Alcohol has a detrimental effect on many organs in our bodies, including the stomach and esophagus. Many scientific studies have associated alcohol consumption with the increased risk of heartburn and other acid reflux symptoms.
Acid reflux after drinking alcohol
Gastroesophageal reflux disease, commonly known as GERD, is a condition in which people often feel a burning pain behind the breastbone (this is called heartburn) due to the reflux of stomach acids into the food pipe and throat.
Alcohol consumption strongly correlates with GERD, especially if the esophagus is already eroded.
Acid reflux after drinking alcohol is associated with two manifestations which depend on the degree of damage to the lining of the esophagus:
- Reflux or erosive esophagitis (RE or EE), which causes erosion of the esophagus due to alcohol intake.
- Non-erosive reflux disease, in which there is no erosion of the esophagus but acid causes symptoms of GERD.
The main reasons for experiencing heartburn after drinking alcohol are:
- decreased lower esophageal sphincter pressure
- motility problems in the stomach
- increase stomach acid production
- drinking and/or eating too much
LES – the cause of heartburn
There is a one-way valve at the gastroesophageal junction (between the stomach and the food pipe) known as the lower esophageal sphincter (LES). The LES constricts after the food moves into the stomach from the esophagus, thus preventing the backflow of digestive fluids.
Alcohol causes the relaxation of this sphincter (just like tea), which allows gastric contents to seep up into the esophagus.
Alcohol and stomach motility
Certain types of alcohol can inhibit stomach motility. In this case, food stays longer in the stomach.
Albeit the exact reasons are not known, such gastric emptying problems seem to play an important role in the development of acid reflux and GERD.
Turns out not all alcohols are created equal:
Alcohol effect on gastric motility depends on the alcohol concentration. In general, beverages with high alcohol concentrations (i.e., above 15 percent) appear to inhibit gastric motility and low alcohol doses (wine and beer) accelerate gastric emptying. Also, acute administration of ethanol inhibits the gastric emptying, while chronic administration of a large dose of alcohol accelerates gastric motility.
(source)
High alcohol concentrations and binge drinking seem to be the main causes.
Does alcohol increase gastric acid?
Excessive gastric acid production is one of the leading causes of acid reflux, which leads to heartburn, gastro-esophageal reflux disease or GERD, and inflammation of the esophagus.
Gastrin, a hormone that stimulates gastric acid production in the stomach, has a strong relationship with alcohol intake:
- Wine and beer stimulate gastrin production, which leads to excessive secretion of gastric acid in the stomach.
- Beverages with higher alcohol concentrations don’t have such a stimulative effect.
Increased stomach pressure
People often consume too much alcohol or eat too much while drinking alcohol. This increases pressure in the stomach.
A high stomach pressure combined with a relaxed LES makes it easier for digestive juices to enter the esophagus and trigger heartburn.
Heartburn and drinking alcohol
Heartburn is a painful condition associated with burning chest pain, causing chest discomfort and sour taste. While this symptom is often triggered by stomach acids entering the food pipe, esophageal problems can also be the culprit.
Causes of heartburn due to alcohol intake are:
- dysfunction of the lower esophageal sphincter
- irritation of the esophagus and lining of the stomach
- delayed emptying of the stomach
- hiatal hernia
- increased acid production in the stomach
The two main contributing factors to alcohol-induced esophageal problems are:
- decreased esophageal motility
- an already damaged esophagus
Motility problems in the food pipe
Another heartburn risk factor of alcohol is its ability to impair the contractility of the smooth muscle of the esophagus.
Esophageal motility abnormalities are often present in people suffering from acid reflux or GERD.
Besides heartburn, typical symptoms of this condition are:
- difficulty swallowing
- regurgitation
- chest pain in the center of the chest
- the feeling of food stuck in the throat
The cause of such motility issues is that alcohol consumption inhibits the entry of calcium into the esophageal muscles, which leads to slow peristalsis (wave of contraction which pushes food down to the stomach).
Esophageal damages
Alcohol irritates the mucosal lining and muscles of the esophagus, which leads to esophagitis, causing heartburn.
Alcohol also seems to contribute to mucosal injuries of the esophagus, making the irritation even more painful.
Barrett’s esophagus is one of the complications of esophagitis which is also associated with severe chest pain.
Heartburn after drinking on an empty stomach
Alcoholic gastritis is a common cause of heartburn when drinking on an empty stomach.
Alcohol irritates the stomach lining, this is especially true when drinking on an empty stomach.
This irritation might increase the risk of developing ulcers and cause inflammation of the stomach lining, called gastritis.
