Acid Reflux and Alcohol

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You may have already heard of stomach contents backing up into the esophagus, or even tasted it yourself:  that sour aftertaste after a heavy meal that only gets worse when bending over or lying down.  Doctors call it acid reflux, a common esophageal activity that resolves by itself by avoiding triggers.

Alcohol is one of those notorious triggers.  Findings indicate that alcohol and reflux go together in a good number of patients.

Several studies were carried out that involved alcohol consumption in small, moderate and large doses.  In each instance, the effect of alcohol in causing acid reflux was measured, and the researchers were able to establish that reflux incidence occurred more often in subjects that were given ample doses.

The reason? Alcohol relaxes the smooth muscles of the upper stomach.  This region is part of the esophago-gastric border known as the lower esophageal sphincter, or LES.  Normally, the LES contracts after food is swallowed.  With alcohol, that contraction is inhibited, resulting to a relaxed sphincter.  Stomach contents have only three ways to go:  downward, stationary and upward.  Smaller meals that are easy to digest tend to go down.  Heavier meals tend to stay in the stomach or, with pressure, go back up.  For people susceptible to heartburn, they will fare better on grazing frequently than sitting down to one large meal three times a day.

Another well-established finding is that alcohol stimulates gastrin, the hormone found in the stomach lining responsible for producing gastric acid. Gastric acid is necessary to digest food.  Obviously, the more alcohol is consumed, the more the hormone is encouraged to pump acid into the stomach.

The nifty combination of a relaxed control valve and the hyper-production of caustic digestive juice could only result to one thing – heartburn, a rather minor discomfort compared to a host of problems that arise from frequent alcohol consumption.

One of that problems is entero-hepatic (gut-liver) in nature.  Liver is the body’s prime organ of toxin elimination.  It does its job by pumping bile into the first part of the stomach, so fatty acids and heavy metals and other forms of toxin bind with it to be eliminated via excretion.  So the more alcohol is introduced into the system, the harder the liver works by pumping more bile to overpower toxins; otherwise, these toxins will be reintroduced into the bloodstream, further putting stress on the liver.

The process of bile-production suggests that fatty substances further aggravate acid reflux.  A certain level of fat is necessary to periodically remove old bile and have it replaced with fresh ones, but diets brimming with fats will likewise overwork the liver, pumping more bile to dilute the fat.

Bile is a bitter liquid.  When combined with stomach acids, they form a corrosive substance that irritates the unprotected lining of the esophagus, leading to ulcers. A one-time occurrence is less likely to create damage, but acid reflux experienced twice a week may already be a symptom of Gastroesophageal Reflux Disease (GERD), which may or may not be manifested by heartburn.  

Lifestyle changes are called for in acute cases of acid reflux or GERD, as prolonged exposure of the esophagus to caustic refluxate leads to changes in cell structure, itself leading to cancer.  Alcohol consumption should altogether be banished, along with consumption of food that provides acid-production.  Coffee and carbonated drinks top the list.

Even with extensive studies into the relationship between alcohol and acid reflux, specialists yet have to further explore the field to issue conclusive evidence that supports the relationship, especially that there are a number of conflicting results carried out in similar studies.

But you don’t need to wait around for those studies; you already know that alcohol leaves a bad aftertaste.