcohol consumption is a known evil in today’s fast-moving stressful life. While some people are able to control their drinking habits, majority fall prey to the adverse effects of alcohol as they fail to control alcohol consumption. The effects of alcohol vary based on several factors such as the amount of alcohol consumed, tolerance level of the individual, any medical history and/or history of drug abuse.

Twelve ounces of beer which is about 5 percent alcohol.Eight to nine ounces of malt liquor which amounts to about 7 percent alcohol.Five ounces of wine which is roughly 12 percent alcohol.One and one-half ounces of 80-proof distilled spirits such as gin, vodka, rum, whisky, tequila, etc. which is about 40 percent alcohol.

An individual’s Blood Alcohol Content (BAC) value must be determined to know the exact effect that alcohol has caused on the system of the individual. Based on the BAC, an individual may suffer from mild to severe complications. Initially, the BAC value is low but eventually body starts developing tolerance to alcohol and the individual starts drinking even more to get the desired high.

• This leads to an increase in BAC percentage which results in more serious health consequences.
• Individuals suffering from alcoholism must approach the alcohol rehabilitation centres in India that have world-class rehab facilities and specialists to help them get back to a healthy and happy life style.

Alcohol is a silent killer. It slowly damages your internal organs without any apparent major signs or symptoms for early detection. Hence, it is important to not ignore the warning signs of alcoholism before it is too late to reverse the health condition.

Liver : Liver is known to be the worst affected organ in heavy drinkers. Normally, the liver breaks down alcohol and prevents its entry into blood. But heavy consumption in a short duration leads to disturbance of this metabolism leading to fatty liver. This, in turn, causes obesity, liver failure, type 2 diabetes and other serious complication such as hepatitis, fibrosis and cirrhosis.

Pancreas : Pancreas is responsible for regulating the blood sugar level. However, prolonged alcohol consumption leads to adverse effects on pancreas which are not detected early and lead to lasting health complications. Excessive drinking can damage the blood vessels of pancreas causing pancreatitis which may eventually lead to a dangerous condition like pancreatic cancer.

Heart : Long term excessive consumption of alcohol leads to negative effects on the heart by deposition of high levels of triglycerides. It affects the functioning of heart leading to low oxygen and nutrient supplement to other vital organs. It can lead to irregular heartbeat, high blood pressure and eventually cause serious conditions such as cardiomyopathy, stroke and cardiac failure.

Brain : Effects of alcohol on the brain range from temporary memory loss to long-term irreversible damage to brain tissue. Prolonged consumption leads to structural damage of the brain leading to loss of balance, emotional disturbances, impaired motor system, and much more.

It is important to understand that such health issues can be avoided only if you quit drinking now. Take help from professionals of rehab centres. There are several alcohol rehabilitation centres in India offering effective treatment programs to overcome alcohol addiction.

1. There are several short-term effects of alcohol such as impaired vision, lack of coordination, extreme mood swings, memory lapses, slurred speech, etc.
2. And long-term effects such as liver, heart, respiratory diseases, ulcers, cancer and nerve damage.
3. The effects of alcohol not only affect the addict but also those around them.

With increased addition, the individual may also indulge in emotional outbursts, drunken driving, criminal activities, etc. leading to loss of social and professional stature with disturbed relationships. If you are struggling with alcoholism, it is time you made a conscious decision to quit drinking.

• We offer personalized treatment under care of professional experts.
• Sunshine Wellness Centre is one of the most trusted alcohol rehabilitation centres in India,
• We help you gain back control on your self and your life through our various rehabilitation programs and facilities with unique amenities and activities that fit your requirements.

During the course of treatment, we provide you insights on how to manage triggers, prevent urges to drink and help you maintain sobriety. So, do not hesitate in putting an end to alcohol abuse to live a happy and healthy life. Connect with us now and allow us to help you with treatment programs and other resources for a speedy recovery.

What organs get damaged by alcohol?

Long-term effects of alcohol misuse – Drinking large amounts of alcohol for many years will take its toll on many of the body’s organs and may cause organ damage. Organs known to be damaged by long-term alcohol misuse include the brain and nervous system, heart, liver and pancreas.

