Author: James Anderson

COPD and Alcohol: Is There a Link?

This hypothesis is further supported by an animal study that determined that aerosolized acetaldehyde but not ethanol induced histamine-mediated bronchoconstriction in guinea pigs (Myou et al., 1994). The mucociliary apparatus consists of mucus secreting cells, sero-mucinous bronchial glands and ciliated cells that line the conducting airways from the trachea to the terminal bronchi deep in the lung. This system traps inhaled particles and debris in secreted mucus, which is then propelled up and out of the lung via the escalator-like function of the waves created by beating cilia. Normal mucociliary clearance ensures a sterile environment in the lung below the vocal cords (Laurenzi et al., 1965; Laurenzi et al., 1963; Laurenzi et al., 1961). This is critical for airflow and gas exchange, and prevents the inhalation of airborne infectious particles laden with bacteria, fungi and viruses. Failure of this system results in recurrent bronchitis, pneumonia and airway deformity in the form of bronchiectasis (Noone et al., 2004).

Normal lung airways branch and taper from the trachea down to terminal bronchi providing balanced and regulable airflow throughout the lung. By virtue of their proximal location in lung airflow distribution, the conducting airways are the first interface of the lung with the outside environment. Despite this front line position, the airways below the vocal cords are normally sterile because of highly effective defense mechanisms (Laurenzi et al., 1961).

Studies of mucociliary function in animals drinking alcohol have provided important information about both the impact and the mechanism of alcohol-impaired airway clearance in vivo. Rats fed alcohol for six weeks demonstrated slowed cilia beating and desensitization of airway PKA activity (Wyatt et al., 2004). Importantly, bacterial clearance was impaired by alcohol feeding in this same model and the degree of impaired clearance correlated with the degree of cilia desensitization (Vander Top et al., 2005). This same finding was reproduced in mice ingesting alcohol in their drinking water (Elliott et al., 2007). Taken together, these studies fully recapitulated the in vitro findings of alcohol-desensitization of ciliary kinases.

Alcohol abuse could exacerbate COPD symptoms to the point that hospitalization is necessary. People who have COPD would benefit from speaking with a medical professional about their alcohol consumption to ensure they are not jeopardizing their health. Alcohol treatment may be necessary for people who drink heavily and are unable to stop on their own. If you or a loved one is diagnosed with chronic obstructive pulmonary disease (COPD), you may wonder if you can have alcohol. Those who suffer from COPD are also at an increased risk for social isolation, depression, and other mental health conditions. Many people who struggle with these co-occurring mental health conditions may turn to alcohol as a way to relieve their emotional pain or anxieties.

In subjects with a “moderate” history of drinking, defined as at least one drink per week but less than two drinks per day, clearance was notably faster following alcohol ingestion. In contrast, half of the subjects with a history of “mild” alcohol ingestion, defined as less than one drink per week and no more than two drinks on one occasion, clearance was significantly slowed by alcohol. This variance could not be explained by other obvious factors such as cigarette smoking. They found no differences in CBF among the subjects related to alcohol intake. In contrast to these few clinical studies, a larger body of literature indicates both short and long term effects of alcohol on the mucociliary apparatus. Two epidemiologic studies from Europe lend credence to the hypothesis that alcohol intake may reduce the risk for COPD.

Is It OK to Drink Alcohol With COPD?

A similar U-shaped risk curve for reduced pulmonary function was observed among non-drinkers, mild drinkers and moderate-to-heavy drinkers. Importantly, the U-shaped risk curve was independent of age, height, body mass index (BMI), smoking status, energy intake or country. Taken together, these studies are the first to link mild alcohol intake to reduced risk for developing or dying from COPD, and are consistent with the controversial autopsy findings of Pratt three decades earlier (Pratt and Vollmer, 1984). The cause of mortality in these studies was not determined although an older study showed that acute ingestion of alcohol increased the incidence of ventricular ectopy and apnea in COPD patients (Dolly and Block, 1983).

1. Those who suffer from COPD are also at an increased risk for social isolation, depression, and other mental health conditions.
2. Bronchospasm following alcohol ingestion is well described in asthmatics of Japanese descent (Watanabe, 1991) and is closely linked to the ALDH2 genotype (Shimoda et al., 1996).
3. Your best bet at slowing disease progression is to quit smoking, reduce your number of drinks, and work toward an overall healthy lifestyle.
4. This issue can lead to breathing problems and symptom exacerbation in people with COPD.
5. This study suggests that while alcohol can immediately trigger an initial small upper airway irritant response, a separate slow bronchodilator effect can be observed in asthmatics.

These findings indicate that brief exposure to alcohol stimulated ciliary motility both in vitro and in vivo. Clinicians and physiologists commonly believe that the alcohol present in exhaled air during alcohol consumption comes from alcohol that is vaporized from the alveolar-capillary interface of the pulmonary circulation. Careful studies by George and colleagues show that almost all of the exhaled alcohol is derived from the bronchial and not the pulmonary circulation (George et al., 1996). During alcohol ingestion, alcohol freely diffuses from the bronchial circulation directly through the ciliated epithelium where it vaporizes as it moves into the conducting airways (George et al., 1996). Indeed, alcohol vapor excreted into the airways in this manner forms the basis of the breath test used to estimate blood alcohol levels (Hlastala, 1998).

Treatment for Co-Occurring Alcohol Abuse and COPD

Airflow obstruction could not be accounted for on the basis of current smoking status or previous infection. Noteworthy in this small study was the high incidence of airflow obstruction in women (77%). The authors asserted that these findings suggest that alcohol per se impairs lung function.

This can include taking medication, getting a flu shot every year, and getting a pneumonia shot regularly, Schachter says. Use of this website and any information contained herein is governed by the Healthgrades User Agreement. Never downplay the potential harm that alcohol can cause when you have COPD. If you have this condition, talk to your doctor about the risks involved in consuming alcohol. They can explain all of the risks involved and help you properly manage your COPD symptoms so you can live a healthy life.

More on COPD

He asserted that this is due to the lung’s delicate structure and its exposure to the entire cardiac output containing alcohol that has escaped first pass metabolism in the liver. Although we have not yet conclusively proven Burch’s hypothesis, there is growing evidence that alcohol plays a role in the pathogenesis of COPD. Direct effects of alcohol on airway smooth muscle function have been suggested by some studies. A study of isolated guinea pig tracheal smooth muscle tone demonstrated that alcohol causes concentration-dependent contraction of airway smooth muscle (Jakupi et al., 1986). This effect was partially reduced by histamine or the alpha-adrenergic blockade, but completed abolished by calcium channel blockade, suggesting a calcium flux mediated alcohol-triggered airway smooth muscle contraction in this model.

Alcohol’s Impact On The Body

Alcohol has various physical and mental effects on anyone who chooses to drink. For people with COPD, alcohol can increase the risk of lung problems, sleep disruptions, and allergies. But if you feel stuffy, have a runny nose, trouble breathing, or any other signs of an allergic reaction when drinking alcohol, you should stop drinking completely, he says. These are all signs of alcohol intolerance, which can potentially make your COPD symptoms worse. Alcohol has an even stronger effect on heart disease than it does on lung disease.