Can You Drink Alcohol with Heartburn?

When you're living with heartburn, you don't just need to watch what you eat; what you drink is important, too. For many people, alcohol can have a negative impact on heartburn symptoms.  But does that mean alcohol has to be completely off-limits if you have heartburn? Not necessarily! Here are some tips that can help you limit your symptoms if you choose to drink alcohol.

Note: The following recommendations are for those who experience occasional heartburn. If you have a more chronic condition, such as GERD, talk to your doctor about whether or not alcohol consumption is appropriate for you.
 
How does drinking alcohol affect heartburn?
The lower esophageal sphincter (LES) is a small bundle of muscles that connects the stomach to the lower end of the esophagus. Its function is to prevent stomach acid from entering the esophagus. As a depressant, alcohol relaxes and loosens the lower esophageal sphincter (LES). This makes it easier for stomach acid to enter the esophagus, which can cause a burning sensation and damage the esophageal lining over time. On top of that, alcohol increases the production of stomach acid. The increase in acid and decrease in LES functionality increases the likelihood that stomach acid will flush back into the esophagus, leading to heartburn. Consistent alcohol consumption increases the possibility of long-term esophagus damage. Over time, excessive alcohol consumption ultimately causes inflammation of the stomach lining (also known as gastritis), which increases the chance of chronic heartburn issues that can become difficult to manage.
 
Can I prevent alcohol's effects on heartburn?
Although drinking alcohol is not recommended for people with heartburn, the choice to drink is a personal one. It is possible for some people to enjoy a beverage or two in moderation without aggravating heartburn symptoms. One of the best ways to manage alcohol-induced heartburn is to choose alcoholic beverages that produce a minimal amount of stomach acid. For example, higher-proof alcohol produces more stomach acid than lower-proof alcohol, and therefore is more likely to cause heartburn symptoms. In order to minimize heartburn symptoms while imbibing, women should have no more than one drink within a 24-hour period, and men should have no more than two drinks within a 24-hour period. (One serving of alcohol is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits.)

Can I drink alcohol while taking heartburn medication?
Mixing alcohol and medications can be dangerous and should be limited or avoided whenever possible. The type of heartburn medication you take can also affect how your body processes alcohol.
  • Proton pump inhibitors (PPIs) (Prilosec, Prevacid, AcipHex) are a classification of medications commonly used to treat heartburn, gastroesophageal reflux disease (GERD) and gastric ulcers. PPI medications do not have any specific warnings related to effectiveness or interactions with alcohol, though keep in mind that alcohol is not generally recommended for people with chronic heartburn. However, a 2008 study found moderate alcohol consumption did not worsen gastroesophageal reflux when a PPI was taken. Be sure to talk with your medical provider or pharmacist if you are considering consuming alcohol while taking a PPI.
     
  • H2 blockers (Zantac, Pepcid, Axid, Tagamet) have been found to increase blood alcohol levels up to 38 percent when taken with alcohol. If you are taking an H2 blocker and consume alcohol on occasion, limiting your alcohol volume and frequency is advised. You can also talk with your medical provider to see if a medication change is possible.

How do I avoid heartburn in social situations involving alcohol?
Sometimes, the heartburn that accompanies alcohol use is actually a result of multiple factors. Consuming alcohol lowers our inhibitions while also stimulating our appetites. This can lead to food choices that exacerbate heartburn. It can be hard to limit or avoid those favorite foods, especially when many of the foods in social situations are heartburn triggers. The greasy fried appetizers and spicy foods are much harder to limit or avoid in the mix of alcohol and friends. Alcohol also causes us to focus less on monitoring our portion sizes, which can lead to overeating.

The only way you can really prevent an alcohol-related heartburn flare is to avoid drinking altogether. However, you may be able to enjoy alcohol in moderation while living with heartburn by following a few simple tips:
  • Wear looser-fitting clothing instead of belts or form-fitting clothes. Tighter clothing can bind and increase reflux and related discomfort.
     
  • Dilute your white wine with water or club soda to lower the alcohol content in your drink. Plus, a wine spritzer made with three ounces of wine only has 60 calories!
     
  • Drink a large glass of water immediately after an alcoholic drink. This will help fill you up, making it easier to skip the heartburn trigger foods, and will dilute the stomach acid.
     
  • Stand up and walk around while enjoying your drink instead of sitting and socializing.
     
  • Skip acid-rich cocktails containing oranges, lemons or cranberries in favor of beer or white wine. If a cocktail is all that will hit the spot, opt for lower-acid fruit options like melon, mango, strawberries, and pears.
     
  • Offer to be the designated driver so you have an excuse to avoid alcohol for the evening.
     
  • Limit yourself to one beer and choose a non-alcoholic beer if one serving won't last you all evening.
     
  • Focus on socializing and participating in activities like darts or dancing to keep you busy, and reach for water often to rehydrate.

Heartburn is never a welcome guest at any social event, but by using the proper precautions, it is possible to enjoy the occasional alcoholic beverage without getting burned. Remember, moderation is the key to staying heartburn-free!


Sources:

National Institutes of Health. ''Esomeprazole reduces gastroesophageal reflux after beer consumption in healthy volunteers,'' accessed May 2013. http://www.ncbi.nlm.nih.gov.