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Nearly 70 percent of American adults consume alcoholic beverages and up to 10 percent abuse ethanol. Blood alcohol concentrations between 0.20 and 0.30 percent cause intoxication with lack of coordination, confusion, nausea and vomiting. A product of alcohol metabolism is acetaldehyde that when accumulates causes tachycardia, flushing, nausea and vomiting.

Vomiting is a reflex to get rid on an ingested toxin or poison. During this reflex gastric and lower esophageal sphincter relax while abdominal muscles contract. Retching occurs when the glottis (the opening between the vocal cords at the upper part of the larynx) closes and respiratory muscles counteract abdominal muscle contraction to prevent the expulsion of gastric content.

Sore Throat and Ulcer Development

All these reflexes and exposure of the throat to gastric contents contribute to the sore throat feeling following the vomiting due to excessive alcohol ingestion. Exposure of the pharynx to gastric juice practically causes a chemical pharyngitis that is felt as sore throat. If the exposure to these contents is prolonged or heavy enough, then an ulcer may develop in the pharynx. If an ulcer develops then there is usually an associated pain with every swallow. In the majority of cases, the ulcer is self-limiting and resolves spontaneously thanks to the ample blood supply of the pharynx and rapid healing. But a physician should be consulted when the ulcer or the associated pain does not resolve over a week. It is also important to note that excess alcohol consumption also contributes to the cancer of the pharynx.


As an over-the-counter (OTC) product, many different kinds of lozenges and throat drops are marketed for symptomatic treatment of sore throat. The active ingredients in a some lozenges is menthol which has some anesthetic activities. Some available lozenges are ambroxol, lidocaine, Benzocaine and AMC/DCBA (amylmetacresol and 2,4-dichlorobenzyl alcohol) lozenges. Throat sprays that are used to treat sore throat has phenol which has anesthetic properties. A nonsteroidal anti-inflammatory drug (NSAID) might also be used to reduce the pain.

Complications from Heavy Alcohol Drinking

The chemical injury to the pharynx could also be part of an ongoing and more severe complications which are known as Mallory-Weiss syndrome and, in more severe cases, Boerhaave's syndrome. Mallory-Weiss syndrome refers to lacerations in the mucosa of the esophagus which is usually caused by severe alcoholism and vomiting. When the vomiting is accompanied by much effort, it may cause the rupture of the esophagus which is known as Boerhaave's syndrome.

These conditions which could be seen as a spectrum extending from simple pharyngitis to Boerhaave's syndrome are primarily seen in heavy alcohol drinking. Due to these complications and numerous other accompanying diseases associated with drinking alcoholic beverages, it is always advised to think again about what to drink.

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