GERD Linked To Heightened Risk of New Alcohol Use Disorder Diagnosis

New research is shedding light on a heightened risk of a new alcohol use disorder (AUD) diagnosis among patients with gastroesophageal reflux disease (GERD).1

Findings from the retrospective cohort study of deidentified data from the Saint Louis University-SSM health care system suggest the presence of GERD, especially among younger to middle aged adults, is an indicator of undiagnosed AUD and may be associated with a greater risk of new onset AUD.1

“Given barriers to detecting AUD in primary care, initiating discussions about AUD in the context of physical problems, particularly GI conditions, may be a novel and less stigmatizing approach to identifying new AUD cases,” Kimberly Schiel, MD, department of family medicine at Saint Louis University School of Medicine, and colleagues wrote.1

Previous research has demonstrated a notable association between alcohol consumption and various gastrointestinal conditions. However, investigators say existing studies have not assessed whether gastrointestinal illness is linked to AUD.1,2

To address this gap in research, investigators assessed whether irritable bowel syndrome (IBS), GERD, and gastritis/ulcer are associated with a new AUD diagnosis using deidentified medical record data for primary care patients seen at Saint Louis University-SSM health care system. For inclusion, patients were required to be ≥ 18 years of age, have an in-person primary care visit in the baseline period from 2020 through 2021, and have ≥ 1 primary care visit in follow-up from 2022 through 2023. Of note, patients were excluded if records indicated AUD diagnosis during the baseline period of 2020 to 2021 or if demographic information was missing.1

The outcome of interest was a new diagnosis of AUD during the follow up period. The primary exposures were IBS, GERD, and gastritis/ulcer, measured using diagnostic ICD-10 codes.1

After applying eligibility criteria, investigators identified 355,020 patients without AUD diagnoses at baseline. Among the cohort, the average age was 56.0 (Standard deviation, 17.1) years, most patients were White (87.6%), and GERD (24.8%) was much more prevalent than IBS (3.4%) or gastritis/ulcer (2.5%).1

Overall, 4468 (1.3%) patients in the sample received a new AUD diagnosis during the follow up period. Before adjusting for covariates, investigators noted gastritis/ulcer and IBS were significantly associated with a new AUD diagnosis. However, after adjusting for covariates, these associations lost statistical significance.1

Of note, GERD was significantly associated with an increased likelihood of receiving an AUD diagnosis both before (odds ratio [OR], 1.23; 95% CI, 1.15–1.31) and after (OR, 1.18; 95% CI, 1.10–1.26) adjusting for all covariates. In subgroup analyses, investigators noted GERD was significantly associated with AUD diagnoses in both females and males. Additionally, while GERD was associated with new AUD diagnoses among patients ≤58 years of age (OR, 1.27; 95% CI, 1.15–1.39), no link was observed among those >58 years of age.1

“Physicians should recognize that a new diagnosis of GERD points to an opportunity to open a discussion about alcohol use with the patient, and to screen for alcohol use disorder with a validated tool. Patients may be more willing to discuss their alcohol use in the context of a newly diagnosed GI disorder, and physicians may be more likely to perform formal screening,” investigators concluded.1 “Because general screening rates are low, this may be the only time that the patient is formally screened. Further research is needed to prospectively evaluate the process of care and acceptability of discussing AUD in the context of GERD as compared with standard screening approaches.”

References

1. Schiel K, Chrusciel T, Gruzca R, Scherrer JF. Gastrointestinal Conditions and New Diagnosis of Alcohol Use Disorder. The Journal of the American Board of Family Medicine. https://doi.org/10.3122/jabfm.2024.240426R1

2. American Addiction Centers. Alcohol and the Digestive System. March 8, 2024. Accessed October 23, 2025. https://americanaddictioncenters.org/alcohol/risks-effects-dangers/gastrointestinal