Why Does My Stomach Hurt When I Drink?

Have you ever found yourself nursing a glass of wine, or sipping on your favorite beer, only to be greeted with an unpleasant sensation in your stomach — an unfriendly ache that has you doubling over, wondering if alcohol was the perpetrator?

Many of us have been there: planning a relaxed, stress-free evening, only to be interrupted by a sharp or dull pain in the stomach. It feels like our bodies are betraying us, right? But, in fact, there is a scientific reason for stomach pain — and understanding it may be the key to keeping our stomachs happy and avoiding this discomfort in the future.

A Love-Hate Relationship

The relationship between alcohol and our digestive system is, well, complicated. We sip our favorite drink, it swirls around in our mouth for a bit, then travels down our esophagus and lands in our stomach, the first stop on a tumultuous ride.

The stomach — equipped with acid and enzymes — is our body's initial processing plant for everything we ingest. Alcohol increases the production of stomach acid, a process termed gastric acid secretion.

Why should we care about a little extra acid? Well, this uptick in stomach acid can irritate the stomach lining, leading to inflammation of the stomach or alcoholic gastritis. Gastritis often manifests as a burning pain in our stomach, nausea, and sometimes vomiting — symptoms we've probably blamed on a hangover more than once. When that protective lining sustains too much damage, we can end up with stomach ulcers. The extra acid can also back up into the esophagus, causing acid reflux.

2. The Emotional Band-Aid: When Feelings Meet Booze

As much as we’d like to deny it, our emotions play a huge role in many of our choices. From the clothes we wear based on our mood, to the comfort food we reach for after a tough day, our feelings often steer the ship. The relationship between emotions and alcohol is no different.

For some, alcohol becomes a trusted ally against stress, sadness, or anxiety. But here's the catch: while it seems to provide temporary relief, it doesn’t fix the root cause of these emotions. Over time, we might find ourselves craving a drink whenever these feelings emerge, because the brain has made a connection: “Feeling down? Alcohol will fix it!”

In this way, alcohol serves as an instant emotional band-aid. Had a rough day? A drink might make it feel better. Feeling anxious about an upcoming event? A little booze might take the edge off. Over time, this pattern can create a more ingrained reflex in the brain:  a negative emotion surfaces, and we instinctively reach for a drink to “soothe” it without giving it a second thought.

Why It Seems to Work (But Doesn’t Really)

Since alcohol is a depressant that slows the nervous system, the initial effects often do, in fact, feel calming. But here's the twist: while the immediate effects might seem relaxing, in the long run, science shows that alcohol can increase feelings of anxiety and depression. It’s like using a leaking bucket to carry water: it might seem helpful initially, but we’re losing more than we’re gaining as the brain’s natural neurotransmitter levels tip in the other direction.

In addition to depleting our dopamine levels over time, the brain overcompensates by releasing dynorphin to counteract the excessive release of dopamine. Instead of producing pleasure, dynorphin does the opposite: it decreases dopamine production, inducing feelings of dysphoria. This is the brain's way of keeping us chemically and emotionally balanced.

The Cycle of Emotion-Driven Drinking

Over time, with repeated exposure to pleasurable stimuli, the brain releases more and more dynorphin to counteract the high dopamine levels. This reduces the overall sensitivity of the brain's reward system, making it harder to feel pleasure from everyday activities and potentially leading to a cycle of increased substance use to reach the original high.

Here’s the cycle many folks find themselves in: they drink to cope with an emotion, the effects of the drink wear off, and they’re left with the same (or heightened) emotional distress, leading them to drink again. It's a loop that can be hard to break, especially if the underlying emotional triggers aren’t addressed.

Meet Our Gut Microbiome

The other stomach mischief alcohol can make has to do with our gut microbiome — the community of trillions of bacteria living in our digestive tract, which plays a vital role in our overall health. Alcohol can alter this microbiome, adding to the discomfort we feel when drinking. It can harm beneficial bacteria and allow harmful bacteria to thrive. These shifts in our gut microbiota can lead to digestive discomfort, bloating, and increased gut permeability — leaky gut syndrome — which allows toxins to enter our bloodstream. This microbial mayhem might explain why we sometimes feel off after a night of indulging.

