What is IBS?
Irritable bowel syndrome (IBS) is referred to as a functional bowel disorder that is chronic in nature. While symptoms may vary somewhat from person to person, they commonly include:
- bloating
- abdominal pain
- altered bowel patterns (constipation or diarrhoea)
While the number of people impacted by this disorder varies depending on continent, approximately 20% of the general population have been diagnosed with IBS. IBS symptoms also impact women far more than men.
Four different types of IBS have been identified. These are:
- IBS-C – constipation-predominant
- IBS-D – diarrhoea predominant
- IBS-M – alternating between constipation and diarrhoea
- Unclassified IBS [Source: Pubmed]
Underlying causes and triggers can vary from person to person. As this article will discuss, alcohol is one of them.
Alcohol and Digestion
The role of contributing factors that lead to IBS symptoms is vast. Research indicates that each person has a unique set of circumstances that have led to their symptoms.
These can include:
- Stressful life events
- Food poisoning/travellers diarrhoea
- Long term dietary patterns
While no conclusive evidence has been found to link alcohol intake to IBS, that may be due to a few factors.
For example, if someone’s symptoms of IBS flare up when they’re experiencing stress, alcohol intake may help to reduce that stress and there for avoid a flare-up in symptoms.
Alcohol and Stomach Pain
As a quick recap, IBS is diagnosed based on the symptoms being experienced. This can be abdominal pain but also must include changes in bowel patterns.
With this in mind, a study examined the relationship between alcohol intake and stomach pain. They concluded that an increase in alcohol consumption led to a clear increase in stomach pain.
This was seen when individuals consumed more than 7 alcoholic drinks per week. [Source: Pubmed]
Alcohol and IBS
Another study examined not only the amount people drank but how they consumed their alcohol.
This study reported that drinking events where approximately 5 drinks were consumed (described as binge drinking) lead to an increase in IBS symptoms.
These symptoms included:
- diarrhoea
- nausea
- stomach pain
- indigestion
This indicated that the amount consumed in a single drinking event is more likely to lead to IBS symptoms. [Source: Pubmed]
Alcohol and Leaky Gut
Alcohol intake has also been shown to impact the health of the gut lining. This can lead to increased intestinal permeability. This is often referred to as a leaky gut.
The integrity of the gut lining is key for not only gut health but also overall health. This can lead to increased inflammation along the gut lining as well as alter the immune response along the gut lining. Both of these factors are highly associated with IBS symptoms. [Source: Pubmed]
Increased alcohol intake has also been shown to increase the risk of developing SIBO as well as imbalances in the gut bacteria. [Source: Pubmed ]
In the simplest way, it can be helpful to see alcohol as a gut irritant that can impact the gut lining and the balance of the bacteria. [Source: Monash]
Can I Drink Alcohol if I Have IBS?
Intake of alcohol has been shown to lead to many changes in the gut and can potentially lead to IBS symptoms.
While this is not always the case that alcohol leads to IBS symptoms, it’s also important to be mindful of alcohol intake. This is due to studies indicating that increased alcohol intake may be more likely to lead to an IBS flare-up.
Can I Drink Alcohol if I Have IBD?
Lifestyle and dietary factors (including alcohol intake) may all contribute to the inflammatory processes seen in inflammatory bowel diseases such as Crohn’s Disease and Ulcerative Colitis.
One study noted that while moderate alcohol intake didn’t increase symptoms in IBD patients, it did increase inflammatory markers as well as markers of leaky gut. Both of these are factors that can influence the long-term risk of an IBD flare-up. [Source: Pubmed]
Are there FODMAPs in Alcohol?
Firstly, FODMAPs, are carbohydrates and sugars found in a wide range of fruits and vegetables. These are also found in some alcohols. For many with IBS, these FODMAPs may lead to an increase in symptoms of IBS. [Source: Pubmed]
Low FODMAP alcohol options include:
- Wine – 1 x 150ml serving
- Spirits (gin, vodka, tequila, brandy) – 1 x 30ml shot
- Beer – 1 x 375ml serving
Conclusion
As outlined in the article, alcohol can lead to a wide range of changes in the digestive system. This can involve alterations to the balance of bacteria, the function of the gut lining, as well as the inflammatory response.
While events of binge drinking may lead to an increase in symptoms, the long-term abuse of alcohol is likely to be the most damaging to the gut.
I find that when working with patients, this is key information to relay as the amount and the frequency of consumption is likely key to the impact it’s going to have on the gut.
Additionally, if you do find that a small amount of alcohol is a trigger, it’s simply that, a trigger.
By this, I mean that it is triggering symptoms and not the cause of symptoms. This underlying cause of IBS symptoms is different from person to person, but by addressing this and supporting gut health triggers become less of an issue. Be they food-based or alcohol-based.
