Ah, friends. They're like family but cooler. Fully customizable. Fall and one of them will be right there to pick you back up. But as great as friends can be, they also do a lot of really stupid stuff. Stuff that blows your mind. Like, sometimes it seems crazy that you even hang out with people who make such crappy decisions. Stuff that, were it to get out, would be mortifying for anyone with even a shred of self-respect. Lucky for your friends, they've got you to ask their deepest, darkest questions for them. And lucky for you, we started this column to answer those most embarrassing of queries.
The Scenario: Your friend started the night innocently enough with wine at dinner, then moved to beer at a bar afterwards, followed by a couple shots and some mixed drinks until the timeline of the night gets fuzzy. Now she's home, her stomach full of liquid, feeling nauseous and getting the spins. She swears she'll feel better if she just makes herself puke, so she sticks her finger down her throat and expels what's left in her stomach after a night of bad decisions. This is her go-to move after a night of drinking; she claims it helps relieve her nausea, helps her sober up, and will prevent a killer hangover the next day.
The Worst That Could Happen: Voluntarily making yourself throw up is different from your body's natural reaction to want to vomit after you've had too much to drink. Alcohol is a toxin— and when your body has had too much of it, it needs to get rid of it ASAP. While it's not pleasant in the moment (or for the poor neighbor whose bushes you end up assaulting), it's a normal bodily reaction we've all experienced at least a few times in our lives.
The problem happens when people make this self-induced vomiting a regular habit, particularly after a few too many adult beverages. Even a couple times a month could be bad news for your GI tract. "You're vomiting a combination of the alcohol that you just consumed, plus stomach acid, plus any food particles that are partially digested, or whole pieces of food," says Benjamin H. Levy, a gastroenterologist at Mount Sinai and Holy Cross Hospitals in Chicago. "When you vomit, it all has to go across the esophagus, so it just causes a whole bunch of inflammation of the esophagus because you have stomach acid that's refluxing back up. Some of it may get stuck if there's food mixed in with it."
Self-induced vomiting is also potentially more dangerous than when you throw up naturally because you're actively trying to vomit up as much as you can, which puts more strain on your esophagus. Vomiting frequently or heavily could lead to esophageal tears known as Mallory-Weiss tears, and cause you to throw up blood.
Constantly exposing your esophagus to stomach acid and alcohol also exacerbates esophagitis (inflammation of the esophagus) and can cause permanent changes. It gets worse: Chronic esophagitis increases your risk of developing esophageal cancer, although developing esophageal cancer from puking a few times a month on purpose is kind of a stretch. There's also a risk of pulmonary aspiration, or having partially-digested food end up in your respiratory system.
"Whether it's self-induced or just natural vomiting, the danger is very high for the alcohol and stomach acid and food contents of whatever they ate earlier to go into their lungs," Levy explains. This could lead to pneumonia, or in a worst-case scenario, asphyxiation.
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What Will Probably Happen: In addition to esophagitis, which Levy says is a common side effect of frequent vomiting, throwing up alcohol and stomach acid can also lead to heartburn. That's the last thing you want to deal with after you're already feeling a little nauseous and dizzy. You may also experience gastroesophageal reflux disease (GERD), where contents from your stomach leak back into your esophagus and cause irritation.Throwing up on a regular basis also wreaks havoc on your teeth. All the stomach acid entering your mouth can wear away at your tooth enamel and lead to sensitive teeth, cavities, and gingivitis. Dental issues are a common problem among bulimia patients; a 2014 study found that patients who made themselves puke were almost 20 percent more likely to develop tooth erosion than patients who didn't.
So Is It Worth It?: Although you may find temporary relief from your stomach being emptied, the alcohol you consumed throughout the night is still in your system. Sure, whatever booze you expel hasn't been absorbed yet, but throwing up won't do much to sober you up. You'll probably end up feeling worse thanks to the heartburn and GERD.
Levy says the risks associated with making yourself puke, especially after a night of drinking and on a regular basis, just aren't worth it. "I do not recommend self-induced vomiting as an antidote to binge drinking because of the risks for aspiration of alcohol, increased stomach acid, and the potential for partially digested food to enter the lungs," Levy says. "Retching also poses a risk for developing a tear in the esophagus."
If your friend is vomiting reflexively after drinking too much, hold her hair back and let her body do its thing. Afterwards, make sure she lies on her side when sleeping to prevent choking, Levy recommends, and if you notice signs of alcohol poisoning like vomiting, confusion, seizures, slow breathing, and unconsciousness, seek medical attention right away.
Of course, the first line of defense is not drinking too much in the first place—binge drinking has its own set of complications, from alcohol poisoning to alcoholic hepatitis. But if your friend is feeling sick after a few too many, she's better off chugging lots of water or Gatorade, going to bed, and hitting the gym the next day.
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