Eosinophilic Esophagitis (EoE) and Alcohol: Is Drinking Safe?
Health ConditionsDigestive Health

Can You Drink Alcohol With Eosinophilic Esophagitis?

Can You Drink Alcohol With Eosinophilic Esophagitis?
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Published on September 30, 2025
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While research on alcohol is evolving, the Centers for Disease Control and Prevention says drinking less or not at all is better for your health.

After sipping your favorite beer, wine, or whiskey, the alcohol in these drinks may impact your esophagus even after you swallow.

 This exposure may not seem like much, but if you have a chronic inflammatory condition of the esophagus, like eosinophilic esophagitis (EoE), you may wonder if it’s safe to drink alcohol at all.

“The relationship between EoE and alcohol is unclear,” says Alex Koral, MD, a gastroenterologist with Yale Medicine in Trumbull, Connecticut.

Research suggests that some people with EoE notice no difference in symptoms when they drink.

 But others find that alcohol worsens heartburn, triggers flares, and damages the lining of the esophagus, and that avoiding alcohol altogether is the safest option for them.

How Alcohol Affects Eosinophilic Esophagitis

As mentioned, drinking alcohol may not cause noticeable symptoms for everyone with EoE, but some may find that it worsens their symptoms. “We know that alcohol can cause changes in the lining of the esophagus and that people with eosinophilic esophagitis have similar changes,” says Dr. Koral.

Research suggests that alcohol may affect EoE in several ways.

Alcohol Increases Inflammation

Alcohol causes inflammation throughout the body, including the esophagus.

 “Since one of the fundamental symptoms of EoE is inflammation of the esophagus, it is practical to assume that alcohol can cause even further inflammation and worsen the symptoms of the condition,” says Destini Moody, RD, a registered dietitian in private practice in Los Angeles.

Alcohol May Cause Reflux and Damage Tissue in the Esophagus

As alcohol travels through your esophagus, it can injure tissue in the esophagus.

 It also relaxes the lower esophagus, which can allow stomach acid to splash back up into it, says Ekta Gupta, MBBS, a gastroenterologist at the University of Maryland Medical Center and an associate professor at the University of Maryland School of Medicine in Baltimore.

“This can act as an irritant for the esophageal lining and cause symptoms of chest pain or worsening of trouble swallowing, which is also a symptom of EoE,” says Dr. Gupta.

Alcohol May Lead to an Imbalance of Bacteria in the Esophagus

You may have heard of the gut microbiome — the population of healthy bacteria in your intestines. But did you know your esophagus houses its own collection of helpful microbes? Alcohol may alter these microbial populations. In one study of 1,044 people, those who drank alcohol had fewer healthy bacteria in their esophagus than those who didn’t drink — and the more they drank, the worse their microbiome balance became.

Alcohol May Slow the Movement of Food Through the Digestive System

When you eat, your esophagus ramps up peristalsis, muscle movements that push food through the esophagus to your stomach. But alcohol can impair these movements, causing problems swallowing and chest discomfort from food sitting in your esophagus longer than normal.

Is It Safe to Drink During or After an EoE Flare?

When your esophagus is already inflamed during an EoE flare, alcohol can worsen your symptoms. It’s probably best to avoid alcohol during a flare.

But not all experts agree on the safety of drinking during remission (when your symptoms have resolved). “Drinking during remission should be okay,” says Koral. “In theory, the lining of the esophagus should be healthy when in remission and should be similar to someone without EoE.”

Moody agrees, adding that recommendations for or against drinking in remission depend on the individual, the severity of their inflammation, and their personal tolerance.

“During remission, the esophageal mucosa [the innermost lining of the esophagus] is less inflamed, so irritation is less likely — but not impossible,” says Gupta. However, in his clinical experience, Gupta finds alcohol is a common trigger for many of his patients with EoE.

There have been mixed research findings on the effects of drinking during EoE remission. According to one research review, some studies have found that alcohol triggers EoE, while others have found it has little to no effect on EoE.

Does Alcohol Interact With Eosinophilic Esophagitis Medications?

In general, alcohol can interact with some medications, causing uncomfortable symptoms and side effects. It can even make some medications less effective.

It’s not clear, though, how alcohol interacts with EoE medications in particular. Common medications used for EoE include:

  • dupilumab (Dupixent)
  • budesonide oral suspension (Eohilia)
  • omeprazole (Prilosec)
One case study found that an individual with atopic dermatitis who took dupilumab with alcohol experienced facial flushing.

 But on a larger scale, experts don’t have solid evidence of interactions between alcohol and the common medications used to treat EoE, says Koral.

That said, it’s still a good idea to limit drinking in general. “Overconsumption of alcohol can cause liver damage, which may affect the effectiveness of medications,” says Koral. When in doubt, ask your healthcare provider for their recommendations about mixing alcohol with any medications you take.

Are Some Alcoholic Drinks Safer for Eosinophilic Esophagitis Than Others?

Alcoholic beverages come in many forms, some with a higher concentration of alcohol than others. For example, beer and wine have between 4 and 16 percent alcohol, but whiskey can be as high as 40 percent.

“Alcohol with a low alcohol percentage (for example, wine vs. spirits) may reduce the risk of adverse reactions,” says Moody. Drinks with lower concentrations of alcohol include:

  • Beer (4 to 8 percent, or 8 to 12 percent for craft beer)
  • Wine (14 to 16 percent)
  • Champagne (12.5 percent)
  • Hard seltzer (4 to 12 percent)
  • Kombucha (0.5 to 2.5 percent)

But even when choosing drinks with lower alcohol content, it’s safest to limit them.

Safe Drinking Practices for People With Eosinophilic Esophagitis

If you have EoE, safe drinking habits can help you minimize the effect of alcohol on your symptoms. “Moderation is key,” says Koral. “Just like with everyone else, occasional consumption of one to two drinks will probably be fine.”

The U.S. Department of Health and Human Services recommends limiting alcoholic drinks to two per day for men and one per day for women. One drink equals:

  • 12 fluid ounces of regular beer
  • 5 fluid ounces of wine
  • 1.5 fluid ounces of 80-proof distilled spirits
  • 7 fluid ounces of a rum and cola

“[When you have EoE] it’s critical to stick to small amounts and avoid binge drinking,” says Moody. “You also want to assess your tolerance by starting with small sips of alcohol to see if you experience symptoms, as thresholds of tolerance will differ between individuals.”

If you choose to drink, be sure to hydrate well before and after drinking, which helps stave off the dehydrating effects of alcohol and keeps your esophagus moist, says Moody.

You can also try nonalcoholic beverages, which have been growing in popularity. From flavored sparkling water and nonalcoholic beer to mocktails and the occasional soft drink, you have a wide range of options. More and more research shows that any amount of alcohol holds risk, and not drinking at all will keep you the safest.

The Takeaway

  • Drinking alcohol may not cause symptoms for everyone with eosinophilic esophagitis, especially during remission, but avoiding alcohol altogether offers the most protective benefits for your overall health.
  • Both EoE and alcohol cause inflammation, and drinking can worsen some symptoms or even trigger a symptom flare.
  • Some drinks with lower alcohol content may be safer than others, but whatever the drink, the most important factor is to limit the amount.

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Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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Abby McCoy, RN

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Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.

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