Evidence of an Association Between Alcohol Use and Gastroesophageal Reflux Disease

There is mixed evidence of an association between alcohol use and gastroesophageal reflux disease (GERD). In this systematic review and meta-analysis, researchers summarized the current epidemiologic evidence based on observational studies.

• 26 cross-sectional and case control studies were identified and included in the meta-analysis.
• In general, people with alcohol consumption had an increased risk of GERD (odds ratio [OR], 1.48) when compared with people who had no or occasional alcohol consumption. Specifically, and using the same comparison group, individuals drinking <3–5 times/week were 1.29 times more likely, and those drinking >3-5 times/week were 2.12 times more likely to develop GERD.
• Dose-response analyses—conducted on 3 studies that had >2 categories of alcohol exposure—showed a linear association between alcohol consumption and GERD. The OR for a unit of alcohol/day increment (one unit =12.5 g, just under one standard drink in the US) was 1.16.

Comments: This study confirms the observations of experienced clinicians that alcohol use is associated with GERD; the dose-response analyses support the idea that it is causal. Nevertheless, the methodology of the included studies necessarily means that firm conclusions cannot be made. Future studies should be prospective ones using validated measures of exposure to better understand this association.

Nicolas Bertholet, MD, MSc

Reference: Pan J, Cen L, Chen W, et al. Alcohol consumption and the risk of gastroesophageal reflux disease: a systematic review and meta-analysis. Alcohol Alcohol. 2019;54(1):62–69.