Alcohol is a known gut irritant, so you may be wondering if you can drink alcohol with irritable bowel syndrome (IBS), what to choose and how much to have to avoid a dreaded flare-up.

Read on to find out more!

How does alcohol contribute to gut symptoms in IBS?

Alcohol is thought to impact our gut function by changing the rate of stomach emptying, absorption of nutrients and leakiness of the gut (1-3).

The evidence on the effect of alcohol in IBS is limited. A small study found a strong association in women with diarrhoea predominant IBS but no association in those with constipation predominant IBS. Additionally in this study, drinking 4 or more alcohol-containing drinks led to worsening in diarrhoea, abdominal pain, gas, nausea, and indigestion (3). Meanwhile, light or moderate drinking did not appear to have this effect.

Despite the lack of evidence, individuals with IBS often report alcohol as a trigger for their gut symptoms e.g. loose stools and urgency (4, 5).

Does the type of alcohol make a difference?

Several factors may contribute to the development of gut symptoms therefore it is important to consider the type of alcohol, FODMAP content and any mixers used.

Type: Beer and wine have been associated with faster stomach emptying which may lead to symptoms of bloating and diarrhoea (1).

FODMAP content: FODMAPs are carbohydrates which are fermented in the gut by our resident bacteria. For that reason high FODMAP drinks can contribute to symptoms such as gas, bloating, distension, abdominal pain and diarrhoea.

Low FODMAP alcohol options are likely to be better tolerated. Low FODMAP options include: beer, whiskey, sparkling wine, brandy, vodka, wine and gin.

Mixers: The use of carbonated mixers can further contribute to gas build-up and bloating. Mixers such as fruit juice may be high in fructose and others may contain high FODMAP ingredients such as fructose and sorbitol which could further exacerbate symptoms.

Some low FODMAP mixers include: cranberry juice, soda water and tonic water (without added fructose).

Hence it is important to take into consideration any known FODMAP intolerances when choosing an alcohol type and a mixer.

What do the guidelines recommend?

At the present time there are no specific recommendations on alcohol intake in IBS. However general public health guidelines recommend to:

• have no more than 14 units a week. Basically, this is equivalent to 6 pints of beer or 7 standard glasses of wine.
• avoid binge drinking and…
• have several alcohol free days a week

For more information on public health guidelines have a look at the NHS website here.

Top tips for drinking with IBS

• Firstly, limit he consumption of alcohol containing drinks to 1-2 drinks in a day.
• Choose low FODMAP options of alcohol and mixer. Check the ingredients of your mixers for added sweeteners such as fructose and sorbitol.
• Lastly, eat food when you drink to help slow down alcohol absorption. However be mindful to avoid any known food triggers.

 

 

 

 

 

So can I drink alcohol if I have IBS?

In summary, everyone with IBS has very individual triggers and sensitivities. If you suspect alcohol may be a trigger for you, reduce your intake or cut out alcohol for a period of time and monitor your symptoms. Working with a dietitian may help to identify whether this may be contributing to your symptoms.

If you choose to drink, follow the national health guidelines and tips outlined above to be able to enjoy a drink without gut symptoms.

References

1. Grad et al, The Effect of Alcohol on Gastrointestinal Motility. Rev Clin Trials; 11(3): 191-195.
2. Bode, C. and J.C. Bode, Alcohol’s role in gastrointestinal tract disorders. Alcohol Health Res World, 1997. 21(1): p. 76-83.
3. Reding et al, 2013. Relationship between Patterns of Alcohol Consumption and Gastrointestinal Symptoms among patients with Irritable Bowel Syndrome. AM J Gastroenterol; 108(2): 270-276.
4. Simren, M., et al., Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion, 2001. 63(2): p. 108-15.
5. Bohn, L., et al., Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol, 2013. 108(5): p. 634-41.