Possible Causes of Pain After Drinking Alcohol

If you've experienced pain with drinking alcohol, what could it mean? Pain after drinking alcohol has been associated with Hodgkin lymphoma. In general, though, there are usually other reasons for the pain.

Drinking too much can cause the familiar hangover and the general feeling of being unwell. It also may cause irritation or pain in the area over the stomach, esophagus, pancreas, gallbladder, and liver. There is a long list of disorders and diseases linked to excessive alcohol use.

This article discusses these conditions, some of which may be quite serious. It will help you to be familiar with symptoms of these illnesses and the causes of pain linked to drinking alcohol.

What Are the Causes of Pain After Drinking Alcohol?

When someone has unusual pain in response to alcohol, there are several possible causes. The list of conditions includes Hodgkin lymphoma, but also something called carcinoid syndrome. Plain old genetics may be at work too.

Alcohol Intolerance and Allergy

Alcohol intolerance and allergy account for most of the unusual responses that happen after drinking alcoholic beverages.

Alcohol intolerance can cause people to feel unpleasant symptoms after drinking alcohol, including skin flushing, nausea and vomiting, headache, and a rapid heartbeat. It's caused by the lack of an enzyme that breaks down alcohol in the body, called alcohol dehydrogenase. It's more common in Asian populations.

Other causes of allergies and intolerances to alcohol may include:

• Celiac disease (gluten sensitivity)
• Histamine intolerance
• Wheat allergy
• Sulfite allergy

Carcinoid Syndrome

Carcinoid syndrome also is quite rare. It involves a type of slow-growing tumor called a carcinoid tumor, which releases serotonin. This is a chemical messenger that can, in turn, produce the symptoms of this syndrome. They include:

• Abdominal pain
• Red flushing of the neck, face, and chest
• Diarrhea
• Heart palpitations
• Wheezing

These symptoms may be triggered by alcohol in some cases.

Medications

Some alcohol intolerance cases are linked to the use of certain medications. They include Antabuse (disulfiram) and Flagyl (metronidazole).

Why Does Alcohol Cause Lymphoma Pain?

About half of people with lymphoma will have enlarged lymph nodes. These nodes are not usually painful to the touch, although they can ache.

In some people, the affected lymph nodes can become painful after drinking alcohol. This seems to happen more often in people with Hodgkin lymphoma.

It is not one of the key symptoms in the diagnosis of lymphoma. In fact, it is quite rare.

There is a long history of this association between alcohol and pain in Hodgkin disease. A 1966 review described 747 patients with alcohol-induced pain linked to cancer-related illness. Hodgkin lymphoma accounted for 40% of cases. Two other reviews in 1994 and 2013 discuss the association but there are few other studies on the books.

Does Drinking Alcohol Cause Pain in All Types of Lymphoma?

There are two main types of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma. However, alcohol-induced pain has only been linked to Hodgkin lymphoma (or Hodgkin disease).

Mechanism of Alcohol-Related Pain

Scientists don't know the reason for alcohol-related pain in Hodgkin disease, but one theory is blood vessel dilation.

Some believe that pain is related to expansion of the blood vessels within the lymph node triggered by exposure to alcohol in the bloodstream. In one case report, this type of pain was relieved with Advil (ibuprofen). Advil acts on a chemical messenger called prostaglandin. The authors' theory, then, was that a process involving prostaglandin might have been involved. It is not known whether this reaction to alcohol reveals or predicts anything about the severity or outcome of Hodgkin disease.

Example Case

One 2019 article published in BMJ Case Report describes the case of a 32-year man with a two-month history of progressively worsening lower back pain. During that period he also recalled noticing a mass near the collar bone region. One week before presentation, he reported worsening back pain immediately after drinking 235–355 mL of alcohol.

There were other symptoms besides the back pain. He had reported frequent fevers, chills, night sweats and unintentional weight loss over the prior six months. 

CT imaging revealed a mediastinal mass extending through the chest wall. MRI revealed tumorous bone lesions in the lower spine. Biopsy of the mediastinal mass led to the diagnosis of Hodgkin lymphoma.

Can You Treat Alcohol-Induced Lymphoma Pain?

Limited research suggests that alcohol-induced pain in those with Hodgkin lymphoma may be treated with an over-the-counter pain medication, such as ibuprofen. However, limiting or abstaining from alcohol use may be the easiest way to manage this condition.

What Are the Symptoms of Hodgkin Lymphoma?

People with Hodgkin lymphoma may develop a variety of symptoms. The most common scenario at diagnosis is an enlarged lymph node(s) and nothing else.

Lymph nodes may be enlarged in the neck, armpits, or groin, causing a painless lump. They also may be in the chest and found on imaging studies. However, these lymph nodes often grow slowly, and you can have Hodgkin lymphoma for months or even years before the nodes are detected.

Other Hodgkin lymphoma symptoms occur less often and are called B symptoms of lymphoma. They may include:

• Weight loss
• Fever
• Itching
• Drenching sweats at night

Summary

Some people experience pain after drinking alcoholic beverages. However, it is rare for this to happen. When it does, the pain may be a sign of an ongoing health condition.

Pain along with drinking alcohol has been linked to Hodgkin lymphoma, a type of blood cancer that is highly curable. Most people live full lives if Hodgkin lymphoma is detected and treated early. The symptoms also may be related to carcinoid syndrome, or to a genetic mutation more often found in people of Asian ethnicity. If you experience pain or have unusual symptoms after drinking alcohol, make an appointment to talk to your healthcare provider.