The issue becomes even more confusing when it comes to people affected by inflammatory bowel diseases (IBD). Is regular alcohol consumption—or even occasional indulgence—a problem in those with ulcerative colitis or Crohn’s disease? How does it affect IBD symptoms in the short-term? What are the potential long-term effects?
Alcohol and IBD Symptoms
Alcohol is generally recognized as a potential trigger food for IBD symptoms. This means that consuming alcohol can increase the risk of frequent and more severe symptom flare-ups. However, as with most common trigger foods, this is not true for everyone with Crohn’s disease or ulcerative colitis.
Some individuals, approximately 25 percent of IBD sufferers, according to a 2010 study, can tolerate moderate alcohol use without any obvious effect on IBD symptoms.1
However, a lack of a clear and immediate increase in symptoms doesn’t necessarily mean that there are no consequences for IBD patients who drink alcohol regularly. For instance, in a 2011 study, researchers found that seven days of moderate red wine consumption in patients with inactive IBD was associated with a significant decrease in levels of calprotectin—a protective molecule—in the gut.2 They also found a significant increase in intestinal permeability (also called leaky gut syndrome), both of which are associated with increased IBD disease activity. Study data suggested that patients with inactive IBD may be at increased long-term risk of disease relapse with daily red wine consumption.
A 2013 Healthline.com article, Ulcerative Colitis and Alcohol, cites the same 2010 study, stating that besides an increased risk of IBD flaring or relapse, other potential consequences related to alcohol consumption and IBD include:
- Acute liver injury: With significant alcohol consumption, a build-up of toxins can damage the lining of the liver and the gut.
- Chronic liver injury: IBD sufferers who consume alcohol regularly are at higher risk of chronic liver injury – which can, over time, progress to liver failure – than chronic drinkers with no history of IBD.
- Drug Interactions: Alcohol may interact with some drugs used in the treatment of IBD, which can lead to liver damage and other complications.
Current Recommendations Relative to Alcohol Consumption and IBD
Alcohol is known to irritate the digestive tract and to have the potential to trigger IBD symptoms in many IBD patients. However, researchers have yet to prove a definitive connection between alcohol use and increased IBD symptoms and/or flare-ups. Due to the high number of patients who report increased IBD symptoms after alcohol consumption, use caution. According to the Crohn’s and Colitis Foundation of America, moderate or excessive alcohol intake can be associated with an IBD flare, and while total abstinence may not be required, moderation is advised.
So what is the bottom line on alcohol and IBD symptoms? Basically, there is no hard and fast rule on whether IBD patients should drink or abstain. If you experience an increase in gastrointestinal symptoms after consuming alcohol, avoiding it is probably your best bet. Even if you are not, it is a personal decision that is best made with the input of your health care team, including careful consideration of potential medication interactions, the severity of your disease and any other health conditions you may have.
1 Swanson GR, Sedghi S, Farhadi A, Keshavarzian A. Pattern of alcohol consumption and its effect on gastrointestinal symptoms in inflammatory bowel disease. Alcohol. 2010;44(3):223-8.
2 Swanson GR, Tieu V, Shaikh M, Forsyth C, Keshavarzian A. Is moderate red wine consumption safe in inactive inflammatory bowel disease? Digestion. 2011;84(3):238-44.