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Heavy alcohol use may increase acid reflux symptoms.
Acid reflux is one of the most common reasons people seek medical care. Nearly half of American adults have heartburn or regurgitation at least once monthly, and 5 to 10 percent experience reflux symptoms every day. A number of anatomical, physiological and lifestyle factors can heighten your risk for acid reflux. Most researchers agree that drinking alcohol, particularly in large quantities, increases the likelihood of acid reflux.
Reflux symptoms occur when acidic stomach contents rise into your esophagus and irritate its sensitive lining. Under normal circumstances, acid reflux is minimized by several mechanisms. Muscular contractions of your esophagus strip its contents toward your stomach, and a valve-like region at the junction of your esophagus and stomach - the lower esophageal sphincter - prevents back-washing of stomach acid. In addition, swallowed saliva helps neutralize refluxed acid and washes it back into your stomach. Anything that interferes with these normal mechanisms might lead to reflux. For example, the authors of a 2010 review in the вЂњJournal of Zhejiang UniversityвЂќ describe one possible hypothesis: that acetaldehyde and other toxic byproducts of alcohol metabolism interfere with esophageal contractions and impair lower esophageal sphincter function, heightening your risk for acid reflux.
Direct Tissue Damage
In addition to its effects on the mechanical functions of your esophagus and lower esophageal sphincter, alcohol and its byproducts may directly injure the delicate mucosal lining of your stomach and esophagus. Drinks with higher alcohol content are more likely to inflict chemical damage on your gastrointestinal tract, whereas beverages with lower alcohol content, such as beer and wine, tend to stimulate stomach acid secretion. Either of these effects could aggravate acid reflux and make your symptoms worse.
Although heavy alcohol use appears to increase your risk for acid reflux, its association with the long-term complications of acid reflux is less clear. Esophageal inflammation, Barrett esophagus - a precancerous condition - and esophageal cancer may occur in people with acid reflux disease whether they drink alcohol or not. Some studies have found that these conditions are associated with alcohol consumption, but others have not.
To add confusion to this issue, a study published in the March 2009 issue of вЂњGastroenterologyвЂќ suggested that drinking wine might even protect some individuals from reflux esophagitis, Barrett esophagus and esophageal adenocarcinoma, which is the most common form of esophageal cancer.
Most studies show a relationship between heavy alcohol use and acid reflux, and acid reflux symptoms can often be controlled when alcoholic beverages are discontinued. In one survey of over 2,500 people in China, where acid reflux disease is less common than in Western countries, individuals who drank heavily were nearly three times as likely as non-drinkers to report acid reflux symptoms.
Aside from its impact on acid reflux, chronic, heavy alcohol consumption increases your risk for other medical problems, such as liver disease. And, while there may be a lack of consensus about whether alcohol is associated with esophageal adenocarcinoma, its link to another form of esophageal cancer - squamous cell carcinoma - is well established.