Medically reviewed by Saurabh Sethi, MD, MPH
Written by Jon Johnson
Heartburn is a painful, burning sensation in the chest and upper throat. Alcohol can trigger or worsen heartburn in some people.
Heartburn happens when stomach acid flows back into the esophagus, or food pipe, causing discomfort or pain. Certain foods and drinks can trigger heartburn, and alcohol is a common cause.
This article looks at the link between alcohol and heartburn, including how alcohol triggers symptoms and how to avoid them.
Understanding heartburn and its causes
Many factors can cause or trigger heartburn. Understanding the causes of heartburn can help people understand how alcohol can be a trigger.
After swallowing, food and drink travel down the esophagus and into the stomach where acid breaks them down. While the stomach can resist the acid, the esophagus and other body tissues cannot. When acid moves back into the esophagus, people experience discomfort and pain.
Causes of heartburn include:
- Lower esophageal sphincter (LES) dysfunction. If the LES that connects the esophagus to the stomach becomes weaker or relaxes, acid can leak into the esophagus.
- Irritation. Foods, drinks, or medicines can directly irritate the esophagus, causing heartburn and irritating the sensitive tissues of the esophagus.
- Slow stomach emptying. Some people have a disorder that prevents the stomach from emptying properly. Food stays in the stomach for longer, increasing the risk of heartburn.
- Hiatal hernia. This condition occurs when a hernia develops at the entrance to the stomach. This may be due to injury, overweight, or a weakening of the diaphragm.
If a person experiences frequent heartburn, they may have gastroesophageal reflux disease (GERD).
How does alcohol cause heartburn?
Many people experience heartburn after drinking alcohol. Alcohol can, in some cases, increase the likelihood of heartburn and GERD.
A 2019 review found that people who drank more alcohol or drank alcohol more regularly had a greater likelihood of GERD. This does not mean that alcohol causes GERD, but it does suggest that there may be a link.
There may be several ways in which alcohol leads to symptoms such as heartburn:
- Irritating the throat or stomach. Because of the chemicals it contains, alcohol can directly irritate the tissues in the esophagus.
- Relaxing the muscle leading to the stomach. According to the American College of Gastroenterology, alcohol relaxes the muscles around the stomach, which makes it more likely for the contents of the stomach to leak out.
- Affecting stomach acid. Alcohol can make the stomach produce more acid. It can also make the tissues more sensitive to acid, which can lead to heartburn.
- Affecting food choices. Alcohol can affect judgment. After drinking alcohol, people are more likely to eat foods that disagree with them, eat late at night, or eat more than usual. These factors can cause heartburn.
- Drinking sugary or carbonated drinks. Alcoholic beverages that are sugary, citrus, or carbonated can lead to heartburn.
- Smoking. Some people smoke or smoke more while they are drinking alcohol. Smoking is a major risk factor for heartburn.
Treatment and prevention
Some people can avoid heartburn by drinking alcohol in moderation, which means one or two drinks only. For others, heartburn can arise even with a small serving of alcohol.
Some drinks can cause heartburn more than others. This may differ between individuals. Working out which types of drinks trigger a person’s heartburn, and avoiding these drinks, can prevent heartburn.
Drinking alcohol may lead to unhealthful eating habits or eating foods that cause digestive upset. Being mindful of these food triggers and avoiding them, even while drinking, can prevent heartburn.
It may also help to avoid drinking alcohol a few hours before bed. Lying down with alcohol in the stomach may make it more likely that this alcohol relaxes the LES, leading to heartburn symptoms.
If an underlying condition such as GERD causes heartburn, the person may benefit from seeing a doctor for treatment. Treatments may include medications and lifestyle changes.
Medications for GERD include:
- antacids, including Maalox and Mylanta
- H2 blockers, including cimetidine and ranitidine
- proton pump inhibitors (PPIs), including omeprazole and esomeprazole
- prokinetics, including bethanechol and metoclopramide
- antibiotics, including erythromycin
Avoiding other common trigger foods and drinks may also help prevent heartburn. These include:
- coffee, both caffeinated and decaf
- citrus fruits and juices, such as orange juice and grapefruit juice
- fizzy drinks, which cause bloating and pressure on the stomach muscles
- chocolate, which contains a chemical that relaxes the opening to the stomach
- peppermint, garlic, and onions, which also relax the opening to the stomach
- fatty, spicy, or fried foods that relax the opening to the stomach and delay stomach emptying
Heartburn triggers differ between individuals. Alcohol is one of the common triggers.
Drinking in moderation can prevent heartburn for many people. Working out which specific drinks trigger heartburn, which may be sugary alcoholic drinks for some people and beer for others, and avoiding them will also help reduce heartburn.