Alcohol can trigger or worsen heartburn for many individuals. Heartburn is a burning sensation felt in the chest, typically behind the breastbone, which can extend to the throat. It occurs when stomach acid flows back into the esophagus, the tube connecting the mouth to the stomach. This article explores how alcohol contributes to heartburn and outlines strategies for prevention and relief.
How Alcohol Causes Heartburn
Alcohol affects several bodily functions that contribute to heartburn. One primary mechanism involves the lower esophageal sphincter (LES), a band of muscle at the end of the esophagus that acts as a valve to prevent stomach contents from re-entering. Alcohol can relax this muscle, causing it to loosen or open when it should remain closed, allowing stomach acid to flow back up.
Beyond relaxing the LES, alcohol can also influence stomach acid production. Alcoholic beverages can stimulate the stomach to produce more acid than usual. This increased acidity can exacerbate the burning sensation if reflux occurs, leading to greater irritation of the esophageal lining.
Alcohol can directly irritate the lining of the esophagus. It can cause inflammation and make esophageal tissues more sensitive to stomach acid. This direct irritation, combined with acid reflux, intensifies the discomfort. Alcohol may also delay stomach emptying, meaning food and acid remain in the stomach longer, increasing the likelihood of reflux.
Which Alcoholic Drinks Are Worse
Certain types of alcoholic beverages and drinking habits are more likely to cause or intensify heartburn symptoms. Carbonated alcoholic drinks, such as beer, sparkling wine, and hard seltzers, can contribute to increased stomach pressure. This pressure can push stomach acid upwards into the esophagus, making reflux more likely.
Beverages with high alcohol content, including spirits like whiskey or vodka, may lead to greater relaxation of the lower esophageal sphincter. Their ability to relax the LES can still contribute to heartburn.
Acidic mixers commonly used in cocktails, such as citrus juices (e.g., orange, cranberry, grapefruit), increase the overall acid load in the stomach. This combination can irritate the esophagus and worsen heartburn symptoms. Drinking large quantities of alcohol or consuming drinks too rapidly, regardless of type, can also increase the risk of heartburn.
Strategies for Prevention and Relief
Several strategies can help prevent alcohol-induced heartburn and provide relief. To prevent heartburn, consume alcohol in moderation. Avoiding known triggers like carbonated beverages, high-proof spirits, and acidic mixers can reduce the likelihood of symptoms. Eating a meal before or while drinking can help buffer stomach acid and slow alcohol absorption.
Staying adequately hydrated by alternating alcoholic drinks with water is helpful, as dehydration can exacerbate acid reflux. To minimize reflux, avoid lying down immediately after drinking, as gravity no longer assists in keeping stomach contents down. Elevating the head of the bed can also benefit those who experience nighttime heartburn.
For immediate relief, over-the-counter antacids can neutralize stomach acid. Histamine-2 (H2) blockers and proton pump inhibitors (PPIs) can reduce acid production, offering more prolonged relief. Simple measures like sitting upright and loosening tight clothing can also alleviate pressure on the stomach.
When to Consult a Doctor
While occasional heartburn is common, certain symptoms warrant medical consultation. If heartburn occurs frequently, such as more than twice a week, or if it does not improve with over-the-counter medications, seek professional medical advice. Persistent heartburn could indicate a significant underlying condition, like gastroesophageal reflux disease (GERD).
Other concerning symptoms include difficulty swallowing or painful swallowing, which could signal irritation or damage to the esophagus. Unexplained weight loss, chronic cough, or hoarseness may also be related to persistent acid reflux and should be evaluated by a healthcare provider. Seek immediate medical attention for chest pain, especially if accompanied by shortness of breath, arm pain, or sweating, as these can be signs of a heart attack rather than just heartburn.