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Beer poisoning

 
, medical expert
Last reviewed: 23.11.2021
 
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Despite the fact that beer resulting from the fermentation of starch sugars in the wort with the formation of ethanol and carbon dioxide (carbon dioxide) is a low-alcohol beverage, alcoholic beer poisoning is not uncommon. In addition, beer poisoning can be similar to food poisoning.

Epidemiology

Excessive alcohol consumption causes over 4,300 deaths among underage young people each year.

Although buying alcohol by people under the age of 21 is illegal, people between the ages of 12 and 20 drink 11% of all alcohol consumed in the United States. More than 90% of this alcohol is consumed in the form of low alcohol drinks, including beer. 

In 2013, people between the ages of 12 and 21 visited approximately 119,000 emergency rooms for injuries and other conditions related to alcohol. [1]

Causes of the beer poisoning

The main causes of beer alcohol poisoning are related to exceeding the limit of the so-called alcohol tolerance of the body - the totality of its functional reactions to the effects of ethanol. Many of its lovers do not even suspect the existence of a tolerance limit for alcohol and drink too much for a short time.

While the liver of an average person without negative consequences for the body within one hour is able to "process" only 360 ml of medium and high strength beer (wine - 150 ml, vodka - not more than 45 ml). [2]

In alcohol abusers, including beer, their sensitivity decreases, so the doses become larger, and the liver metabolizes alcohol more and more slowly. And in such cases, even small amounts of alcohol can lead to its high concentration in the blood, as a result of which the toxic effect of ethyl alcohol leads to poisoning. See details -  Alcohol poisoning .

Poisoning with expired beer (with expired shelf life and sale), poisoning with live beer (that is, unpasteurized), as well as poisoning with draft beer (dispensed not in sealed containers, but for bottling) are classified as foodborne infections due to ethanol exposure  .

In violation of the rules of sanitation and microbiological purity of production, not only the so-called wild yeast (Saccaharomyces, Hansenula anomala, Torulopsis), which negatively affect its quality and reduce storage time, but also conditionally pathogenic and pathogenic bacteria can get into the must and final product : Leuconostoc spp., Acetobacter, Enterobacter, Pectinatus, Proteus vulgaris, Staphylococcus aureus, Clostridium perfringens.

Studies have disproved the general belief that pathogens cannot survive in fermented alcoholic beverages, particularly beer. Such pathogenic bacteria as Escherichia coli, Listeria monocytogenes, Salmonella enterica (Typhimurium serotype) and Bacillus cereus, having got into the wort upon cooling, aeration or fermentation, remain viable at a beer storage temperature of + 5-22 ° C. [3] Escherichia coli and salmonella do not survive in strong beer, but in medium-strong beer at a temperature of + 4 ° C they remain alive for a month and reproduce very quickly in non-alcoholic, low-alcohol and unpasteurized beer. [4]

In addition, filters made from diatomite, a natural siliceous sedimentary rock, which, as reported in the Journal of Agricultural Food Chemistry, may contain heavy metals toxic to humans (lead, cadmium) and arsenic, are often used to clean beer. For example, cadmium irritates the stomach, causing vomiting and diarrhea. Experts judge the presence of heavy metal ions in beer by its colloidal turbidity. [5]

Risk factors

Alcohol poisoning with beer is the result of its excessive consumption, especially of high-strength varieties (with ethyl alcohol content up to 8.5-14%). The presence of beer alcoholism in a person increases the risk of such poisoning  .

And the risk factors for foodborne toxicoinfection are associated with the use of poor-quality beer: produced in violation of sanitary standards, contaminated with microbes, improperly stored, sold after the expiration date of the drink.

Pathogenesis

The mechanism of the development of alcohol poisoning by beer is not much different from the development of poisoning by other types of alcoholic beverages. Absorbed in the digestive tract, alcohol enters the bloodstream; drinking large amounts of alcohol leads to a rapid increase in its concentration in the blood (up to 0.08% or higher), which exceeds the ability of the body (the liver enzyme alcohol dehydrogenase) to break down ethanol. As a result of this, there is a violation of the functions of the life-supporting centers of the cerebral cortex that control respiration, heart rate, body temperature, the work of the endocrine system, etc. [6]

The pathogenesis of bacterial beer poisoning is associated with exposure to cells of the intestinal mucosa of exotoxins (enterotoxins) or enzymes produced by enteropathogenic or enterotoxicogenic microorganisms (listed above).

Enterotoxins damage the cell membranes of the intestinal mucosa, due to which, due to the leakage of sodium and water, the osmolarity of the contents of the intestinal lumen is disturbed. As a result, secretory diarrhea occurs.

Symptoms of the beer poisoning

The first signs of alcoholic beer poisoning are manifested by dizziness and impaired coordination of movements, general weakness, as well as pale skin and cold sweat. Even when a person stops drinking, alcohol in the stomach and intestines continues to enter the bloodstream and circulate throughout the body, causing typical symptoms: nausea and spontaneous vomiting, tremors and cramps of the extremities, hypothermia (decreased body temperature), dull reactions, sudden failures in the unconscious state (followed by alcoholic amnesia), mental disorders, respiratory depression and heart rate. [7]

In cases of non-critical doses of low-quality beer - expired, live, draft - general weakness, nausea, vomiting, abdominal pain, intestinal colic, diarrhea, low-grade fever, in general,  symptoms of food poisoning occur .

Diagnostics of the beer poisoning

The diagnosis of alcohol poisoning with beer is made clinically, but differential diagnosis is necessary to exclude poisoning with narcotic substances, methanol or ethylene glycol.

More detailed information in the materials:

Who to contact?

Treatment of the beer poisoning

Treatment of any poisoning begins with first aid to the victim. How to render it correctly, read in the publications:

In severe cases, the ambulance called by the ambulance directs the victim to a medical institution, where they carry out  symptomatic intensive care for poisoning  and use appropriate medications that are injected into the vein infusion. [8]

With a mild degree of poisoning, treatment is carried out at home: they wash the stomach, take adsorbents (activated carbon, Polysorb, etc.), they must drink Regidron's solution or salt solution with sugar (a teaspoon of each ingredient per liter of boiled water) - to replenish the liquid and salts lost due to vomiting and diarrhea. More in publications:

An alternative treatment suggests adding  potassium permanganate or baking soda to the water for  gastric lavage (which does not make sense in cases of alcohol poisoning with beer). But the dried-up green tea or tea with ginger root will complement the rehydration effect in food poisoning.

As an auxiliary treatment with herbs is possible: nausea can be reduced by taking a decoction of lemon balm or chamomile (a tablespoon of dry raw materials per 250 ml of boiling water, take half a glass three times a day); [9]the elimination of enterotoxins contributes to the decoction of elecampane root, which is prepared in the same proportions, but is taken three to four times a day 30 ml at a time.

Prevention

How to prevent beer poisoning? Know the measure in its use and never drink on an empty stomach.

And the prevention of foodborne diseases depends on how carefully you choose beer, checking the presence of sediment or turbidity in it, as well as specifying the end of its shelf life (which is indicated on the label).

Forecast

Both beginners and experienced beer lovers can suffer from severe, life-threatening intoxication. The outcome of beer poisoning, that is, its prognosis, depends on many factors and, unfortunately, can be fatal.

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