Alcohol and the Digestive System

How Can Alcohol Damage the Digestive System?

Given the multiple organs and components of the digestive system—and the fact that they’re involved in alcohol consumption, metabolism, and/or elimination—alcohol can have myriad effects on the digestive system. Here’s how that works.

The digestive system is made up of the liver, pancreas, and gallbladder along with the entire gastrointestinal tract (aka GI tract and digestive tract). The GI tract comprises a series of hollow organs starting at the mouth and leading through the esophagus, stomach, small intestine, and large intestine to the anus.¹

Many people know that when someone drinks alcohol, it enters the blood stream via the stomach and small intestine, where it is distributed throughout the body and is drained into the liver.² Furthermore, when it comes to alcohol and the digestive system, many people are familiar with conditions related to the liver, pancreas, and gallbladder—such as cirrhosis, pancreatitis, and more. However, alcohol can affect myriad organs and functions in the digestion system from the point it enters the body until it is metabolized or excreted.

For example, chronic, heavy alcohol use can damage saliva glands and lead to inflammation in the mouth and tongue. A single episode of heavy drinking can weaken the function of the esophageal sphincter, which may lead to acid reflux and heartburn. Alcohol can also impede the muscles around the stomach and small intestines, interfering with gastric and intestinal motility. And alcohol misuse is associated with colon and rectum tumors.³

Potential Risks of Long-Term Excessive Alcohol Consumption on the Digestive System

Recent research suggests that chronic, excessive alcohol use promotes inflammation and other forms of damage in the GI tract and organs of the digestive system.⁴ This includes:⁴

• Chronic liver disease.
• Pancreatitis.
• Alcohol-involved gastritis (inflammation of the stomach and small intestine).
• Increased risk of GI cancers.

Heavy alcohol consumption can exacerbate certain GI conditions and can lead to damage within the GI tract (which is the focus of this page).

Alcohol’s Impact on the Mouth and Esophagus

Almost immediately after alcohol is ingested, it comes into contact with the oral cavity (i.e., the lips, inside of the cheeks, part of the tongue, gums, etc.), pharynx (i.e., the cavity behind the nose and mouth connecting them to the esophagus), and esophagus. Particularly since alcohol is in a mostly undiluted form at this point, large amounts of alcohol can lead to injuries to the mucosal lining of these areas.³

Additionally, damage to the salivary glands, which can interfere with the secretion of saliva, can also occur with chronic alcohol abuse, as can the incidence of tooth loss, gum disease, and tooth decay. Plus, those with a substance abuse disorder can also experience inflammation of the mouth and tongue, which may be linked to poor nutrition or alcohol’s impact on the mucosa.³

When it comes to the esophagus, heavy drinking can lead to the aforementioned weakening of the esophageal sphincter function. However, chronic alcohol misuse also leads to an increased incidence of both heartburn and esophagitis (i.e., inflammation of the mucosa in the esophagus) and other injuries that can induce mucosal defects.³

Some people with an alcohol use disorder (AUD) also exhibit a type of abnormal esophageal motility (high amplitude peristaltic esophageal contractions, sometimes referred to as nutcracker esophagus) whose systems resemble those of coronary heart disease. And a significant proportion of those with Barrett’s esophagus (a condition characterized by damage to the lining of the esophagus) also have an AUD.³

Alcoholic Gastritis

Alcoholic gastritis is a term that has been variably applied to a broad range of symptoms experienced by people who drink alcohol excessively.

Alcohol-related gastritis and gastropathy are conditions affecting the stomach lining (aka mucosa) experienced by individuals who regularly drink excessively. Gastropathy occurs when the mucosa are damaged, and gastritis describes inflammation of the mucosa.⁵  Both conditions can be chronic or acute, and when alcohol is identified as contributing to its cause, they can at least partly be reversed by abstinence.^3,5

Drinking excessive amounts of alcohol may be a cause of acute erosive gastropathy, where  the stomach lining develops ulcers, erosions, and bleeding; however, lower concentrations are not toxic.^5,6 Inflammation of the stomach lining is also sometimes seen in people who chronically drink in excess, and this alcohol-involved gastritis is strongly associated with active infection of the bacteria Helicobacter pylori (H. pylori).⁶ A common cause of peptic ulcer disease, it can increase the risk of stomach cancer if left untreated.⁵

