Alcohol, or ethanol, can have profound impacts on multiple organ systems in your body, and it is a complicated substance. Your gastrointestinal (GI) tract is typically the first line of defense that your body employs to protect against foreign toxins, including alcohol and other substances. When discussing your GI tract, a medical professional is referring to the entire length of your GI tract, including the mouth, esophagus, stomach, small intestine, large intestine, and colon. However, gastritis is a condition specific to your stomach.
Here’s an easy way to remember what gastritis is: Any medical terminology that ends in “-itis” is referring to inflammation of that specific tissue. Gastritis is when the inner lining of the stomach becomes inflamed (swells) and tender. Alcohol commonly causes this issue by irritating the lining of the stomach and damaging the cells it comes into contact with.
Over time, alcohol can interfere with the natural production of bicarbonate ions that protect your stomach cells from the harsh environment present in the stomach. Without these protective ions, the acidic environment can alter the cellular membranes of gastric cells and impact the health of the cells. As the cell layers erode, this erosion exposes deeper layers of cells that do not have protection from the acidic environment of the stomach, and the inflammation process protects them from further damage.
What are Some Other Causes of Gastritis?
While alcohol certainly causes gastritis, it is important to recognize that there are many potential causes. Some of these causes include:
- Bile reflux: Bile reflux is hard to distinguish from gastric acid reflux and presents many of the same symptoms. If you experience upper abdominal pain, nausea, frequent heartburn, and other gastric symptoms in the absence of alcoholic intake, this may be a sign of bile reflux or severe gastric acid reflux and possibly gastroesophageal reflux disease (GERD).
- Chronic vomiting: Chronic vomiting causes prolonged irritation to the lining of the stomach, often leading to chronic gastritis. The process of vomiting exposes your esophagus to high levels of acid. Typically gastritis occurs near the connection between your stomach and esophagus, or lower esophageal sphincter.
- Helicobacter Pylori (H.pylori) infection: H.pylori is a common cause of stomach ulcers. H.pylori infection can mimic many of the symptoms of alcoholic gastritis. Additionally, chronic alcoholic gastritis can make it easier to contract an H. pylori infection. Therefore, it is important to see your primary care provider if you are experiencing the symptoms described.
- Medications: Several medications can weaken the lining of the stomach, but the most common are steroids and non-steroidal anti-inflammatory drugs (NSAIDs). Oral steroids are commonly prescribed for asthma exacerbations or endocrine disorders. Taking these medications with alcohol can make it more likely to experience acute alcoholic gastritis.
- Other infections: H. pylori is the most common gastric pathogen, but other less-common microorganisms like viruses and other bacteria can make a home within your stomach, weakening its inner lining. Pathogens can release toxins that break down your cells to use them for food.
What is Alcoholic Gastritis?
Alcoholic gastritis can come in two different forms: acute or chronic. Acute alcoholic gastritis is temporary and vomiting, a burning sensation with drinking and general pain often accompany it. Since alcohol has mild analgesic effects and can impair judgment, some symptoms are not felt until the next day.
Chronic alcoholic gastritis is the long-term breakdown of the mucosal layer in your stomach. This breakdown occurs through the same process as acute alcoholic gastritis, but the symptoms are often a little different. For people who drink alcohol regularly, they usually do not experience the symptoms of acute gastritis because, over time, alcoholic decreases their sensitivity to nausea and vomiting. This change can desensitize pain receptors. If left untreated, chronic alcoholic gastritis can lead to recurrent ulcers, liver damage, pancreatic damage and stomach cancer.
Causes of Alcoholic Gastritis
The cause of alcoholic gastritis is simple: ingestion of alcohol. However, knowing if you’re experiencing gastritis is complex. Because everyone metabolizes alcohol differently and because stomach cells are all different, gastritis impacts different people in different ways. Some people may have a drink or two of alcohol and experience intense burning every time. These people may have co-occurring GI disorders or may be sensitive to the gastric impact of alcohol. Other people may drink in large amounts for many years and never experience gastritis. This fluctuation of individual experience is why it’s important to discuss any notable symptoms (especially if you drink alcohol) with your primary care provider.
