Many people enjoy a nice cold beer once in a while, but no one enjoys acid reflux. Acid reflux most commonly involves a painful, burning sensation in the area of your breastbone. It can also cause other symptoms such as a sour, acid taste in the throat or back of your mouth. When acid reflux occurs frequently, it is called gastroesophageal reflux disease, or GERD. While you may experience acid reflux more often after you have had a beer or two, the medical evidence on the relationship between alcohol consumption and reflux is unclear. Beer has the potential to aggravate acid reflux by causing bloating and making stomach contents more likely to travel into the esophagus, yet the avoidance of alcohol doesn't consistently improve acid reflux symptoms.
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The Anatomy of Acid Reflux
The reason beer may aggravate acid reflux relates to how it affects a muscle called the lower esophageal sphincter, or LES. At the bottom of your esophagus, the tube connecting the mouth to the stomach, you have a muscular ring that opens to let food pass into the stomach. When you are not swallowing, this sphincter is supposed to stay closed so the acidic contents of your stomach do not travel back up into the esophagus. But sometimes the sphincter relaxes, and some of these acidic stomach contents escape -- which can irritate and damage the lining of your esophagus and produce the burning pain commonly known as heartburn. Beer and other alcoholic beverages can cause relaxation of this sphincter, making acid reflux more likely.
Alcohol and Acid Reflux
Alcohol may also slow the movement of food through your digestive system, and the likelihood of acid reflux is greater when your stomach is full or stays full longer than usual. As summarized in a review in the May 2006 "Archives of Internal Medicine," there have been a few small-scale studies linking alcohol consumption with increased acid reflux symptoms. However, neither the American Gastroenterological Association in its 2009 medical position statement nor the American College of Gastroenterology in its 2013 clinical practice recommendations recommend routine avoidance of alcohol in GERD treatment, because there is insufficient evidence that avoiding alcohol improves symptoms. These guidelines do acknowledge that an individual approach is useful and some people may benefit from specific lifestyle changes, such as reducing or avoiding alcohol.
Beer, Bloating and Acid Reflux
Beer might aggravate your acid reflux because the swallowed air from the beer's carbonation can cause bloating and belching. Bloating results in increased abdominal pressure -- which can push stomach contents back up into the esophagus, making you more likely to experience acid reflux. After consuming carbonated beverages, you might accidentally or purposely belch to relieve some of the pressure. As you belch, the lower esophageal sphincter opens to allow some of that gas to escape, and some acidic stomach contents may travel up into the esophagus. This may not only aggravate heartburn symptoms, but if the stomach contents travel up far enough, you may also experience that sour, acidic taste in your mouth.
Reducing Acid Reflux
If you drink beer and suspect it may be contributing to your acid reflux symptoms, try avoiding it for awhile, and then assess your response. You can also try additional lifestyle changes such as losing excess weight, avoiding late-night meals, and raising the head of your bed when you sleep. If you find that your acid reflux is associated with bloating, you may improve symptoms by eating more slowly, eating smaller meals and avoiding foods that cause you to have excess gas and bloating -- such as carbonated beverages, beans and cabbage. Your doctor can also prescribe medications to control your symptoms. While occasional acid reflux and bloating are common and not serious, if you are experiencing either on a regular basis, see your doctor. In addition, since excessive alcohol consumption poses serious health risks, if you find you consume more than a few drinks on a regular basis, discuss the consequences with your health-care professional.
Medical adviser: Jonathan E. Aviv, M.D., FACS