The Mystery of Malabsorption

On top of wreaking havoc on our stomach lining and microbiome, alcohol can also impact our intestines' ability to absorb nutrients, a condition known as malabsorption. Studies show that alcohol inhibits the absorption of vital nutrients such as thiamine, folic acid, and zinc, leading to deficiencies that can exacerbate our discomfort and have long-term health consequences.

Alcohol and The Elusive IBS

And finally, there’s Irritable Bowel Syndrome (IBS). Anyone who has experienced it knows it's no walk in the park. The link between IBS and alcohol is complex, but many people with IBS experience worsening symptoms after drinking. Scientists have suggested that alcohol could contribute to IBS by altering gut motility, exacerbating visceral hypersensitivity, and causing gut inflammation. So, that extra glass of wine might be why we're making frequent bathroom trips or struggling with cramps and bloating.

What We Can Do?

Now that we've discovered the causes of alcohol-induced stomach discomfort, we can better understand why our seemingly innocent drinking can wreak havoc on our insides.

The good news? Our drinking habits are well within our control to change. Understanding how alcohol interacts with our bodies is a critical first step in making more informed choices about our drinking habits. A delicate balancing act of drinking alcohol in moderation and considering both our eating habits and the types of drinks we consume can make a world of difference in avoiding that pesky stomach discomfort, acid reflux, and ulcers.

Moreover, there are some specific tips that can help keep alcohol-related stomach troubles at bay:

1. Avoid consuming alcohol on an empty stomach. This is a common habit among people, often due to a misconception that food will "slow down" the effects of alcohol. In reality, when we drink alcohol on an empty stomach, our body absorbs the alcohol faster, leading to higher blood alcohol levels and causing irritation in our stomach lining. Our stomachs were never designed to handle alcohol alone. They are used to a complex mix of nutrients — carbs, proteins, and fats — which help protect our stomach lining. The next time we think about grabbing a drink, it may be better to pair it with some food to ease the burden on our stomachs.
2. Say no to binge drinking. Binge drinking — consuming large amounts of alcohol in a short span of time — can increase the production of stomach acid, leading to inflammation, and, in severe cases, stomach ulcers. The World Health Organization defines binge drinking as consuming six or more standard drinks in a single occasion, which equates to about three 12-ounce beers, or three 5-ounce glasses of wine. Unfortunately, these are quantities many of us consume without even realizing it, especially during social events. Cutting back on the alcohol and drinking water between alcoholic beverages can help us avoid this discomfort.
3. Don’t mix alcohol with fizzy drinks. We might love that refreshing tanginess that comes with a cocktail mixed with a fizzy drink, but our stomach? Not so much. Fizzy drinks increase the rate of alcohol absorption in our stomach. We get drunk faster, and we also increase our risk of stomach irritation. Instead, could consider mixing alcohol with non-carbonated mixers to avoid this discomfort.
4. Limit high-alcohol-content drinks. Hard liquors (such as whiskey, vodka, and rum) are known for their high alcohol content. But these drinks are also harder on our stomachs, which aren't designed to handle concentrated amounts of alcohol. These spirits might be efficient for a quick buzz, but the aftermath often includes an angry stomach. Opting for drinks with a lower alcohol content, like beer or wine, can be a more stomach-friendly choice.
5. Watch your pace. When we drink too quickly, it doesn't give the stomach enough time to process the alcohol. The quicker we drink, the faster alcohol enters our bloodstream, irritating our stomach lining. Slowing down can help to avoid these painful repercussions.

Ultimately, our bodies are incredible machines that work constantly to keep us healthy. Sometimes, the discomfort we experience is a signal that we need to make better choices.

Research has shown that even small reductions in alcohol consumption can significantly improve digestive symptoms and overall health. A 2021 study published in Alcohol and Alcoholism found that individuals who reduced their drinking experienced an improvement in gut health and reduction in inflammation markers. How's that for motivation?

We should consider strategies like setting drinking limits, choosing alcohol-free days, or exploring tasty non-alcoholic beverages. Every step we take, no matter how small, brings us closer to improved health and wellness.