Symptoms of Gastritis Caused By Alcohol
- Abdominal pain: This pain can manifest in both acute and chronic gastritis conditions
- Abdominal bloating: Types of bloating may be a sign that your food is not digesting properly and can be present in both acute and chronic gastritis
- Black, tarry stools: While this issue is not a medical emergency, it is a medically urgent condition. Black, tarry stools indicate bleeding somewhere along your GI tract, but the bleed is not currently active. If you are experiencing red stools you have an active bleed and this is a medical emergency.
- Hiccups: This is a non-specific symptom, meaning that hiccups by themselves do not mean much. However, if you experience hiccups with a few of these other symptoms, they may be associated with alcoholic gastritis.
- Indigestion: Damaged mucosal cells cannot digest food as well as a healthy stomach. Under normal conditions, your stomach cells produce enzymes that help digest your food. If they cannot do so, you may experience symptoms of indigestion.
- Loss of appetite: This symptom is a common symptom of chronic alcoholic gastritis
- Nausea or recurrent upset stomach: These are other common symptoms of chronic gastritis
- Vomiting blood or coffee grounds-like material: This symptom is a medical emergency. Vomiting blood or coffee grounds-like material indicates there is bleeding somewhere in your upper GI tract. Seek emergency medical assistance immediately.
Diagnosis & Treatment
Your primary care provider diagnoses gastritis, sometimes after a referral to a GI specialist. A gastroenterologist usually performs an endoscopy, which is a thin tube with a camera that is inserted through your mouth into your stomach to look at the GI lining and help make a diagnosis. If necessary, a biopsy can be performed, where a piece of tissue is taken for testing. You may also complete a fecal occult blood test, which is a stool sample where the physician looks for the presence of blood. Additionally, your blood may be drawn to rule out other conditions (H.pylori infection) or to screen for the presence of long-term symptoms like anemia.
Treatment will probably include cessation of alcohol. Continued consumption of alcohol damages the lining of your stomach and can lead to long-term complications like stomach cancer. You may be given antacids (proton pump inhibitors, H2 receptor blockers, or direct antacids) to minimize ongoing damage and prevent additional damage. Lifestyle modifications like avoiding spicy and acidic food can also help your GI lining repair over time.
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Bernstein, Susan. “What Is H. Pylori?” WebMD, Oct. 2009. Accessed April, 20 2019. Healthline. “Chronic Gastritis: Causes, Symptoms & Diagnosis.” 2012. Accessed April 20, 2019. National Institute of Diabetes and Digestive and Kidney Diseases. “Gastritis | NIDDK.” July 2015. Accessed April 20, 2019. Harvard Health. “Gastritis – Harvard Health.” December 19, 2014. Accessed April 20, 2019. Mayo Clinic. “Upper Endoscopy – Mayo Clinic.” 2018. Accessed April 20, 2019. Mayo Clinic. “Vomiting Blood.” 2018. Accessed April 20, 2019.
Bernstein, Susan. “What Is H. Pylori?” WebMD, Oct. 2009. Accessed April, 20 2019.
Healthline. “Chronic Gastritis: Causes, Symptoms & Diagnosis.” 2012. Accessed April 20, 2019.
National Institute of Diabetes and Digestive and Kidney Diseases. “Gastritis | NIDDK.” July 2015. Accessed April 20, 2019.
Harvard Health. “Gastritis – Harvard Health.” December 19, 2014. Accessed April 20, 2019.
Mayo Clinic. “Upper Endoscopy – Mayo Clinic.” 2018. Accessed April 20, 2019.
Mayo Clinic. “Vomiting Blood.” 2018. Accessed April 20, 2019.