Alcohol and Ulcers

Peptic ulcers are sores on the lining of the stomach or duodenum (i.e., the first part of the small intestine). There is no evidence to suggest an association between alcohol consumption and peptic ulcer disease, although studies suggest heavy drinking makes it more likely that symptoms will be present vs. being asymptomatic.⁷ Healing of GI ulcers is not slowed or otherwise made problematic by relatively low amounts of alcohol consumption; however, alcohol-related gastritis or gastropathy as a result of heavy drinking may exacerbate symptoms and can increase your chances of developing ulcers.^5,6

IBS and Alcohol

Irritable bowel syndrome (IBS)—aka spastic colon, mucous colitis, IBS colitis, spastic bowel, etc.—is a problem with how your brain and gut work together. The disorder includes symptoms of abdominal pain and changes in bowel movement, such as diarrhea, constipation, or both.⁸ Doctors aren’t sure what causes IBS. When it comes to IBS and alcohol, scientific studies haven’t revealed an association between alcohol and IBS.⁹

IBD and Alcohol

Inflammatory bowel disease (IBD) comprises two primary conditions involving chronic inflammation in the GI tract: Crohn’s disease and ulcerative colitis. Crohn’s disease and ulcerative colitis are both associated with symptoms of diarrhea, abdominal cramping, pain, and weight loss, with ulcerative colitis affecting only the large intestine (i.e., colon) and Crohn’s disease affecting the entire GI tract. The cause of IBD is unknown, but experts think that autoimmune reactions, genes, and other factors—such as smoking, use of NSAIDs, and a high-fat diet—may play a role in its development.¹⁰

Evidence does not suggest an association between alcohol consumption and the development of new-onset IBD. Alcohol has been reported to cause nonulcerative inflammatory changes in the colon, which may contribute to worsening existing bouts of diarrhea but is usually not recognized as the sole cause. Mild alcohol consumption has a negligible clinical impact on patients with established IBD, and alcohol use is generally discouraged as it may exacerbate some symptoms and interfere with pharmacological treatment interventions.¹¹

Alcohol and Digestive System Cancer

Considerable research demonstrates a link between alcohol and cancer development in the throat, esophagus, stomach, and colon.¹² This risk typically increases along with increased alcohol consumption and exists in combination with factors such as smoking or metabolic syndrome.⁴

According to the National Cancer Institute, moderate to heavy alcohol use is associated with higher risks of various digestive system cancers. For example, compared to those who abstain from alcohol use, heavy drinkers have a 2.6-fold higher risk of larynx cancers and a 5-fold higher risk of throat and oral cancers. Risks are also higher for moderate drinkers, who have a 1.4-fold higher risk of larynx cancers and a 1.8-fold higher risk or oral cavity (excluding the lips) and throat cancers.¹³

When it comes to the esophagus, any level of alcohol consumption is associated with an increased risk of esophageal squamous cell carcinoma, which is a type of esophageal cancer. Additionally, moderate to heavy alcohol use increases the risk of colon and rectum cancers by 1.2 and 1.5 fold, respectively. Data also indicates that cancers of the liver and pancreas are linked to heavy alcohol consumption.¹³

Alcohol-Induced GI Disorders: Symptoms and Treatment

People with alcohol-induced GI disorders may not show any symptoms. When they do, they commonly  present as indigestion (aka dyspepsia) and include:^3,14

• Nausea.
• Vomiting.
• Feeling overly full during or after a meal.
• Abdominal discomfort or pain.
• Flatulence.
• Loss of appetite.
• Weight loss.

Treatment for these conditions generally includes stopping or significantly reducing alcohol use. Should complications arise from alcohol-induced GI disorders, additional medical interventions may be necessary.¹⁵

Given alcohol’s myriad effects on the body, particularly when consumed in excess, sobriety may be beneficial for those with problematic use and chronic, alcohol-related health problems. But sometimes, people need help to get and stay on the road to recovery.

If you or someone you love is struggling with alcohol and/or you’re concerned about its impact on your body, treatment is available. American Addiction Centers operates multiple treatment centers throughout the country that can provide everything from detox and inpatient treatment to outpatient treatment and aftercare.

Reach out to us at to speak to an admissions navigator to learn more about treatment, admissions, and how to take your first steps toward recovery.