Alcohol Consumption and the Risk of Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis

Alcohol Alcohol. 2019 Jan 1;54(1):62-69. doi: 10.1093/alcalc/agy063.


Aims: Epidemiologic evidence on alcohol consumption increasing the risk of gastroesophageal reflux disease (GERD) is contradictory. This study aimed to investigate the correlation between alcohol consumption and GERD by a meta-analysis of observational studies.

Short summary: Gastroesophageal reflux disease (GERD) is a prevalent disease, and the incidence is rising. We conducted a meta-analysis of observational studies, indicating that there was a significant association between alcohol consumption and the risk of GERD. This finding provides important implications for the prevention and control of GERD.

Methods: Two investigators retrieved relevant studies on PubMed, Cochrane and EMBASE, respectively. The summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by random effects model to assess the association. Heterogeneity was quantified using the Q statistic and I2. Subgroup analysis, publication bias and sensitivity analysis were also conducted.

Results: Twenty-six cross-sectional studies and three case-control studies were included in the meta-analysis. The pooled random effects OR was 1.48 (95%CI, 1.31-1.67; I2 = 88.8%), in comparison between drinkers and non-/occasional drinkers. For reflux esophagitis and non-erosive reflux disease, two subtypes of GERD, the ORs were 1.78 (95%CI, 1.56-2.03; I2 = 87.5%) and 1.15 (95%CI, 1.04-1.28; I2 = 0.3%), respectively. In addition, the pooled OR for drinkers who drank <3-5 times or days per week was 1.29 (95%CI, 1.14-1.46; I2 = 35.5%), while for those who drank more frequently, the OR was 2.12 (95%CI, 1.63-2.75; I2 = 55.1%). Dose-response analysis showed a linear association between alcohol consumption and GERD (Pfornonlinearity=0.235). The pooled OR for a 12.5 g/day increment of alcohol was 1.16 (95%CI, 1.07-1.27; P = 0.001).

Conclusions: This meta-analysis provides evidence for a potential association between alcohol drinking and the risk of GERD. The increase in alcohol consumption and frequency showed a stronger association with GERD.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / trends*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Gastroesophageal Reflux / diagnosis*
  • Gastroesophageal Reflux / epidemiology
  • Gastroesophageal Reflux / etiology*
  • Humans
  • Observational Studies as Topic
  • Risk Factors