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Acid Reflux

Does Alcohol Worsen Acid Reflux?

Jul 27, 2017

Whether you like to pour yourself a night cap after a tiring day at work, prefer to drink a glass of wine with a scrumptious meal, or are the kind of person who cannot imagine enjoying a hot summer day without a chilled beer in your hand, the idea of giving up alcohol can be daunting. Sadly, it is one of the harsh realities of living life with GERD, because alcohol is an all-too-common trigger for acid reflux.

While alcohol doesn’t give reflux to everyone, it can aggravate symptoms in those who already suffer from acid reflux. The acidity of alcoholic drinks, combined with alcohol’s ability to relax the esophageal sphincter, is to blame here. So, if you suffer from acid reflux, it’s time to rethink what you drink!

How Exactly Does Alcohol Aggravate Acid Reflux?

Acid reflux happens when stomach acid flows back up the esophagus and spills into the throat, causing a burning sensation, pain, nausea and other symptoms. The LES or Lower Esophageal Sphincter is a muscular flap that allows food from the esophagus into the stomach but shuts tightly after swallowing to stop stomach acid and other contents to come back up. When the LES doesn’t function properly —meaning that it becomes loose, weak, relaxed or floppy, acid as well as other stomach contents can travel back into the esophagus, causing acid reflux or GERD. Also, when you eat or drink something that stimulates gastric acid secretion, this increased acidity can also irritate the esophagus, triggering reflux.

Alcohol can aggravate acid reflux in several ways. Scientists believe that it relaxes the LES, which allows stomach contents to leak into the esophagus. Also, a relaxed LES results in erratic swallowing contractions, which contributes to GERD. Researchers from School of Medicine, Zhejiang University believe that ‘acetaldehyde and other toxic by-products of alcohol metabolism interfere with esophageal contractions and impair lower esophageal sphincter function, heightening risk for acid reflux’.

Additionally, the high acidity in alcoholic beverages increases gastric acid production which can irritate the delicate stomach lining. Studies have found that since alcoholic beverages come in direct contact with the esophageal and gastric mucosae, they may cause direct mucosal damage. Think of alcohol as an irritant that inflames the delicate lining of the stomach and the esophagus. It’s for this very reason that drinks that contain higher alcohol content, such as hard liquors, are more likely to trigger reflux when compared to beer and wine which are low in alcoholic content.

Finally, after you have had a few drinks, you are more likely to make unhealthy food choices which will further aggravate acid reflux.

Does What And How Much You Drink Matter?

Researchers at Yokohama City University School of Medicine, Japan found that alcohol consumption in Japanese men tends to be associated with an increased risk of erosive esophagitis and Barrett’s epithelium, which are both advanced stages of GERD. However, how much alcohol you drink does come into play. Their clinical trial studied the correlation between different magnitudes of alcohol consumption and reflux esophagitis. They found that the more alcohol you drink, the higher your risk of GERD, though all drinkers are at increased risk.

Researchers have found that chronic and long-term consumption of alcohol in excessive quantities is associated with the development of GERD because it leads to hypertension of the LES, which may be caused by a disturbance in the function of the autonomous nervous system. However, that doesn’t mean you’re off the hook just because you don’t drink too much. A PubMed study found that even relatively modest quantities of alcohol induce gastro-esophageal reflux in healthy people.

On the other hand, many GERD patients tend to believe that if they choose low- alcoholic drinks like wine and beer, they will keep acid reflux at bay. According to research, this is not always true either. A German research study has found that ‘both beer and wine induce gastroesophageal reflux, which is neither related to their ethanol content nor to their pH. The mechanism for this effect remains to be identified’.

To summarize – alcohol will worsen your acid reflux, irrespective of whether you drink every day or occasionally. The best way to minimize your risk and to enjoy occasional social drinking is to limit the amount you consume to just 1 drink at any time, if you must drink at all.

7 Tips On Drinking Alcohol When You Have Acid Reflux

Since alcohol contributes to acid reflux, we believe the BEST strategy is to give up alcohol completely, especially if you suffer from chronic acid reflux. In fact, there are quite a few non-alcoholic drinks that are good for acid reflux, and do work for social settings as well. However, we do understand that alcohol is not always avoidable, so here are a few tips to lower risk of alcohol-induced acid reflux.

  1. Limit how much and how often you drink. The best rule of thumb is to limit yourself to just one drink. That means, safe limit of alcohol for you is – 5 ounces of wine, 8 ounces of malt liquor, 12 ounces of beer or 1.5 ounces of distilled liquor. Also, don’t drink every day; save alcohol only for special occasions.
  2. You know your body best. Because acid reflux triggers are different for everyone, an occasional glass of wine may not bring about a bout of severe heartburn for some, but trigger reflux in others. Similarly, some people don’t get reflux if they drink a pint of beer, while others are better off with a small peg of scotch.
  3. Make sure that you have your drink at least 2-3 hours before bed time to prevent night-time reflux. It will also help if you stay upright during this time, so gravity can keep stomach acid where it belongs – in the stomach; not creeping up the esophagus.
  4. Opt for healthy snacks while you drink. Don’t combine alcohol with other reflux-triggering finger-foods like chips, nachos with salsa or French fries.
  5. Steer clear of any alcoholic drinks that use citrus fruit juices and sodas as mixers, as these exacerbate acid reflux symptoms. If drinking liquor, mix only with water or low-acid juices like carrot, mixed vegetable or coconut water.
  6. If you want to be a social drinker, keeping a food diary is important. It will allow you to note down what you eat and drink, so you are better equipped to spot a pattern with your acid reflux symptoms. It is possible that a particular alcoholic drink, when combined with certain snacks, will aggravate reflux, but not otherwise.
  7. Refrain from giving in to the urge of lighting a cigarette with your drink. Smoking further aggravates acid reflux, and along with drinking, makes you very susceptible to a severe GERD attack.

Whether you must raise a toast to a new bride and groom, or need to have that obligatory drink with your boss to celebrate your promotion, these tips ensure that you don’t have to worry about a looming acid reflux attack later on. Drink responsibly, if you must!

Maneera Saxena Behl
Maneera is a health and fitness enthusiast who is also a firm believer in the power of dietary supplements. A health buff, she likes to help others improve their overall well-being by achieving the right balance between nutrition, exercise and mindfulness.

References:

Is alcohol consumption associated with gastroesophageal reflux disease? – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880354/

Alcohol consumption is associated with an increased risk of erosive esophagitis and Barrett’s epithelium in Japanese men – https://www.ncbi.nlm.nih.gov/pubmed/19077221/

Alcohol-related diseases of the esophagus and stomach – https://www.ncbi.nlm.nih.gov/pubmed/16508284/

Induction of gastro-oesophageal reflux by alcohol – https://www.ncbi.nlm.nih.gov/pubmed/25830/

Chronic alcoholism and esophageal motor activity: a 24-h ambulatory manometry study – https://www.ncbi.nlm.nih.gov/pubmed/16824069/

Low-proof alcoholic beverages and gastroesophageal reflux – https://www.ncbi.nlm.nih.gov/pubmed/8420765/