Many people develop a stuffy or runny nose shortly after consuming alcoholic beverages. Drinking alcohol can certainly cause or significantly worsen nasal congestion. This occurs because alcohol triggers several physiological responses that lead to the swelling of the delicate tissues lining the inside of the nose. Congestion is the feeling of a blocked nose that results from this internal swelling, making it difficult to breathe clearly.
How Alcohol Affects Nasal Passages
The primary mechanism behind alcohol-induced stuffiness is the effect of ethanol, the alcohol in beverages, on the body’s blood vessels. Alcohol acts as a potent vasodilator, meaning it causes blood vessels to widen throughout the body, including those that supply the nasal lining. When these vessels dilate, they fill with more blood, causing the nasal tissues and the turbinates—structures inside the nose—to swell. This rapid swelling is what physically blocks the nasal passages and creates the sensation of congestion.
Beyond this direct vascular effect, alcohol can also trigger a release of histamine from mast cells. Histamine is a compound associated with allergic reactions, and its release causes an inflammatory response. In the nasal passages, this contributes to increased swelling and mucus secretion. Alcohol also acts as a diuretic, increasing urine production, which can quickly lead to dehydration. Dehydration can thicken the mucus and irritate the sinus membranes, making existing congestion or allergy symptoms feel worse.
Why Specific Drinks Cause Worse Reactions
While the ethanol in any alcoholic drink can cause congestion, certain beverages are more likely to trigger a strong reaction due to their non-ethanol components. Fermented drinks, like red wine and beer, often contain high levels of histamine produced during the brewing and aging processes. Consuming these drinks introduces histamine into the body, which can trigger symptoms similar to an allergic response in sensitive individuals.
These fermented beverages also contain compounds known as congeners, which are byproducts created during fermentation. Congeners, along with additives like sulfites, can trigger stronger intolerance reactions compared to highly distilled, clear spirits like vodka or gin. Sulfites are commonly added to wine as preservatives and can cause inflammatory reactions, particularly in people who have asthma. A separate factor is a genetic variation that affects how the body metabolizes alcohol. The body converts ethanol into acetaldehyde, which is normally broken down by the enzyme ALDH2. If a person has a less effective version of the ALDH2 enzyme, acetaldehyde builds up rapidly, causing flushing and inflammation that exacerbates nasal congestion.
Strategies for Relief and Prevention
Prevention
For those who frequently experience congestion after drinking, selecting beverages with lower levels of congeners and histamines is a preventative measure. Clear spirits, such as gin and vodka, contain fewer irritants than dark liquors or fermented products like red wine and beer. Minimizing the intake of known triggers, particularly red wine, is an effective way to reduce the likelihood of a stuffy nose.
Relief
During consumption, drink water between alcoholic beverages to mitigate dehydration, which helps keep mucus thin and flowing. For immediate relief, over-the-counter options can be useful. Non-drowsy antihistamines may help counter the effects of the histamine released by the body or introduced in the drink.
Using a saline nasal rinse or a nasal irrigation tool can help flush out irritants and moisten the nasal passages. Short-term use of a decongestant nasal spray may temporarily shrink the swollen nasal blood vessels, providing quick relief from blockage. However, these sprays should only be used for a few days to avoid rebound congestion.