If you’ve experienced nausea after having cocktails – or simply a bloated, overfull feeling after a few too many – you’ve seen how alcohol can affect your digestive system in different (and often unpleasant) ways. Here are some of the most common effects and why they happen.

Heartburn. Alcohol is a trigger for heartburn. That’s because alcohol allows the flap between the esophagus and the stomach to relax, which lets stomach acid splash up into the esophagus and throat. That can give you the telltale burning feeling. Over time, heartburn can also damage your esophagus. 

Nausea and vomiting. Alcohol is tough on the stomach lining. This irritation of the lining can cause a burning, gnawing stomach pain and trigger the stomach to produce more acid, which can cause nausea. Vomiting can also occur with excessive drinking as the body’s natural way of getting rid of excess toxins that it can’t break down fast enough.

Bloating. Alcohol causes inflammation (swelling) in the digestive tract, which can lead to looking and feeling bloating. Alcohol is also infamous for being dehydrating and that can make you feel puffy too. Another culprit for bloating: fizzy cocktails made with soda.

Gut imbalance. Both heavy and moderate drinking can result in negative changes to the gut microbiome, the trillions of microbes living in the digestive system. An imbalance between healthy and unhealthy microbes, called dysbiosis, can increase your risk for conditions like small intestinal bacterial overgrowth (SIBO) and inflammatory bowel disease (IBD). Beyond your gut, it’s believed that the health of your microbiome also impacts your immune system, body weight, and even mental health. 

If you do drink alcohol, you can help protect your gut by drinking in moderation, drinking with meals (not on an empty stomach), and staying hydrated by having water before and after an alcoholic beverage.

According to the Dietary Guidelines for Americans, “moderate” drinking is considered no more than two servings a day for men and no more than one for women. What counts as a serving: 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits like vodka and gin.

If you don’t drink, there’s no reason to start, since even moderate drinking may be associated with increased risk of death from conditions like cancer and cardiovascular disease.

And if you have IBD, there’s evidence that avoiding alcohol altogether may be a smart move, as it can trigger flare-ups and may interfere with your IBD medications.

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