Typical symptoms of alcoholic gastritis are abdominal and chest pain, which feels like heartburn.
Even if you are not prone to having heartburn, it is recommended to steer clear of drinking alcohol on an empty stomach, as it still damages the stomach lining.
Can alcohol make heartburn worse?
As discussed above, alcohol can worsen heartburn due to:
- excessive acid production
- slowing down peristalsis
- delayed emptying of the stomach
- irritation and inflammation of the esophagus
However, when drinking alcohol, other factors are also responsible for experiencing heartburn:
- Impaired judgment: One of the short-term effects of alcohol abuse is cognitive and physical impairment.
- Altered food choices: Alcoholics usually take large meals without realizing the amount of food they have eaten. They are also prone to eat unhealthy foods, which causes heartburn.
- Alcohol containing sugary and carbonated drinks: Such drinks are known for aggravating or triggering acid reflux symptoms.
- Smoking: People often smoke while drinking alcohol, which is also an aggravating factor of heartburn. The risk of carcinoma also increases with this combination.
How to drink alcohol with heartburn?
If you are prone to getting heartburn after drinking alcohol, these tips might help:
- Add less acidic juices – like apple juice or carrot juice – to avoid symptoms.
- Avoid mixing alcohol with soda, lemon, or other common heartburn triggers.
- Drink less. The more you drink, the more likely you are to experience symptoms.
- Experiment with different types of alcohol. Some people instantly get heartburn after small amounts of beer or wine but can get by with some vodka. Non-grain vodka is said to be the “best alcohol for acid reflux”, i.e. the least likely to trigger symptoms.
As a last resort, you can take antacids after drinking alcohol to relieve the burning pain in the chest. Always ask your doctor before taking antacids, as some antacids might cause unwanted side effects.
You must be careful with antacids if you are pregnant, lactating mother, taking other medicines or supplements, have kidney or renal failure, and have drug allergies.
Take the only recommended dose, read the prescription and guidelines carefully.
How to relieve heartburn after alcohol intake?
Dietary and lifestyle changes can go a long way in relieving or even completely avoiding heartburn:
- 10-15 minutes walk: Do not lie down immediately after drinking alcohol; walk for a few minutes. Gas produced during the digestion of food is released in this way, and food contents present in your stomach will move down due to the effect of gravity.
- Chew gums: Chewing gums stimulate the production of excessive saliva, which neutralizes gastric acids to some extent and flushes down stomach acids from the esophagus. Actually, there are scientific studies proving that chewing gum is good for acid reflux.
- Try eating bananas: Banana is alkaline, it reduces the acidity of the stomach, so it can be used to relieve signs and symptoms of heartburn. However, some people might have symptoms after eating bananas (e.g. IBS sufferers).
- Apple cider vinegar: Apple cider vinegar is supposed to reduce acidity, and you can take it in case of heartburn after drinking alcohol. It has no side effects, provided that you take it in small quantities.
- Do not take coffee and tea: Caffeine can trigger heartburn, as it relaxes the LES: On top of that, coffee, tea, and other hot beverages are thought to aggravate heartburn due to their damaging effects on the esophagus and stomach lining.
- Carrot juice: Carrot juice also has a soothing effect. It reduces burning pain and irritation of the stomach.
- Baking soda: Baking soda is alkaline, and it relieves the acidity of the stomach. Take one teaspoon baking soda, mix it in one glass of water, and drink. It neutralizes the acidic environment of the stomach.
- Wear loose clothes: Tight belts and clothing can build pressure in the abdomen, causing back food contents into the stomach. Wearing loose clothes can make you feel better.
- Change your lifestyle: If you have a sedentary lifestyle, it is also a risk factor for heartburn and indigestion.
- Do not eat late at night. Chances are you are going to lie down soon after eating, which increases the risk of a reflux attack.
- Lose some weight if you are obese. Obesity is another risk factor for heartburn.
- Your head should be lifted while sleeping to avoid back flush and water brash.
Final thoughts
Alcohol consumption affects almost every organ of your body. Your chances of developing serious diseases increase with alcohol intake. It damages the stomach and liver severely, making them prone to cancer.
Never exceed recommended safe doses of alcohol to avoid problems like heartburn, GERD, esophagitis, gastritis, and esophageal as well as gastric carcinoma.
If you experience severe chest or abdominal pain, blood in stool or vomit after drinking alcohol, always contact your doctor!
Eating healthy food and a physically active lifestyle can relieve symptoms.
This article has been written by:
Department of Medicine and Surgery,
Nishtar Medical University and Hospital
