Whiskey drinkers often complain that as they get older (which of course does mean that they drink more over the course of their lifetime), they find it harder to regularly consume some of their favorite whiskeys – including prime single malt scotches. Presuming we are not talking about liver disease or other serious conditions that can occur from regular use of alcohol, the main reason to shy away from whiskey may be indigestion, heartburn or acid reflux, which is a form of heartburn.
The cause and effect may not be correlated with age, necessarily. Chronic heartburn can happen to much younger people and as such, they may have problems ingesting certain types of alcohol on a regular basis. But it may be a bit sadder for someone who has regularly enjoyed Macallan, say, or Lagavulin, for 20 or 30 years and suddenly find themselves torn when reaching for a glass of the same.
Let’s see what may be going on.
What is Heartburn?
During the digestive process, food that is chewed by, and liquid that is ingested in, the mouth passes to the esophagus, a muscular tube just below your mouth that leads into the digestive track. The esophagus moves the food down through a tiny series of contractions into the stomach, where the process of digestion actually begins. There are two openings that control the inflow and outflow of food into and out of the esophageal tube – the upper esophageal sphincter (UES) and the lower esophageal sphincter (LES). In healthy digestive systems, the sphincters play a vital role – the upper sphincter opens up to allow food into the esophagus, just like the lower sphincter allows food to pass into the stomach. Immediately after the material passes through, each sphincter automatically closes up again to ensure that food does not come back up from the stomach to the esophagus or the esophagus to the mouth.
There are a number of esophageal diseases, both common and rare. But heartburn is one of the most common and annoying sensations directly related to the upper and middle digestive system. Heartburn is primarily felt as a burning sensation in the esophagus, which means a painful feeling under your front ribs. The causes may lie with one of the following phenomena:
1. Direct Irritation of the Esophagus
2. Weakness of the LES – which causes stomach acids to splash back into the esophagus, a condition we typically call Acid Reflux
3. Motility Disorders of the Digestive Tract, which makes food/beverages take longer to get processed and emptied out; and
4. Hiatal Hernia – when a portion of the stomach pushes up through the diaphragm muscle into the chest area.
A number of the above conditions may be interrelated and many of them are connected to the development of, or predisposition towards, Gastrointestinal Reflux Disorder (GERD). GERD is a condition that occurs in people with abnormal muscle or nerve functions within their stomach. This in turn could lead to a whole host of problems, including Irritation of Esophagus, Motility Disorders and eventually a serious condition such as Hiatal Hernias.
What Does Whiskey Do if You Are Prone to Heartburns?
If you are prone to heartburns, either because of slow developing conditions, bad habits or excessive consumption of food or beverages that trigger it or due to some already existing condition such as GERD, Motility Disorders or Hiatal Hernias, certain types of alcohols are counted among the foods that will cause you distress. Unfortunately, whiskey happens to be one of them.
Alcohol and sugars are both triggers for heartburn, especially if you are prone to acid reflux. Beer is the worst type of alcohol, being acidic and carbonated. These are terrible for heartburn. However, hard alcohol exacerbates heartburn for an entirely different reason – beer does not have that problem.
With hard alcohol, the trigger for heartburn may be a naturally occurring compounds called congeners, which can increase irritation of the esophagus and stomach and therefore cause heartburns. Doctors recommend drinking clear liquor, such as tequila, gin or vodka in such cases, which are lower in congeners compared to darker liquors like whiskey, rum and brandies, which contain more congeners.
What are Congeners? What Effect Do They Produce?
Congeners are biologically active chemicals that are formed in the fermentation and aging process, when organic chemicals are broken down. Naturally, single malt whiskeys, which are aged for 10 years at least – often as much as 30 more – contain many more congeners than do less aged spirits. Also, dark alcohol like whiskey, rum or brandy contains far more congeners than do clear white spirits such as vodka or gins.
Congeners trigger powerful reactions with the body and the brain. For example, they are often directly responsible for hangovers. Bourbon whiskey has been shown to create 40 times the propensity for the imbiber to have a hangover as one who drinks vodka. These same conveners cause a whole host of problems down the esophagus and stomach.
Types of Congeners Contained in Whiskey
Among the various congeners that could be contained in various types of alcohol, the two most potent ones that are likely to be in whiskey are the ones caused by the breakdown of ethanol – methanol and acetaldehyde. These are both toxic by-products that remain in whiskey and react with the human body and brain to produce unpleasant effects. Other congeners that may be present include furfural and fusel oil, though they are likely less harmful and may even add to the aroma and flavor of the finished product.
If you mix your drinks with sugary sodas or mixers, the problem gets compounded. But more on that later. Let’s see three ways that whiskey directly contributes to indigestion, heartburn or acid reflux. The three main factors that determine how bad the effect may be are the amount you drink, the strength of the alcohol (Alcohol by Volume (ABV)) and the degree of carbonation.
Whiskey Keeps Acid Content in the Stomach Longer and Stimulates It to Produce More Acid
Whiskey will cause your stomach to produce more acid and also create additional acidic content for a longer time within the stomach. Both of these conditions mean that the stomach is literally “sloshing” with acid which is not moving down the intestine. This in turn means that in case of a backflush (see below), there is more acid reflux that occurs in the esophagus.
