Alcohol and Irritable Bowel Syndrome: Does Drinking Cause Flare-Ups?

Drinking alcohol can cause IBS flare-ups. Alcohol is a neurotoxin that contributes to dehydration, oral health problems, and even cancer. It can, and often will, wreak havoc on your digestive system (mouth, stomach, small intestine, large intestine, and liver).

Irritable bowel syndrome (IBS) affects an estimated 3.2 million Americans — not counting those who don’t realize their digestive symptoms are IBS. No pill can cure it, but you can reverse IBS by identifying and addressing the underlying cause.

Alcohol is inflammatory and damaging to the beneficial bacteria in your gut microbiome. If alcohol consumption results in symptoms of irritable bowel syndrome for you, consider limiting or eliminating alcohol from your diet to prevent IBS.

Schedule your free consultation to develop an individualized IBS treatment plan and address how alcohol impacts your systemic health.

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How Alcohol Affects Digestion

Alcohol has numerous harmful effects on your digestive system, IBS included. 

The effects of alcohol on your digestive tract are as follows:

• Alcohol may kill good bacteria in your gut. Your gut microbiome is made up of beneficial bacteria. Alcohol contributes to an imbalance of gut bacteria. This imbalance can cause bloating, stomach pain, and loose bowel movements.
• Alcohol causes inflammation. Excessive drinking is associated with systemic inflammation. A glass of wine a day may reduce heart inflammation. However, more than one glass can impact your gut health and whole body wellness, negating any benefits.
• Alcohol impacts gut motility. Gut motility is how quickly your gut muscles push food and waste through your intestines. Low doses of alcohol accelerate motility, increasing the chances of diarrhea. High concentrations of alcohol may actually slow motility, resulting in constipation.
• Alcohol dysregulates stomach acid production. Drinking alcohol increases your risk for gastroesophageal reflux disease (GERD) — stomach acid rising from your stomach into your throat. GERD can damage your throat and teeth and promote inflammation, all of which negatively impact digestion.
• Alcohol increases your risk for liver disease. The liver is part of your digestive system, producing and secreting bile. Alcohol use increases the chances of liver disease, such as non-viral hepatitis, impacting your digestion.

Can You Drink With IBS?

If you have IBS, you may drink if you limit your alcohol consumption (1 drink/day for women, 2 drinks/day for men) and find that it doesn’t cause flare-ups. 

If you’re still experiencing symptoms of IBS — particularly diarrhea — cut out alcohol altogether.

After working with hundreds of IBS patients, we recommend limiting your alcohol consumption as much as possible. While it’s true that some people find alcohol doesn’t cause major flare-ups, we consistently find that our patients have better overall results when eliminating alcohol entirely.

FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are carbohydrates that contribute to IBS flare-ups. Many alcoholic drinks contain some FODMAPs, which can impact your gastrointestinal system. Avoid high-sugar drinks and opt for dry spirits.

Alcohol does not mix well with many IBS medications. If you are taking anticholinergics or antispasmodics like dicyclomine (Bentyl), alcohol may cause dizziness or drowsiness. Alcohol may interact with IBS pain blockers like eluxadoline (Viberzi), increasing the risk of pancreatitis.

How to Determine if Alcohol Is an IBS Trigger

If drinking a small amount of alcohol triggers IBS symptoms within 30 minutes, such as cramping, indigestion, and abdominal pain, alcohol is likely an IBS trigger.

Determining whether alcohol is your primary IBS trigger requires an elimination diet — in addition to enough sleep, regular exercise, and ensuring your home and workplace are free of toxins. 

A typical elimination diet goes as follows:

1. Eliminate all potential IBS triggers from your diet, including dairy, coffee, and alcohol.
2. Every 2 weeks, add one potential trigger back into your diet. If IBS symptoms do not flare up in 2 weeks, the food or beverage is not a trigger for you.
3. If you add alcohol back and experience IBS symptoms like bloating and diarrhea, you have now determined that alcohol is your main IBS trigger.

Can you drink on a low-FODMAP diet?

Yes, you can moderately drink alcohol on a low-FODMAP diet designed to treat IBS. We’ve compiled a list of low-FODMAP alcohols below.

