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Why do my extremities (hands and feet) get swollen every time I drink alcohol?

My girlfriend is a 29 year old woman, who used to drink heavily when she was younger (16-19). She rarely drinks that much anymore, but when she does, her hands and feet become swollen; even when having just a single drink. Is this a serious problem and should she see an allergist immediately? She isn't taking any medication.
It is unlikely that having 1 drink would cause swelling of the hands and feet. In rare cases, drinks that have high concentrations of histamine (such as certain wines) may cause a histamine-like reaction in certain sensitive people, but this usually manifests as gastrointestinal discomfort or worsening of asthma symptoms. Another more likely possibility is that your friend has a variant in one of the enzymes that breaks down alcohol; this is quite common and can lead to blushing or flushing or blotchiness of the skin, but is not a true allergic reaction. True allergic reaction to alcohol (ethanol) is technically possible but would be very, very rare. However, if your friend has any of the following concerning symptoms when drinking alcohol, she should immediately seek medical attention: swelling of the face, lips or tongue; wheezing or difficulty breathing; violent nausea, vomiting, and abdominal pain. In people with an underlying medical problem, such as a liver or heart problem, drinking alcohol can lead to problems with how the body handles fluid and this can definitely lead to swelling. Therefore, if your friend has any serious medical problems, this is a possibility. The best advice would be for her to see her primary care doctor for advice.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under ZocDoc’s Terms of Service.
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