Whiskey Inhibits the Ability of the Esophagus from Keeping Food Down
The causes of this are less well known, but it may be a combination of the congeners irritating the esophagus and higher acid content below making it harder for the tube to keep sending more material downwards. This in turn will cause gag reflexes that are classic signs of heartburn and indigestion, including the sour tastes in the back of the mouth, tendency to vomit and a whole host of other problems. The longer the esophagus remains coated with acid, the more irritated the lining will be, thus compounding the problem.
Whiskey Makes it Easier for Acids to Rise Up from the Stomach to the Esophagus
In addition to the above, the excess congeners and acids act in concert to trigger a backflush around the LES region. Heavy drinking sessions often cause the LES to open inadvertently, allowing the acid back into the esophagus, which then causes irritation and heartburn.
Whiskey Can Cause Significant Issues if You Develop GERD
As mentioned above, GERD is an umbrella condition that combines almost all the issues that prompt indigestion, heartburn and acid reflux. So, while drinking whiskey has many of the same effects on a person with advanced GERD, there are more risks involved since they have a predisposition to experiencing painful symptoms in the short term, and long-lasting effects on their digestive systems. One of the possible effects of drinking whiskey without checks and balances if/when you have GERD may be the erosion of the mucus lining of your stomach and esophagus and the loosening of the LES. This will not only lead to acid reflux when you drink alcohol, it will cause problems on an ongoing and continuous basis and lower your overall quality of life – definitely not a desirable outcome.
Take care and drink within boundaries (see below) so your condition does not degenerate into GERD and if you do develop the condition and wish to continue drinking, consult with your physician.
8 Tips to Help Prevent Hearburn While Drinking Whiskey
There are a number of things that you can do to help yourself if you intend to continue to enjoy good whiskey without feeling any of the painful side effects of heartburn. It all boils down to some basic principles:
1. Don’t drink on an empty stomach
When you drink on an empty stomach, you are compounding the problem since the stomach is producing acids that cannot react with food and neutralize the abrasive effects. Pouring whiskey on top of it is adding fuel to the fire. Eat some food before drinking but be careful about what you eat.
2. Eat the right foods (and beverages) when you drink whiskey
Certain types of food, such as fried foods, tomatoes, ketchup, mustard, chocolate, sugars, carbonated water, coffee and soft drinks will cause the esophagus to become more acidic and allow food to return from the stomach to the esophagus. If you are prone to heartburn, DO NOT compound the problem with sugary or carbonated mixtures or a bunch of fried food.
3. Eat in moderation
Eating more puts pressure on the system to process more. If you are prone to indigestion and layer shots of whiskey on top, it’s a volatile combination.
4. Avoid hot sauce
Hot sauces are tart and high in acidity. Avoid it while drinking.
5. Drink in moderation
This principle holds true in this context, as in many other instances. Not only will you save yourself other problems, a couple of drinks may be your limit when you find yourself prone to indigestion or heartburn. Remember, the more whiskey you pour down your gullet, the more you are taxing your esophagus and stomach if they are prone to build up acidity and cause acid reflux.
6. Space your drinks
Drinking slowly will allow your system to catch up and move the acid down the digestive track, reducing painful backflush.
7. Drink water in between
To many aficionados, this is a huge no-no. If you cannot bear to put a few drops to water in your whiskey, drink water as a chaser. It will help dilute the acidity and dull the reflux pain.
8. Stop drinking a few hours before going to sleep
If you suffer from indigestion or heartburn, the problem is compounded when you lie down in a prone position. All the stomach and esophageal liquids sloshing about the same elevation will tend to slow down the process of eliminating the irritation and acidity, for the simple reason that gravity is no longer your friend. If you are prone to indigestion from alcohol, try and finish your last drink well before bedtime.
9. OTC Medication for Acid Reflux?
Some recommend using heartburn meds like Prilosec OTC or others. While this may definitely help, depending on the true underlying cause of your heartburn or acid reflux, this is probably not the best idea – to continue doing all the things that trigger indigestion and reflux, then depend on a chemical to stop the ill effects. Changing your behavior is a better long-term solution.
Are Some Whiskeys Better than Others for Heartburn?
There are a number of opinions on this and reactions seem to vary based on the individuals reporting symptoms. There are a few commonalities, all hinging on the fact that higher alcohol content will typically exacerbate problems with acidity and heartburn. So higher ABV scotches, especially cask strength varieties, may need to be drunk in moderation. Many report problems with sherried-cask scotches such as A’bunadh, Glendro and Cardhu. Others seem to have problems with heavy peat contents and higher ABV, especially those from Islay, such as Lagavulin. In many cases, watering the drink down may help.
Indigestion, heartburn, acid reflux – whatever name you call it by, most of us will suffer from some degree of these conditions when you drink alcohol for a long time and are getting on in age. Don’t give up, necessarily. Take some of the precautions outlined above and hopefully you will still be able to enjoy the taste, mouthfeel and flavor of your favorite whiskey without writhing in pain within a few hours.
We live, learn and adopt … don’t we?