A painful, burning sensation in your chest, right behind the breastbone, could be heartburn, which is caused by a backup of your stomach contents into the food tube, or esophagus. Many people experience heartburn from time to time -- but if this occurs frequently, you may have gastroesophageal reflux disease. Some people who suffer from GERD notice that liquor can act as a trigger for heartburn. Alcoholic beverages may increase stomach acid secretion and alter the movement of food through the digestive system, which might allow the stomach contents to back up into the esophagus. In addition, liquor is often consumed with foods that may trigger heartburn. While avoiding alcohol may or may not improve your GERD, several lifestyle and medical interventions can help.
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Effects on Motility
Reflux occurs when your stomach contents travel up into the esophagus. Your lower esophageal sphincter, the ring of muscle that separates the esophagus from the stomach, is supposed to prevent this from happening by staying closed when you aren't swallowing. Liquor or alcoholic beverages can cause a relaxation of this muscular ring and may lead to heartburn symptoms if your stomach contents back up into your esophagus. Alcohol consumption can also slow stomach emptying, particularly when large amounts of alcohol are consumed. This could contribute to GERD symptoms, as the pressure of a full stomach can more easily push the stomach contents back into your esophagus.
Effect on Acid Secretion
Your stomach makes high levels of acidic fluid that aids in the breakdown of food. When your stomach contents back up into the esophagus, this acid irritates the esophagus, contributing to heartburn symptoms. A review article published in "Journal of Zhejiang University Science B" in June 2010 reports that modest amounts of alcohol can increase the production of stomach acid, although large amounts of alcohol had no effect or reduced stomach acid secretion. This review also found that beer and wine increased secretion of stomach acid, while distilled liquors such as whiskey or gin did not.
Association With Diet
Even though alcohol could contribute to the symptoms of GERD, the American College of Gastroenterology in its 2013 clinical practice guidelines stops short of recommending that people with GERD curtail alcohol. There is simply not enough clinical evidence to prove that avoidance relieves symptoms. However, if you find that alcohol triggers your heartburn, you may want to limit or avoid these beverages. Also consider when and what you eat with your beer, wine or other liquor. For instance, drinking beer with fatty or fried foods may trigger heartburn. Also, drinking liquor with a large meal eaten just before you lie down to sleep can trigger heartburn. Consider keeping a daily journal of when and what you eat and drink to help identify the causes of your symptoms.
While avoiding alcohol may not alleviate your heartburn, some lifestyle changes may prove beneficial. Reducing your weight, if you are overweight, is strongly recommended by the American College of Gastroenterology as a way to deal with GERD symptoms. Avoiding late night meals, eating smaller meals and elevating the head of your bed may also help. Many medications can treat heartburn as well. Your doctor can recommend over-the-counter or prescription medicines that can neutralize or reduce stomach acid production. In some cases, surgery may be recommended to repair the lower esophageal sphincter.
Warnings and Precautions
Heavy, long-term drinking can directly damage the lining of your esophagus and stomach, disrupting their normal functions. These problems are often accompanied by frequent and persistent heartburn along with other symptoms, such as difficult or painful swallowing and feeling as if something is stuck in your throat. See your doctor right away if you experience these symptoms or have difficulty controlling your drinking. Regardless of your drinking habits, it’s also important to see your doctor if you have more than occasional heartburn because you might have GERD. Left untreated, GERD can lead to serious health problems.
Medical advisor: Jonathan E. Aviv, M.D., FACS