If you sometimes develop nasal stuffiness and sinus congestion associated with drinking alcohol, you are not alone. These relatively common symptoms occur for a variety of reasons, working alone or in combination.
In most people, this congestion clears relatively quickly. In some cases, rapid development of congestion and other symptoms associated with drinking represents acute alcohol sensitivity. This genetic condition most commonly occurs in people of East Asian descent.
You've probably noticed that drinking often makes you feel warm. This occurs because alcohol triggers expansion of the blood vessels near you — body surfaces — including the lining of you nose and sinuses. This extra blood flow can lead to temporary swelling and increased mucus production, potentially provoking nasal and sinus congestion.
Alcohol acts as a diuretic, meaning you lose increased amounts of body water through your kidneys. This can potentially lead to dehydration with increased thickness of the mucus in your nose and sinuses that might lead to congestion.
Additionally, some research data from animal experiments suggest that alcohol itself might increase the thickness of the mucus secretions of your upper respiratory system independent of inducing dehydration. However, this has yet to be proven in humans.
You've likely heard of histamine, probably in the context of allergies. While histamine plays a pivotal role in allergic reactions, it also acts as an important signaling chemical, a function that can potentially contribute to congestion related to drinking alcohol.
Drinking beer and wine — especially red wine and champagne — strongly stimulates stomach acid secretion, an effect not typically seen with spirits. Increased histamine produced by cells in the stomach serves as a signal to trigger this response.
Because your stomach possesses rich blood flow, some of the histamine seeps into the circulation. Researchers speculate that this increased level of histamine in the bloodstream can lead to effects such as congestion after drinking beer or wine.
Histamines present in beer and wine might can also contribute to development of nasal and sinus congestion after imbibing these alcoholic beverages.
Eating high-histamines foods while you're drinking can further boost the histamine level in your body and increase the likelihood of developing symptoms. Common high-histamine foods frequently paired with beer or wine include aged cheese, peanuts, cured meats, pickles, olives, guacamole and sour cream.
Like many medical terms, vasomotor rhinitis sounds ominous but generally is not. The condition involves development of upper airway-related symptoms in response to environmental triggers, including drinking alcohol.
Other possible triggers include strong smells and exposure to cold air, among others. Typical symptoms include a runny nose and congestion, which might be accompanied by postnasal drip, headache and/or a dry cough.
Vasomotor rhinitis does not involve an allergic reaction, although the exact mechanisms leading to congestion remain incompletely understood. Some researchers speculate that the condition represents exaggerated sensitivity of the lining tissues of the nose and sinuses.
Your body primarily breaks down alcohol in two steps, each dependent on a separate enzyme. Genetic variations in these enzymes influence how your body metabolizes alcohol and related symptoms you might experience. People of Chinese, Japanese and/or Korean descent often have a variant of one or both enzymes that leads to an impaired ability to metabolize alcohol.
Those who have these variant enzymes typically experience pronounced facial flushing, a rapid heart rate, and nasal and sinus congestion shortly after drinking even a small amount of alcohol. Other genetically determined variations in the first enzyme involved in alcohol breakdown can cause similar symptoms in people of non-Asian descent, although this is less common.
Next Steps and Precautions
Sinus congestion that clears up within a day or so after drinking alcohol typically poses no cause for concern. You might try switching the type or brand of alcoholic beverage you typically drink or the foods you eat along with your drink to see if you can avoid this unpleasant symptom.
See your healthcare provider if your sinus congestion persists or is accompanied by warning signs or symptoms, including wheezing, hives or facial pain, to rule out an underlying medical problem.
- National Institutes of Health, Genetic and Rare Diseases Information Center: Acute Alcohol Sensitivity
- World Allergy Association Journal: Nonallergic Rhinitis, With a Focus on Vasomotor Rhinitis Clinical Importance, Differential Diagnosis, and Effective Treatment Recommendations
- Respiratory Medicine: Alcohol-induced Upper Airway Symptoms: Prevalence and Co-morbidity
- American Journal of Physiology, Heart and Circulatory Physiology: Direct Effect of Ethanol on Human Vascular Function
- GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery: Physiology and Pathophysiology of Respiratory Mucosa of the Nose and the Paranasal Sinuses
- Alcohol Use Disorders and the Lung: A Clinical and Pathophysiological Approach; David M. Guidot and Ashish J. Mehta
- Histamine Intolerance: Histamine and Seasickness; Reinhart Jarisch
- Alcohol Research Current Reviews: The Genetics of Alcohol Metabolism: Role of Alcohol Dehydrogenase and Aldehyde Dehydrogenase Variants