Can I drink alcohol with Crohns Disease or Ulcerative Colitis?
How does alcohol impact our gut health?
Drinking alcohol is pro-inflammatory and can affect the health of the lining of our intestines. It breaks down the lining of our intestines which provides us with a physical but also immune barrier to the outside world (1). A break down of intestinal barrier function is thought to be one of the factors that causes IBD, and may also trigger flares (2).
Alcohol and IBD
Clinical studies have indicated that drinking alcohol may cause symptoms and/or flares in inactive inflammatory bowel disease (3). It has been suggested that up to 75% of IBD patients may find drinking alcohol a trigger for gut related symptoms (4).
One study showed that drinking larger volumes of alcohol may more than double the risk of flare in UC, compared to more moderate alcohol consumption (5).
Interestingly, in UC there seems to be some evidence that sulfite containing alcoholic drinks (additives in drinks like wine and beer) might be associated with increased risk of flare. On the other hand, spirits, which do not contain sulfites, were not associated with UC disease activity. Although we know that alcohol has a negative impact on our gut health, if we do chose to drink in UC, avoiding high sulfite drinks like wine and beer, and instead opting for spirits, may be a better option (6).
Unlike sulfite drinks in UC, the type of drink does not seem to make a difference on symptoms experienced when drinking alcohol with Crohn’s. However, one study found that alcoholic drinks Smirnoff Ice and beer seemed to increase abdominal pain in CD patients, but researchers suggested this was probably due to the high sugar content in these drinks (7).
Its not all terrible news though, one small, very short term study (1 week) did show that stool calprotectin was reduced after the consumption of red wine in a small group of patients with inactive Crohns and colitis (8). This may be due to the high polyphenol content of red wine which is a potent antioxidant and has been shown to help promote the growth of supporting microbes that live in our gut. Although this doesn’t give us an excuse to go and drink lots of red wine! This was a very small and very short study – it is possible that longer term the affect that alcohol has on our intestinal lining could delete the beneficial effects of the polyphenols.
Can I drink alcohol with my Crohns or Colitis medication?
It is important to note that there are some medications that are taken for Crohn’s and colitis that may interact with alcohol. Please speak with your consultant or look at the instructions that come with your medication to check if this applies to the medication you are taking.
Take Home
The available evidence suggests that alcohol consumption may have a negative effect on symptoms in CD patients, UC patients and UC patients with a pouch (8).
Given the impact we know that alcohol has on the health of our intestinal tract, I would suggest keeping alcohol to a minimum when in remission, and avoid all together when you are having a flare.
If you have UC, a trial of avoidance of alcohols containing high levels of sulfites (e.g. beer and wine) is reasonable (6).
I have written a free e-book to help you find a way forward for your everyday life with Inflammatory Bowel Disease. Whether you are right at the beginning of your journey with IBD or have been living with your condition for years and feel like you have tried almost everything, there are things you can do everyday, beyond the medication you are taking, to help you take back control.
Disclaimer: All content found on the nalmclinic.com website, including: text, video, or other formats have been created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor, consultant or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
We are all wonderfully unique and what works for one person may not work for another so please seek help and advice before changing your diet to work out the right way forward for you.
References
Bishehsari, F., Magno, E., Swanson, G., Desai, V., Voigt, R. M., Forsyth, C. B., & Keshavarzian, A. (2017). Alcohol and Gut-Derived Inflammation. Alcohol research : current reviews, 38(2), 163–171.
Antoni L, Nuding S, Wehkamp J, Stange EF. Intestinal barrier in inflammatory bowel disease. World J Gastroenterol. 2014;20(5):1165-1179. doi:10.3748/wjg.v20.i5.1165
Jussila A, Virta LJ, Pukkala E, Färkkilä MA. Mortality and causes of death in patients with inflammatory bowel disease: a nationwide register study in Finland. J Crohns Colitis 2014;8:1088-1096.
Swanson GR, Sedghi S, Farhadi A, et al. Pattern of alcohol consumption and its effect on gastrointestinal symptoms in inflammatory bowel disease. Alcohol 2010;44:223–228.
Jowett SL, Seal CJ, Pearce MS, et al Influence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study Gut 2004;53:1479-1484.
Levine, A., Rhodes, J. M., Lindsay, J. O., Abreu, M. T., Kamm, M. A., Gibson, P. R., … Lewis, J. D. (2020). Dietary Guidance for Patients with Inflammatory Bowel Disease from the International Organization for the Study of Inflammatory Bowel Disease. Clinical Gastroenterology and Hepatology. doi:10.1016/j.cgh.2020.01.046
Mantzouranis G, Fafliora E, Saridi M, et al. Alcohol and narcotics use in inflammatory bowel disease. Ann Gastroenterol. 2018;31(6):649-658. doi:10.20524/aog.2018.0302
Swanson GR, Tieu V, Shaikh M, Forsyth C, Keshavarzian A. Is moderate red wine consumption safe in inactive inflammatory bowel disease? Digestion 2011;84:238-244