Poor drinking habits can contribute to gastroesophageal reflux disease (GERD).
GERD occurs when stomach acid flows back into the esophagus, damaging its lining and leading to complications. It can be caused by poor drinking habits, such as lying down immediately after drinking alcohol or frequently inducing vomiting after eating.
“Repeated acid reflux is not just an uncomfortable symptom, but it chronically damages the esophageal mucosa, which can lead to serious complications, so it is very important to manage drinking habits,” said Professor Lee Sang-jin of the Department of Gastroenterology at GangNeung Asan Hospital in Gangwon Province, on a YouTube channel.
Professor Lee Sang-jin explains GERD to a patient. (Courtesy of GangNeung Asan Hospital)
The number of GERD patients in Korea is steadily increasing.
According to the Health Insurance Review and Assessment Service, 4.79 million Koreans had GERD in 2023, a 36 percent increase from 10 years ago (3.59 million). Why is the number of GERD patients increasing?
The primary cause of GERD is an underactive lower esophageal sphincter. The lower esophageal sphincter prevents stomach acid or stomach contents from backing up into the esophagus. However, when this function is weakened by various factors, including alcohol, smoking, soda, coffee, and obesity, reflux can occur.
In particular, alcohol lowers the pressure on the lower esophageal sphincter and reduces muscle tone, which increases the likelihood of reflux. Carbonated alcoholic drinks, such as beer, further irritate the esophagus and increase stomach pressure, raising the risk of reflux. In addition, alcohol consumption stimulates the secretion of stomach acid, which slows down digestion and prevents the stomach from emptying properly, increasing the risk of reflux.
The most common symptoms of GERD include a feeling of acid reflux, heartburn, chronic cough, hoarseness, and a foreign body in the throat. It’s characterized by symptoms that are worse after eating, and in severe cases, it can even cause sleep disturbances.
However, it’s difficult to distinguish between simple heartburn and GERD based on symptoms alone. If you have recurrent and persistent symptoms, you should have a more thorough examination, such as a gastroscopy or 24-hour esophageal acidity test.
A 24-hour esophageal acid test involves inserting a thin tube through the nose into the end of the esophagus to measure acidity and then removing the tube after 24 hours to analyze the results.
If left untreated, GERD is more than just an uncomfortable symptom; it can lead to serious complications. Repeated acid reflux can lead to esophagitis, esophageal ulcers, and strictures. In esophageal stricture, the esophagus narrows, making it difficult to swallow food and significantly reducing quality of life.
Notably, it can lead to “Barrett's esophagus,” a condition in which the esophageal mucosa is deformed to resemble the mucosa of the small intestine due to constant irritation from stomach acid. Early diagnosis and thorough management are essential, as the disease is incurable, and the risk of developing esophageal cancer is up to 30 times higher than in the general population.
The goal of treatment for GERD is to minimize reflux and protect the esophageal lining. The most common treatment is medication with acid-secreting drugs, but it’s also essential to include lifestyle and dietary changes. If medication alone is not effective enough, endoscopic or laparoscopic surgery may be performed.
“The most important thing is early diagnosis and lifestyle modification,” Professor Lee said. “If the symptoms are left untreated, they can progress to complications, which can be difficult to treat and lead to a sharp decline in quality of life.”
To prevent GERD and alleviate symptoms, it is essential to minimize alcohol consumption and smoking, as well as to reduce the intake of irritating foods, including soda, coffee, fatty foods, juices (orange and lemon), and chocolate. A particularly harmful habit is repeated vomiting after eating, which can severely damage the esophagus and even cause life-threatening complications like esophageal perforation.
Obesity is also a major risk factor for GERD, so it's essential to keep your weight under control and give yourself at least two to three hours to digest your meals without lying down immediately afterward. It's also recommended not to wear clothes or waistbands that are too tight and to sleep with your upper body slightly elevated to prevent reflux.
“GERD is a disease that can be prevented, and symptoms can be controlled by improving lifestyle,” Lee said. “It is necessary to check your lifestyle and make efforts to improve it.”