Pain After Drinking Alcohol

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, and this seems to be more common in people with Hodgkin lymphoma.

Pain with Alcohol: What Could it Be?

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

Pain in the lymph nodes after drinking alcohol does occur in some patients with Hodgkin's lymphoma, however.

In general, pain associated with alcohol consumption is much more common due to other conditions. Specifically, drinking too much alcohol can produce the familiar hangover, the general feeling of being unwell, along with, at times, irritation or pain in the area over the stomach, esophagus, pancreas, gallbladder and liver. Indeed, excessive alcohol consumption is associated with quite a long list of ailments, disorders and chronic diseases.

Alcohol Intolerance vs. Painful Lymph Nodes

When someone has an unexpected response to alcohol, there are a number of possibilities. The list of ailments or conditions includes Hodgkin lymphoma, but also something called carcinoid syndrome, as well as plain old genetics: mutations of the gene encoding alcohol dehydrogenase (most commonly found in Asian populations).

Carcinoid syndrome is something that occurs rarely and is associated with a certain type of slow growing tumor, or carcinoid tumors, that release serotonin which can produce symptoms like abdominal pain, red flushing of the neck, face and chest, diarrhea, palpitations, and wheezing, and these symptoms may be precipitated by alcohol in some cases.

Alcohol intolerance is also associated with the use of certain medications including disulfiram and metronidazole.

The association with alcohol pain with Hodgkin's disease goes back a number of years. In a 1966 review describing 747 patients with alcohol-induced pain associated with cancerous conditions, Hodgkin lymphoma accounted for 40 percent of cases.

Alcohol Pain in Hodgkin Lymphoma

What is responsible for alcohol-related pain in Hodgkin's disease? Scientists do not know the precise mechanism biologic cause, but there are several theories. Some believe pain is related to the expanding of the vessels within the lymph node capsule following exposure to alcohol in the bloodstream. In one case report, alcohol-induced pain was relieved with ibuprofen, and since ibuprofen acts on a chemical messenger called prostaglandin, the authors speculated that a prostaglandin-mediated process might have been involved.

If you do have Hodgkin’s disease, and if you experience this sort of reaction to alcohol, it is not known whether the alcohol intolerance reveals or predicts anything in terms of the severity or prognosis of the disease.

Case of a 31-year old man with Pain after sips of Alcohol

In 2013, Dr. Andrew Bryant and Dr. John Newman of Vanderbilt University Medical Center reported the case of a 31-year-old man who came to their clinic with severe chest pain that began minutes after ingesting two-to-three sips of alcohol.

This reaction had been occurring for the previous three months. The patient felt no pain when swallowing other liquids or solids, and his pain was relieved with low doses of ibuprofen.

In this particular patient’s case, lymph nodes near the right lung, heart, and diaphragm had become involved with Hodgkin disease. In addition to the pain in his chest with sips of alcohol, he had periodic fevers, night sweats and general malaise. Imaging and biopsy of one of the abnormal lymph nodes led to the diagnosis of Hodgkin lymphoma.

A Word From Verywell

Alcohol pain is not a common, typical or prominent presenting symptom of Hodgkin's lymphoma, however painful lymph nodes after alcohol consumption is a symptom that has been documented many times in people with Hodgkin's disease.

People with Hodgkin lymphoma may develop different symptoms, but the most common scenario at diagnosis is enlarged lymph node(s) and nothing else. Lymph nodes may be enlarged in the neck, armpits, or groin, causing a painless lump, or within the chest. Less commonly, those with Hodgkin lymphoma may have weight loss, fever, itching, or drenching sweats at night, collectively called B symptoms.

If you experience pain after drinking alcohol or are concerned about an unusual symptoms or reactions from drinking alcohol, make an appointment to talk to your doctor.


Bryant AJ, Newman JH. Alcohol intolerance associated with Hodgkin lymphoma. CMAJ. 2013;185(8):E353.

Symptoms of Lymphoma. Accessed. February 2015.

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