Gastrointestinal Conditions and New Diagnosis of Alcohol Use Disorder

Despite the availability of safe and effective outpatient treatments for alcohol use disorder (AUD), primary care physicians screen and treat only a fraction of their patients with AUD. To better detect AUD, it may be effective to evaluate whether the known gastrointestinal consequences of heavy alcohol consumption are linked to subsequent AUD diagnoses. This study examined whether irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD) and gastritis/ulcer were associated with a new AUD diagnosis.

Deidentified medical record data from a large Midwestern health care system was used to identify primary care patients without an AUD diagnosis in 2020 and 2021. Separate multivariate regression models were computed to estimate the association between each GI condition measured in 2020 and 2021 and odds of AUD diagnoses in follow-up (2022 to 2023).

The average age was 56.0 (SD 17.1) years old. Patients were most commonly White race (87.6%). Gastroesophageal reflux disease (GERD) (24.8%) was much more prevalent than either IBS (3.4%) or gastritis/ulcer (2.5%). After adjusting for covariates, there was no significant association between gastritis/ulcer or IBS and a new diagnosis of AUD within 2 years. However, after adjusting for all covariates GERD was significantly associated with new AUD diagnoses (OR = 1.18; 95% CI: 1.10-1.26).

This study suggests that primary care physicians should screen their GERD patients for AUD, as these patients are at higher risk of being diagnosed with AUD within 2 years. Further research is needed to determine patient acceptability to discussing AUD following a GERD diagnosis as compared with standard screening.