Should You Be Drinking Alcohol If You Have IBS?

Alcohol is a known digestive system irritant. For a person who has a chronic digestive health disorder like irritable bowel syndrome (IBS), the question as to whether or not to enjoy some drinks is a complicated one. Many people who have IBS avoid alcohol altogether due to the fact that they perceive it to be a trigger for their symptoms.

If you are wondering if that is necessary, this overview will provide you with the information that you need to make an informed decision for yourself as we will cover the pros and cons of drinking, the research on alcohol use and IBS, and offer some tips so that you can make an informed decision for yourself.

Alcohol and Digestion

Alcohol affects the working of your digestive system in many ways. Heavy alcohol use can cause significant damage to digestive system organs and the lining of the tissues found throughout your digestive tract. But even moderate use of alcohol can have a negative effect on digestion.

Alcohol has a weakening effect on the esophageal sphincter which can lead to acid reflux. In the stomach, alcohol can cause an increase in acid secretion and slow down stomach emptying, leading to irritation and feelings of nausea or at higher amounts, episodes of vomiting.

In the small intestine, alcohol can reduce the absorption of nutrients. This malabsorption, particularly of carbohydrates, can contribute to problems with gas and diarrhea as these substances interact with bacteria in the large intestine.

Health Risks

The more alcohol you drink, the more you raise your risk for detrimental effects on your health. Even moderate drinking can raise your risk for some types of cancer, for example, breast cancer.

Excessive and binge drinking is associated with a wide variety of health and safety risks. In addition to raising your risk for acute alcohol poisoning, excessive alcohol use raises your risk for a variety of other health problems, including:

• Alcohol dependence
• Heart disease
• High blood pressure
• Liver cirrhosis
• Birth defects
• Miscarriage
• Stroke
• Certain cancers

Excessive alcohol use can also contribute to the risk of injury through violence, falls, and car accidents. Alcohol use raises your risk of health problems stemming from risky sexual behaviors. Excessive drinking is associated with mental health problems, such as anxiety and depression, and has a negative effect on your family and work life.

If you are breastfeeding, you should discuss the benefits, risks, and appropriate use of alcohol while nursing.

Recommended Intake

The effect of alcohol on your digestive system is, of course, going to depend in some part on how much you drink. The Office of Disease Prevention and Health Promotion (ODPHP) addresses alcohol consumption in their Dietary Guidelines for Americans.

The guidelines say that if you are going to drink, moderate drinking for women should consist of no more than one drink a day, and for men no more than two drinks a day. People who are over the age of 65 should limit themselves to no more than one drink a day.

The OHPHP Dietary Guidelines define binge drinking as having four or more drinks on a single occasion if you are female and five or more drinks on a single occasion if you are male.

The OPDHP places some restrictions on alcohol use. Thus, you should avoid alcohol if you:

• Are younger than 21
• Are pregnant
• Are taking medications that interact with alcohol
• Have a history of alcohol dependence
• Driving or operating machinery
• Have certain kinds of cancers
• Don't want to drink

Alcohol and IBS

The research on the relationship between IBS is pretty rare, and studies that have been done to date have yielded mixed results.

A 2013 study in the American Journal of Gastroenterology compared drinking habits and next-day symptoms in 166 women, ages 18 to 48, who were diagnosed with IBS.

No differences were found as to how much alcohol was consumed when compared to a group of 48 women who do not have IBS. However, the experience of next-day digestive symptoms was different between the two groups.

According to the research, women with IBS are far more likely to experience diarrhea, nausea, stomach pain, and indigestion after a night of binge drinking than those who engage in moderate or light drinking.

Not surprisingly, the association between drinking and next-day symptoms was more likely to be seen in the women who had diarrhea-predominant IBS as opposed to those who had constipation-predominant IBS or mixed-type IBS. Alcohol can affect intestinal permeability and also inhibit colonic absorption of water causing diarrhea

Alcohol and FODMAPs

FODMAPs is the collective term for a group of carbohydrates that have been associated with contributing to digestive symptoms in people who have IBS. Researchers from Monash University have shown that following a low-FODMAP diet can be effective in bringing about symptom relief in a large majority of people who have IBS.

Whether you choose to follow the diet or not, you can use the information about specific drinks that the Monash researchers offer based on laboratory testing of the FODMAP content of certain drinks to help you to choose drinks that might be less likely to set off your symptoms.

In general, the recommendation out of Monash University is to keep your alcohol intake to a minimum. Low-FODMAP drink choices include:

• Beer
• Red wine
• White wine
• Gin
• Vodka
• Whiskey
• Sparkling wine
• Sweet wine

Rum is high in FODMAPs due to its high fructose content. If you have fructose malabsorption, you will want to avoid drinks containing rum.

Practical Tips

Because there is little information as to the interaction of IBS and alcohol, the answer as to whether or not you should be drinking if you have IBS seems to be that it is a fairly personal decision.

If you see an association between drinking and your IBS symptoms, you may choose to abstain. You can keep in mind that the silver lining of this choice is that not drinking alcohol at all may end up being good for your overall health and serve to protect you from more serious diseases.

If you do choose to drink, here are some tips to reduce your risk of dealing with worsened IBS symptoms the next day:

• Limit yourself to one drink per day.
• Drink plenty of water to keep your body well-hydrated. This may also serve to dilute the alcohol, causing it to be less irritating to the lining of your digestive system.
• Be sure to eat a meal before or with your drink. Having food in your stomach may help protect the lining of your digestive tract.
• If you do choose to have more than one drink, slow down your intake. This will give your digestive system time to process the alcohol, potentially reducing next-day symptoms.