5 Reasons Your Stomach Hurts After Drinking Alcohol or Coffee

Many of us consume coffee or alcohol for their feel-good effects. But what happens when your sip seems to mess with your stomach?

Both caffeine and booze can affect the stomach's production of digestive acids, explains Max Pitman, MD, a gastroenterologist at NYU Langone Hospital and medical director at Salvo Health. That can set the stage for mild irritation or worsen an existing stomach condition you already have.

Here are some of the most common scenarios that could cause discomfort, plus what you can do to make your coffee or drink more tolerable.

There's not much evidence to show that having coffee or alcohol on an empty stomach causes more GI problems than having it on a full stomach. Still, it's possible you might notice some discomfort if your stomach is particularly sensitive.

"The bitter taste of coffee and some alcohol can lead to increased acid production, which could trigger heartburn or acid reflux symptoms," explains Dr. Pitman. But, he adds: "Everyone reacts differently."

If you think an empty stomach might be to blame, try having a snack or a small meal before your coffee or drink to see if it makes a difference.

Both alcohol and coffee are known triggers for heartburn and GERD, per the Mayo Clinic. Not only can both beverages increase the production of acid in the stomach, they also relax the esophageal sphincter — the muscle at the bottom of the esophagus that forms a valve above the stomach. When that happens, acid is more likely to splash up from the stomach into the throat.

"The effect is usually mild, so it depends how sensitive you are to GERD symptoms," Dr. Pitman says.

Other common symptoms of GERD include the following, per the Cleveland Clinic:

• Heartburn
• Chest pain
• Cough
• A feeling of food coming backward
• Discomfort in the upper abdomen
• Difficulty swallowing
• Sour taste of acid in the back of the throat
• Sore throat
• Regurgitation
• Vomiting

You're more likely to have GERD if you regularly drink alcohol. Other risk factors include:

• Having a hiatal hernia
• Having overweight or obesity
• Pregnancy
• Smoking
• Taking certain medications, such as those for allergies, high blood pressure, depression and some painkillers
• Often eating foods with a lot of fat
• Having a condition called scleroderma, which can slow down your digestive system
• Delayed stomach emptying

Peptic or stomach ulcers occur when digestive acids damage the walls of the stomach. This can cause an intermittent burning sensation in your belly (often between meals and at night) along with an unusual feeling of fullness, mild nausea or trouble drinking as much liquid as you normally do, according to the National Library of Medicine (NLM).

Neither coffee or alcohol causes ulcers, nor does spicy food. According to the NLM, ulcers develop from certain bacterial infections or frequent use of NSAID medicines like aspirin or ibuprofen.

But going heavy on acidic beverages like coffee or alcohol could potentially make an existing ulcer feel worse.

"Sometimes eating or drinking anything, even in moderation, will trigger symptoms," Dr. Pitman says. Heavy drinking may even prevent an ulcer from healing, he notes.

Both caffeine and booze can cause irritable bowel syndrome symptoms to flare and lead to diarrhea, bloating and abdominal pain.

"White wine may be better tolerated than red wine, and lighter beers like pilsners or lagers may be easier to tolerate than heavier beers like IPAs or stouts," Dr. Pitman says.

Mixed drinks can also be problematic, because ingredients like sugars and carbonated sodas can also trigger symptoms.

Symptoms can come and go and often vary widely from person to person, but they generally include the following, per the Mayo Clinic:

• Diarrhea, constipation or both (alternating)
• Bloating and gassiness
• Always feeling like a bowel movement is incomplete
• Bowel movements that contain mucus
• Severe or mild stomach discomfort, cramping and abdominal pain that usually subsides after a bowel movement

You're more likely to have IBS if you:

• Are younger than 50
• Were assigned female at birth
• Have depression or anxiety
• Have a history of physical or emotional abuse
• Have IBS in your family history

Gastritis, or inflammation of the stomach lining, is another condition that can lead to a stomachache after drinking alcohol.

Gastritis is typically caused by a bacterial infection or overuse of NSAID pain relievers. But chronic, heavy alcohol use can also be a culprit, Dr. Pitman notes.

According to the Mayo Clinic, excessive alcohol intake can cause the lining of the stomach to erode, making it more sensitive to acidic digestive juices and causing inflammation.

Symptoms of the condition include:

• An uncomfortable burning sensation in the stomach (upper abdomen) that gets either better or worse with eating
• A feeling of unusual fullness after eating
• Nausea
• Vomiting

Managing stomach pain from drinking coffee or alcohol can be a process of trial and error.

"There's not much scientific evidence that one strategy is better than another, so I suggest people try a few things and see what works for them," says Dr. Pitman.

Here's what he recommends:

• ‌Eat something first:‌ If sipping on an empty stomach causes discomfort, have some food. Eat breakfast before having your coffee, or have a small snack (like nuts or olives) with your drink.
  
• ‌Try an Americano instead of drip coffee:‌ Americanos, made with hot water and espresso, have less caffeine than drip, so they might be less irritating.
  
• ‌Add milk to your coffee:‌ A splash or two will make your coffee less acidic. Dairy, soy, almond or oat will all do the trick, so pick what you like best.
  
• ‌Have a lighter drink:‌ White wine and lighter beers (like pilsners or lagers) tend to be the least irritating types of booze. If you're in the mood for a cocktail, choose something without added sweeteners, like vodka or tequila with club soda. (Or stop drinking altogether and dive into the world of mocktails instead.)
  
• ‌Try an antacid:‌ Taking an over-the-counter antacid (like Tums or Pepcid) could help prevent stomach pain from coffee or alcohol.

It's a good idea to let your doctor know about frequent or persistent stomach pain, whether it seems to be caused by coffee or alcohol or the trigger is unknown.

"It's best to discuss with your doctor to see if any testing or medication is needed," Dr. Pitman says. "There's no need to suffer without figuring out if there's something that could be treated in order to prevent symptoms."