Drinking beer -- or any other alcoholic beverage -- can cause swelling, or edema. Edema occurs when an abnormal amount of fluid collects in the tissues of your feet, hands or other parts of the body. Edema that occurs after a bout of beer drinking but goes away within a day or two may not be a medical concern. However, if your feet or ankles consistently swell after drinking or stay swollen for several days, it may indicate a problem with your liver, heart or kidneys.
Alcohol affects your kidneys' filtering ability. As alcohol enters your bloodstream, it suppresses release of antidiuretic hormone, or ADH. The reduced level of ADH along with direct effects of alcohol on your kidneys leads to rapid loss of water -- and frequent trips to the bathroom to urinate. This effect is most profound when you start drinking. When you stop drinking and your blood alcohol concentration stabilizes, ADH levels rebound and the kidneys begin retaining water again.
Because alcohol also changes your kidneys' handling of electrolytes -- such as sodium and potassium -- your total body water is temporarily increased after a bout of drinking. This can manifest as swelling of your feet or hands. If you are otherwise healthy and not a heavy drinker, this swelling usually goes away in about a day.
Hepatitis and Cirrhosis
Chronic, heavy drinking of beer or other forms of alcohol over several years can cause swelling in your feet for a much more serious reason: liver problems. Alcoholic hepatitis describes a condition in which your liver becomes enlarged, inflamed and cannot function normally. Swelling of the feet and hands, and fluid accumulation in the belly are common with this condition, especially if you are malnourished.
Heavy drinking over a period of years can also lead to cirrhosis of the liver. With this condition, your liver is heavily scarred and functions poorly. Scarring distorts your liver and partially blocks blood flow through it, leading to increased pressure in the vein that leads to the liver. This condition -- portal hypertension -- triggers a complex series of events that lead to marked water retention. Persistent swelling of your feet, hands, face and belly results.
Overindulging in beer or another form of alcohol damages your kidneys over time. Because your kidneys control water balance in your body, alcohol-induced kidney damage commonly leads to an increased amount of total body water. Reduced kidney function related to heavy alcohol intake also leads to abnormal levels of electrolytes in your bloodstream, including sodium, potassium and phosphate. The combination of increased body water and abnormal electrolyte levels leads to fluid leakage into the body tissues, with swelling of your feet and hands.
Heavy drinking can have toxic effects on your heart, leading to stretching and weakening of the muscle over time. With this condition, known as alcoholic cardiomyopathy, the weakened heart struggles to pump blood. Heart failure occurs in the advanced stages of alcoholic cardiomyopathy. Fluid from your bloodstream leaks into the lungs and body tissues. Common symptoms include swollen feet and ankles, fatigue and shortness of breath.
If you experience frequent or persistent swelling of your feet or ankles, see your doctor. The problem may or may not be related to your drinking, but it's important to find out the underlying cause. Also talk with your doctor if you have difficulty controlling your drinking. Frequent, short-term swelling of your feet or hands after drinking might signal your alcohol consumption is getting out of hand.
Reviewed by: Tina M. St. John, M.D.