Wine and acid reflux: an expert clarifies all doubts

An evening of wine and reflux isn't exactly fun! Burning, heartburn, heaviness. Those who suffer from gastroesophageal reflux often wonder if a glass of wine can worsen their symptoms. Alcohol is, in fact, one of the factors that can contribute to the onset or worsening of gastroesophageal reflux. However, the effects can vary based on the amount consumed, the type of wine, and individual sensitivity. To shed light on the topic of "wine and reflux," we interviewed Dr. Roberto Bertè, a specialist in gastroenterology and digestive endoscopy at the Complex Gastroenterology Unit of the ASST Crema and a member of the Pancreas Commission of the Italian Association of Hospital Gastroenterologists and Digestive Endoscopists (AIGO).

Does wine worsen acid reflux?

"Wine can exacerbate gastroesophageal reflux, or the reflux of acid from the stomach into the esophagus, because it slows the esophagus's natural ability to "cleanse" itself of acid and increases the frequency of reflux episodes," explains gastroenterologist Roberto Bertè. "Furthermore, some studies show that certain alcoholic beverages, particularly beer and wine, especially white wine, directly stimulate acid production, prolonging the esophagus's exposure to acidity."

Why does wine cause reflux?

What happens to the stomach and esophagus when you drink alcohol? "Alcohol tends to relax the lower esophageal sphincter, the muscle that separates the esophagus from the stomach, thus facilitating the reflux of gastric contents," says the expert. "In a study conducted on healthy volunteers, white wine was shown to reduce pressure on the muscles between the stomach and esophagus to a greater extent than red wine and to make the esophagus less effective in contracting to counteract the reflux of acid."

White, red, or sparkling wine: which should you choose if you suffer from reflux?

Although all alcoholic beverages can trigger reflux symptoms, some studies highlight differences between different types of wine. White wine is often the most problematic overall, followed by red wine, which generally appears to be a little more tolerable. Sparkling wines, on the other hand, add to the alcohol factor the presence of carbon dioxide, which causes gaseous distension in the stomach and increases internal pressure, potentially encouraging the reflux of gastric contents.

Is there a safe amount of wine you can drink with acid reflux?

"It all depends on quantity and individual tolerance. Reflux management guidelines recommend a personalized approach, eliminating "trigger" foods and drinks—those that trigger symptoms in each individual," explains Dr. Roberto Bertè. "There is no completely "safe" consumption threshold, considering that doses of about 300 ml can significantly increase acid reflux and alter lower esophageal sphincter pressure. To reduce the risk, it's advisable to limit quantities and not exceed a single glass, drink slowly and, preferably, during meals, and avoid drinking just before bedtime or lying down. Among the various options, it's often better to choose a glass of red wine than white."

What are the symptoms of acid reflux caused by wine and when is it best to avoid it?

Typical signs to monitor after drinking wine include a burning sensation behind the breastbone, also called retrosternal heartburn, acid reflux, a lump in the throat, a dry cough, or hoarseness. If these symptoms consistently appear after drinking wine, especially when severe, it's advisable to avoid or significantly reduce consumption.