1. Heavy drinking can also increase your blood pressure and blood cholesterol levels, both of which are major risk factors for heart attacks and strokes.
2. Long-term alcohol misuse can weaken your immune system, making you more vulnerable to serious infections.
3. It can also weaken your bones, placing you at greater risk of fracturing or breaking them.

There are many long-term health risks associated with alcohol misuse. They include:

high blood pressure stroke pancreatitis liver disease liver cancer mouth cancer head and neck cancer breast cancer bowel cancer depression dementia sexual problems, such as impotence or premature ejaculation infertility damage to the brain, which can lead to problems with thinking and memory

As well as having a significant impact on your health, alcohol misuse can also have long-term social implications. For example, it can lead to:

family break-up and divorce domestic abuse unemploymenthomelessnessfinancial problems

What are 4 ways alcohol leaves the body?

How The Body Processes Alcohol – The body follows a pretty straightforward process when digesting and metabolizing alcohol. Therefore, the amount of time that a drink will stay in someone’s system has more to do with how much a person drinks than any other factor.

• Once swallowed, alcohol enters the digestive system and travels to the stomach and small intestine.
• Approximately 20% of alcohol is absorbed through the stomach, and most of the remaining 80% is absorbed in the small intestine, then directly to the bloodstream.
• Once in the blood, alcohol is rapidly transported throughout the entire body, which is why alcohol impacts so many different bodily systems.

Most of the alcohol that enters the body eventually ends up in the liver, where the vast majority of alcohol metabolism takes place. In general, the liver can process one ounce of liquor (or one standard drink) in one hour. If an individual consumes more than this, the system becomes saturated, and the additional alcohol will accumulate in the blood and other tissues until it can be metabolized.

If this happens too many times or too fast, damage to the brain and tissues of the body can develop. The human body is very effective at processing alcohol, provided that alcohol is not consumed so quickly as to cause alcohol poisoning, It is estimated that between 90% and 98% of all alcohol that enters the body is metabolized and absorbed.

The remaining alcohol is then expelled from the body through sweat, urine, vomit, and feces.

Does alcohol affect liver or pancreas?

Liver and pancreas are vital organs in the digestive system. The abnormalities of liver and pancreas are usually susceptible to develop further serious diseases due to their complicated structures and functions. Disorders of the liver and pancreas can range from mildly troublesome to intensely painful.

• It might start from acute to chronic inflammation and infection, benign hepatic or pancreatic tumor and hepatic cysts as well as liver and pancreatic cancers.
• It is widely acknowledged that alcohol abuse or alcoholism is one of the major contributing factors to develop acute and chronic inflammation of both liver and pancreas.

Fatal conditions caused by alcoholic abuse include a severely liver inflammation, acute liver failure or/and cirrhosis presented with liver cancer. Besides serious conditions of liver and pancreas, other body’s systems are substantially impacted including digestive system, cardiovascular system, endocrine system, kidney, blood circulation and coagulation process as well as impaired immune system which subsequently leads to severe infection and sepsis.

What is the pancreas responsible for elimination of?

The pancreas is responsible for the elimination of 95% of ingested alcohol from the body through metabolism. Blood Alcohol Concentration (BAC) refers to the amount of alcohol contained in a person’s blood.

What is the function of pancreas?

Physiological Functions of the Pancreas – The pancreas has two essential and very important functions in the body: endocrine (production of hormones that regulate blood sugar levels and glandular secretion) and exocrine (the function of the digestive gland) ( Yamada et al., 2005 ).

Endocrine activity is performed by the Langerhans islets and involves the production of hormones such as insulin, proinsulin, amylin, C-peptide, somatostatin, pancreatic polypeptide (PP), and glucagon. Insulin helps to lower blood sugar, and glucagon causes blood sugar to rise. On the other hand, the exocrine activity consists of the production of enzymes that are part of the iso-osmotic, alkaline pancreatic juice and support the digestion of food in the intestines.

The intravesical cells produce the enzymatic components of the juice, which is led into the duodenum through the pancreatic ducts. In addition, mucus is secreted in the pancreatic ducts through goblet cells. The composition of pancreatic juice includes enzymes that digest proteins, fats, carbohydrates, and nucleic acids, as well as electrolytes and a small amount of mucus ( Dąbrowski et al., 2007 ).

