Did you know that alcohol is the most avoided food and beverage item by individuals with IBD? (PMID: 34924888). Does that mean everyone with IBD should avoid it? What about alcohol in moderation? Does it have any protective effects? Let’s dive in!
Alcohol is a known toxin, and yet, it is one of the most commonly consumed things in the world.
There is a lot of conflicting evidence around this topic – with some studies saying moderate alcohol consumption can be health promoting, and others saying alcohol consumption can lead to a wide array of illnesses – and here is what we want you to know about the effects of alcohol on the gut.
Alcohol, inflammation and its effects on the gut microbiome
The gut is full of bacteria – good bacteria, and bad bacteria. Heavy alcohol consumption is known to increase pro-inflammatory bacteria and decrease anti-inflammatory bacteria in the gut, leading to bacterial imbalance and an increase of inflammation (PMID: 34299105).
The IOIBD (International Organization for the Study of Inflammatory Bowel Disease) guidelines show that in a small study it was found that those with higher alcohol consumption with ulcerative colitis were 2.7 times more likely to flare.
A survey showed that of those with Crohn’s Disease who chose to drink alcohol, 40% stated symptoms worsened, and 41% said they did not (https://doi.org/10.1016/j.cgh.2020.01.046).
The IOIBD has found that there is not enough evidence to completely avoid alcohol for people with IBD.
Alcohol and hydration
Adequate hydration is a common issue for those with IBD. Multiple trips to the bathroom, decreased absorption, and frequent cases of diarrhea can all lead to dehydration. When you add alcohol into the mix, it dehydrates the body, which can further enhance hydration needs. When cells of the body do not have enough fluid, it can interfere with how well they work and interfere with the immune response and how well it can fight infection.
IBD meds and alcohol
There are some medications (ie. methotrexate) that are not recommended to be consumed with alcohol due to alcohol interfering with the absorption of the medication and of course, alcohol and medications can be hard on the liver. To ensure medications are working in the most optimal form, avoidance of alcohol may be necessary. If you are curious about the medications you are taking, please reach out to your healthcare provider
Protective effects?
Some studies have shown positive effects of red wine on fecal calprotectin levels. Red wine contains an antioxidant (called resveratrol) which we know are helpful for fighting illness. Red wine has also been shown to increase anti-inflammatory bacteria in the gut. However, studies have also shown that consumption of red wine can increase intestinal permeability which in the long run, can contribute to an increase in inflammation (PMID: 34924888).
If you notice an uptick in gastrointestinal symptoms after alcohol consumption, there is some evidence to support that choosing beverages WITHOUT sulfites may be helpful in reducing symptoms (https://doi.org/10.1016/j.cgh.2020.01.046). So, if choosing to consume red wine, double check the label for sulphite content to decrease your instance of symptoms.
Bottom line
- Binge drinking has been shown to increase intestinal permeability, increase gastrointestinal symptoms, decrease beneficial bacteria, increase hydration needs, and increase inflammation in the body
- Choosing alcoholic beverages without sulfites may decrease gastrointestinal symptoms
- Moderate consumption of red wine was shown to decrease fecal calprotectin levels in individuals with inactive IBD
- Current IOIBD guidelines show that there is no association with a particular type of alcohol to cause worsening of symptoms
- More research needs to be conducted on alcohol and IBD, and it has been shown that alcohol consumption in humans leads to a variety of gastrointestinal symptoms and decreased immune health
- Our own conclusions: studies show that increased alcohol consumption can lead to worsening of GI symptoms and decrease the quality of bacteria in the gut microbiome. If you are someone who consumes alcohol, pay attention to how your body and gut feels and determine if there is a type of alcohol that works best for YOU or the difference you feel when you consume less alcohol. Don’t forget to talk with your health care team when deciding what food or drinks to consume with IBD
- IBD or not, decreasing alcohol intake can support your health in a positive way