Alcohol Abuse, Alcoholism, and Pneumonia

Alcohol Abuse, Alcoholism, and PneumoniaPneumonia is a general medical term used to describe inflammation that occurs in various places inside the lungs. While most people develop this inflammation as a consequence of exposure to certain viruses or bacteria, others develop lung inflammation from additional, less common sources. Alcohol abuse is a known risk factor for the onset of pneumonia. In some alcohol abusers and alcoholics, this risk comes from decreased immune function and increased susceptibility to infection. In others, it comes from structural changes that reduce the body’s ability to mechanically expel infectious microorganisms. Alcohol abuse and alcoholism also increase the chances for development of a specific form of pneumonia, called aspiration pneumonia, associated with the inhalation of foreign material into the lungs.  

Pneumonia Basics

Doctors can categorize pneumonia according to its location in the lungs, the type of microorganism responsible for inflammation, or the setting in which inflammation is acquired. Forms of pneumonia defined by their location include lobar pneumonia – which occurs in a single segment (or lobe) of lung tissue – and bronchopneumonia, which is spread more widely and affects air passageways within the lungs called bronchi and bronchioles. Viruses capable of triggering pneumonia include the influenza and parainfluenza viruses, as well as adenovirus and respiratory syncytial virus. Bacteria capable of triggering pneumonia include Streptococcus pneumoniae, Chlamydia, and Haemophilus influenzae. Doctors refer to pneumonia acquired in a hospital setting as hospital-acquired pneumonia, while pneumonia acquired outside of a hospital setting is known as community-acquired pneumonia, or CAP.

The US National Library of Medicine lists common symptoms of pneumonia that include chills, body tremors, coughing (with or without mucus production), shortness of breath and varying degrees of fever. Less common symptoms include headaches, appetite loss, unusually high sweat output, fatigue, skin clamminess, confusion and chest pain that intensifies during coughing or deep breathing. When treated promptly, most cases of pneumonia fade after a couple of weeks. However, potential complications of the condition include the formation of abscesses within the lungs’ tissues, an abnormal accumulation of fluid underneath the lining surrounding the lungs, and potentially fatal alterations in normal lung function.

Alcohol’s Effects

Heavy alcohol consumption leads to lower lung levels of cells in the immune system called macrophages, according to an extensive study review published in 2007 by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Normally, these cells circulate in large numbers and act as the main line of immune defense for sacs in the lungs, called alveoli, which pass life-giving oxygen into the bloodstream and remove the toxic waste gas carbon dioxide. The presence of alcohol in the body also apparently suppresses the activity of immune system proteins called chemokines. These disruptions make the lungs more susceptible to the microorganisms responsible for most cases of pneumonia. In addition, once pneumonia sets in, alcohol-related changes in the immune system slow down the body’s ability to effectively respond to those microorganisms. A major change that contributes to this slowed response is underproduction of the vital immune system components called white blood cells.

In the body’s upper airways, bacterial invaders are commonly trapped and repelled by the secretion and expulsion of mucus (phlegm) generated in the mucous membranes, the NIAAA explains. However, habitual heavy alcohol consumption damages these membranes and decreases the level of phlegm production. In turn, a decrease in phlegm production increases the chances that pneumonia-causing bacteria will make their way into the lungs and lead to inflammation. Within the lungs themselves, heavy alcohol consumption can damage mobile, hair-like structures called cilia, which project outward from certain cells and sweep microorganisms out of the lungs along with secretions from the lungs’ mucous membranes. Lack of proper cilia activity also increases the risks for lung penetration by pneumonia-causing microorganisms.

Aspiration Pneumonia

As stated previously, aspiration pneumonia occurs as a result of foreign materials being inhaled into the lungs. These materials may provide fertile ground for a lung infection, a lung abscess, or generalized inflammation and swelling. The most obvious source of the material aspirated (drawn by suction) into the lungs of alcohol abusers and alcoholics is vomiting triggered by varying degrees of alcohol poisoning. In addition, alcohol abusers and alcoholics may breathe in pneumonia-causing microorganisms, like the bacterium Klebsiella pneumoniae, residing in the walls of the throat. Because of the changes wrought by chronic, excessive alcohol consumption, heavy drinkers commonly have much higher throat populations of these microorganisms than non-drinkers.

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