What is heartburn?

“Heartburn” or “reflux” is the name given to the burning sensation felt when acid from your stomach irritates the lower esophagus. Gullet or food pipe are other commonly used non-medical terms for your esophagus.

Stomach acid is meant to stay in the stomach only. And, the cells lining your esophagus are not designed to withstand the highly acidic nature of your stomach contents.

There are many different causes of heartburn and in this article, we’re going to focus specifically on its relationship with alcohol. In particular, why some people get heartburn when hungover.

Why do you get heartburn when hungover?

The relationship between alcohol, hangovers, and heartburn is more complicated than it initially looks. That’s because, in most cases, there is no single cause for hangover heartburn. And often, it’s a combination of different factors that ultimately result in symptoms of heartburn.

Before we start this section, it’s important to note that most of the damaging effects of alcohol are seen when alcohol is consumed in excess. That means chronic alcohol use or binge drinking.

1) Alcohol potentially increases stomach acid production

Interestingly, studies have shown that weaker alcoholic drinks like beer and wine stimulate acid secretion in your stomach. Whereas higher concentration alcohols like spirits don’t increase stomach acid production.(1)(2)

Therefore, it could mean that something other than alcohol is stimulating acid secretion. In any case, there is a relationship between increased acid production and certain types of alcohol and this could contribute to hangover heartburn.

2) Inflammation of the gut lining

Although we drink alcohol, ultimately it’s a toxin. As a result, alcohol has irritant properties, and repeat exposure to it can irritate the stomach lining.(3)

Furthermore, when alcohol is broken down by your liver cells, toxic by-products such as acetaldehyde are formed which also fuel inflammation.(4)

3) Alcohol slows down gut motility and relaxes muscles

Alcohol is well-known to relax the muscles of your gut and also impair “gut motility”.

Firstly, alcohol relaxes the muscles around the lower esophagus (the sphincter) which stops stomach contents from splashing back up.

Secondly, alcohol impairs the rhythmic motions of your stomach and small intestine. This means that food and drink are pushed down your gut at a slower pace. Therefore, food sits in your stomach for longer. This is called “delayed gastric emptying”.

Studies have shown this effect of alcohol is more pronounced with strong alcoholic drinks like spirits.(5)

4) Smoking

Drinking and smoking often go hand in hand. Particularly for those who are social smokers.(6)

Smoking, in general, is a well-known risk factor for reflux. Therefore, for those who smoke, this will be a contributing factor to hangover heartburn.

5) Overindulgence in food

More often than not, we drink alcohol alongside a meal. And, for the party-goers, you may have a large meal on the way back home after a big night out.

Overindulgence in food and drink don’t go well together when it comes to heartburn. Waking up with hangover heartburn could simply be due to eating too much and too close to bedtime.

In summary: Waking up with heartburn when hungover is likely due to a combination of the factors mentioned above. Alcohol irritates the stomach lining, slows down your gut and combined with overeating can explain why you wake up with heartburn.

Hangover heartburn remedies

So, you’ve woken up with a hangover and on top of that, you have heartburn. What next?

There are many different things you can try to remedy your discomfort.

1) Antacids

There are myriad antacids available on the market that all work in different ways. Most of which you can purchase from your local pharmacy.

Broadly, antacids can be split into two different categories. Ones that neutralize stomach acid and ones that reduce stomach acid secretion.

Neutralizers: over the counter medications such as Alka-seltzer, Gaviscon, Pepto Bismol, Tums all work by neutralizing stomach acid. They work quickly and are effective. The only thing to bear in mind is that some preparations contain aspirin or other similar anti-inflammatories which can make heartburn worse.

Stomach acid reducers: Medication like Zantac (ranitidine) reduces stomach acid secretion by blocking specific histamine receptors on the cells of your stomach. With that said, all Zantac products were recalled in 2019 by the FDA due to safety concerns.(7)

There are other medications such as proton pump inhibitors (PPI) that are more powerful and usually require a prescription. These medications take longer to work than the neutralizers mentioned but, over time, are more effective.

Before taking any medication, either speak to your pharmacist or read the product labels as it may not be suitable for you. This is especially important if you have any medical conditions or are taking regular medication which can interact.

2) Have smaller meals

Overeating when you’re feeling ravenous as you wake up with a hangover is easy to do. But doing so will only make heartburn worse. It’s important to stick to smaller meals that are easy to digest. These include plain carbohydrates like pasta, rice or potatoes. You can find out more in our article about the best foods to eat when hungover.

3) Don’t eat for at least 3 hours before napping

If you’re hungover, chances are you’re going to need to have a nap at some point during the day. Sleeping with a full stomach is a sure-fire way of making hangover heartburn worse. On average, 3 hours is the time it takes for your stomach to empty its contents. However, everyone is different and certain foods such as red meat take longer to pass.

Things to avoid

Now that we’ve covered the things you can do to remedy hangover heartburn, it’s also important we cover some things you should avoid as well.

Foods that trigger heartburn

Everyone has their own triggers for heartburn. But there are certain foods and drinks that are particularly common. Therefore, if you want to get over your hangover heartburn faster, it’s best to avoid spicy foods, garlic, onion, and citrus fruit.

Exercise

Exercise when hungover is generally not a good idea. It’s also not great if you’ve got heartburn. That’s because rigorous activity can aggravate your symptoms as your stomach contents splash around and may go back into your lower esophagus.

How to prevent hangover heartburn

Hangovers are a sign from your body that you’ve been drinking more than your body can handle. Reducing your alcohol intake is the best way to prevent hangover heartburn. In addition, make sure not to have a large meal at the end of your night out.

That said, some people will still experience hangover heartburn even if drinking small amounts of alcohol. In this case, you may want to see if the type of alcohol you’re drinking is where the problem lies. You can read more about this in our article on bloating after drinking.

Hangover heartburn – Final words

That brings us to the end of our look into the causes of heartburn when hungover and things you can to do reduce your symptoms.

Having heartburn when hungover is usually a sign that you’ve been drinking or eating too much the night before. So, it’s a good time to consider cutting down.

If your symptoms persist or it doesn't feel like your usual heartburn symptoms, it's best to discuss it with a doctor right away.