Hangovers that last for days – The cause and the cure

This post turned out to be a bit more lengthy then first intended so here’s the main points:

• Hangover symptoms that last up to 5 days: Fatigue, brain fog, bad taste in mouth, pressure behind the eyes, irritability
• Cause is alcohol induced gastritis
• Cure is PPIs or proton pump inhibitors a few days before and after drinking, antacids during drinking. And of course not drinking so much.

Backround

So today I will talk about the substance that every health oriented person avoids or at least tell others to avoid due to it’s abundant negative health effects. I’m of course talking about alcohol. For me personally alcohol is great for relieving stress. These days this means having drink or two on the weekend with friends or a good meal. When I was a bit younger I used to binge drink on the weekends – as many young adults in Finland do – with my friends. I was very high wound, anxious and stressed introvert and beer was simply like a miracle drug that changed me in to a laid back, social and confident bloke who liked going to parties and socializing with friends and strangers. I also never had the negative effects many have like aggression and fighting, drinking too much and passing out, crying and drama etc. Sure I sometimes drank too much and got a bit nauseous and tired but that’s about it. Acutely alcohol just seemed to bring the best out of me and calm my nerves so I could actually enjoy life.

That’s all fine and dandy but Jukka, if alcohol made you feel so good how come you didn’t become addicted and turn in to an alcoholic?

We’ll there are two reasons. First is that I don’t have an addictive personality. I constantly rationalize and review everything I do and I knew the health risks associated with alcohol very early on so I had the will power to abstain when necessary. I always had this unspoken rule that alcohol can’t stop me taking care of my responsibilities or cause any form of harm to myself or to my loved ones that I would regret. And this is where the second part comes in naturally. The reason I’m writing this post, hangovers.

It took me a few years of absolute misery to draw the connection between alcohol intake during the weekend and extreme fatigue and malaise during the first part of the week. Since I drank almost every weekend and sometimes two nights in a row, I lacked a reference point for sobriety. I also did not realize alcohol consumption was behind my symptoms as everyone around me was drinking also and they seemed to get hangover symptoms only the day after. No one, including doctors, ever suggested that alcohol consumption during the week could be the cause for my symptoms during the week.

The Symptoms

So here are the symptoms I would get from drinking let’s say ten beers.

The day after: Headache, nausea, thirst, heartburn, tiredness. Your textbook hangover symptoms. Nothing that an ibuprofen, gallon of water and a pizza wouldn’t fix. On a rare occasion I would be so nauseated that I would vomit every 15 minutes, if I didn’t drink or eat anything I would dry heave stomach acid. And sometimes this shit lasted till the evening so I might have hurled 30 or more times. Trust me you don’t want to experience that. This part is important later.

Two to four days after: Bad taste in mouth, pressure in head and behind the eyes, fatigue, irritability, constant feeling of hunger or similar stomach upset and extreme brainfog. I was completely unable to concentrate in work, studying or anything that required mental effort. In a word I felt exhausted and just wanted to sleep. But sleep did not help and only time would take these symptoms away. Usually by thursday I felt better and by friday I was back to 100 %. And usually friday evening I would drink alcohol and the cycle would start all over again.

At some point I started to suspect alcohol as there were of course weeks when I consumed no alcohol and felt much better during the week. I of course searched the internet for my symptoms and sometime around 2012 or so I stumbled upon this group at netdoctor.co.uk called “hangovers lasting 3 -4 days when I don’t even drink that much“. To my amazement there were many people having the exact symptoms I was, I was relieved that I was not alone. Unfortunately no one had found a working cure except for reducing alcohol consumption radically or abstaining completely.

So I started to avoid alcohol but wasn’t able completely abstain due to having a need for social life. But I very rarely drank enough to notice any symptoms several days after drinking and kind of forgot the whole “problem”. Until once at a friends summer cottage we drank from evening to the next morning destroying something along the lines 24 cans of beer and 3 litres of white wine between the two of us. I woke up feeling surprisingly good and had some breakfast. After about 20 minutes I felt extreme nausea and had to vomit. I knew what was coming and kept drinking and vomiting every 15 minutes like clockwork. This time it lasted to the night and I decided to go to the doctor the next day worried that my liver was giving up or something else serious was wrong with my body.

The doc checked my liver function(which was fine) by running labs and concluded that I very likely had acute alcohol induced gastritis which caused the nausea and violent vomiting. My stomach lining was inflamed and secreting gastric fluids constantly which induced the vomiting. The cure was simple enough. PPIs or proton pump inhibitors and avoid drinking so god damn much. PPIs are a group of drugs that reduce gastric acid production significantly and this gives the inflamed stomach lining a better change of healing.  Fortunately the doc realized I wasn’t an alcoholic a didn’t lecture me too much about alcohol consumption. She also told me to avoid NSAIDs like ibuprofen and aspirin since they irritate the stomach lining also. Of course I had routinely taken ibuprofen when going bed drunk to counter possible hangover headache and in retrospect it makes perfect sense that my gut was irritated.

The Epiphany

After that one incident I once again avoided alcohol for some time and forgot about the problem. At some point I drank again, not enough to induce vomiting the morning after but enough to have the dreaded multiple day hangover. That’s when I realized maybe there is a connection between the 3 to 4 day fatigue and stomach irritation. Surely my gut was irritated by the alcohol even though not enough to induce vomiting. It was time to do some testing.

I started taking a PPI called esomeprazol about a week before drinking and also took some antacids while drinking to counter the acidity of alcohol. And guess what? I had a one day hangover. By the evening next day I was feeling fine. No fatigue or bad taste in mouth for a week. The answer was so simple it’s hard to believe but I have tested this many times since and at least in my case it works.

When you think about it it makes perfect sense. Our stomach and gut are deeply connected with our brain through the central nervous system. I haven’t found my symptoms like fatigue and brain fog documented as a symptom of gastritis but when we know the brain gut connection it makes sense and since the cure for gastritis cures my weird multiple day hangovers I’d like to assume there is a connection.

That’s about it for today. I don’t want to encourage anyone to consume alcohol or binge drink but let’s face, most adults do enjoy a few drinks every now and then and having a 4 day hang over for few hours of fun is just not fair. So if you have these weird long hangovers –  next time your about to go out maybe try taking PPIs couple days before and antacids while drinking and see how it goes. To my knowledge there should be no negative side effects of combining alcohol and PPIs but always check with your doctor as I can’t be held responsible for any negative effects. Drop a comment below if you have any questions or want to share your results!