Enzymes such as trypsin, chymotrypsin, carboxypeptidase, and elastase belong to the group of proteolytic enzymes (they digest proteins). Trypsin and chymotrypsin are secreted in the form of proenzymes: trypsinogen, chymotrypsinogen. The pancreatic lipolytic enzymes are lipase, phospholipase, and esterase, which digest fats.

The glycolytic (carbohydrate digesting) enzymes are lactase and amylase, which breaks down starch into maltose, maltotriose, and dextrins. Nucleolytic enzymes include ribonuclease and deoxyribonuclease, which break down nucleic acids into mono- and oligonucleotides.

Does the liver eliminate 90% of alcohol?

Metabolism of alcohol More than 90% of alcohol is eliminated by the liver ; 2-5% is excreted unchanged in urine, sweat, or breath.

Which organ eliminates 90 95 of alcohol in the body?

Table 3 – Reactions involved in ethanol metabolism and elimination in the whole-body genome-scale metabolic model (Harvey). *Values were implemented as the lower and upper bounds of the corresponding reactions in the WBM.

Harvey reaction abbreviation	PBPK model reaction name	% of total metabolism*	Notes
‘Diet_EX_etoh’	Input		Diet intake
‘EX_etoh_’	kLungout	0.05%	Lung/breath
‘EX_etoh’	kKid	3–10%	Urine excretion
‘EX_etoh’	kSkin	3–10%	Sweat excretion
‘Excretion_EX_etoh’	kLI		Feces excretion
‘Liver_ALCD2if’	rliv	90–95%	Liver alcohol dehydrogenase
‘Colon_CAT2p‘	rLI	0–2%	Colon catalase
‘Colon_ALCD2if’ ‘Adipocytes_ALCD2if’ ‘Adipocytes_ALCD2yf’			Colon/adipose alcohol dehydrogenase

Traditionally FBA only solves for steady state fluxes, however the results of FBA can be used in a dynamic model to better understand the kinetics of ethanol metabolism. Integration of the two models employed dynamic FBA (see Eq 2.4), in which an objective function is maximized subject to a set of constraints, Here, the Michaelis-Menten parameters in the PBPK model were used to set boundaries for the WBM liver alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH2) reactions, The objective was to maximize the amount of ethanol removed by the liver alcohol dehydrogenase (‘Liver_ALCD2if’), and given that the liver accounts for 90–95% of total ethanol metabolism, the boundaries for the other metabolic and excretion reactions were calculated and constrained based on the liver ethanol metabolism rate, To solve the WBM model, FBA was performed with the function ‘SolveCobraLPCPLEX’, and the flux values from the FBA solution were used in a dynamic FBA fashion to update the PBPK model for the next time step, The FBA flux solutions were continuously used in the solver until their values deviated from the Michaelis-Menten rate past an acceptable tolerance range (typically 1–2.5%), shown by Eq 2.5, after which the WBM was solved again to update the fluxes in the PBPK model. A schematic of this process can be found in S1 Fig, max f T v s,t, S v = 0 l b i < v i < u b i w h e r e u b i = V m a x C i K m + C i (4)

What organ is 90% of alcohol detoxified by?

Alcohol Metabolism – Alcohol is a toxin that must be neutralized or eliminated from the body. Ten percent of alcohol is eliminated through sweat, breath, and urine. Alcohol is volatile (will evaporate in air), so when alcohol in the blood comes in contact with air in the alveoli of the lungs, it can be transferred out of the body through breath.

The liver is the primary organ responsible for the detoxification of alcohol. Liver cells produce the enzyme alcohol dehydrogenase which breaks alcohol into ketones at a rate of about 0.015 g/100mL/hour (reduces BAC by 0.015 per hour). Nothing will speed up the rate of detoxification, but the effective metabolism of alcohol can be limited by medications and liver damage.

When the rate of consumption exceeds the rate of detoxification, BAC will continue to rise.

Does 90% of alcohol must be metabolized through the liver?

Ingested alcohol is absorbed through the stomach and intestines. Less than 10% of absorbed alcohol is excreted in breath, sweat, and urine. This means that more than 90% of the absorbed alcohol circulates through the body and is eventually transported to the liver via the portal vein.