Even low-FODMAP alcohol is a gut irritant that can increase motility, resulting in worsened diarrhea symptoms. However, if you adhere to a low-FODMAP diet to treat your IBS-D (diarrhea-predominant IBS), consider limiting all alcohol. 

Low-FODMAP alcohols include:

• Most beers
• Red wine (non-dessert)
• White wine
• Gin
• Vodka
• Whiskey
• Tequila

Mixers are often high in FODMAPs, so avoid most mixers on a low-FODMAP diet. Cranberry juice and club soda are usually low enough in FODMAPs to add as mixers.

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What Are the Safest Alcoholic Beverages for IBS?

If you are able to moderately drink alcohol without triggering your IBS symptoms, the safest types of alcohol for IBS patients include wine, beer (especially gluten-free beer), and low-sugar spirits. These are all included on a low-FODMAP diet, which can improve or eliminate IBS symptoms in some people.

Wine

Red, white, and sparkling wines are relatively low-FODMAP and safe to drink in moderation if you have IBS. Ideally, you’d stick to a non-alcoholic wine that’s also low-FODMAP and low in sugar.

We don’t recommend drinking more than 1-2 glasses (5 ounces each) of even low-FODMAP wine, as the trace FODMAPs present can still trigger IBS symptoms.

Avoid dessert wines that contain high sugar content.

Beer

Despite being made from wheat, barley, and rye (which are high-FODMAP), the fermentation process turns those sugars into low-FODMAP alcohols. A safe-for-IBS serving size of beer is larger than any other alcohol at 12 ounces.

However, avoid standard beer if you’re gluten-free or have celiac disease. Gluten-free diets may also help alleviate IBS symptoms, so if you want to try gluten-free beer, opt for a brand like Holidaily.

Spirits

What alcohol is easiest on your gut? Spirits like vodka and gin are the easiest alcoholic drinks on your gut. 40 proof spirits that are low-FODMAPs and safe to drink with IBS include:

• Gin
• Vodka
• Whiskey
• Brandy
• Tequila

One serving of each is 1.5 ounces.

Avoid rum, the main spirit that is high in FODMAPs. Rum is more likely to cause gastrointestinal symptoms.

Mixers

If you add mixers to any of these alcoholic beverages, opt for low-FODMAP mixers, such as:

• Cranberry juice
• Lime juice
• Lemon juice
• Coconut water
• Tomato juice blend
• Fresh-squeezed orange juice

Avoid high-sugar mixers like apple juice, pear juice, and apricot juice.

Recommended Alcohol Intake

How much alcohol can you drink with IBS? The recommended alcohol intake for those with IBS is different per sex:

• For most women, 0-1 low-FODMAP drinks per day
• For most men, 1-2 low-FODMAP drinks per day

It’s also wise to reserve at least 1-2 alcohol-free days every week.

Binge drinking leads to all sorts of health problems, including IBS. While moderate drinking may be OK for some, others may have to completely avoid alcohol to resolve their IBS symptoms.

If moderate alcohol consumption does not trigger symptoms of IBS, females can safely drink one serving of alcohol a day, and men can drink 2 servings a day. Below are the daily serving sizes for alcoholic drinks:

• Beer: 12 oz.
• Wine: 5 oz.
• Gin: 1.5 oz.
• Vodka: 1.5 oz.
• Whiskey: 1.5 oz.
• Brandy: 1.5 oz.

How to Drink Mindfully With IBS

Here are the best tips for drinking mindfully with IBS:

• Limit overall consumption. For women, 0-1 drinks/day is the maximum recommended amount while 1-2 drinks/day maximum is recommended for men.
• Drink plenty of water. It’s important to stay hydrated. Drinking water helps support a healthy digestive system and whole-body wellness. People who drink more water are less likely to experience IBS. Consider Berkey Water Filters for the healthiest water possible. Use code PRIME for 5% off a Berkey Water filter.
• Choose low-FODMAP drinks and mixers. FODMAPs are carbohydrates that contribute to IBS flare-ups. Choose low-FODMAP alcoholic drinks and mixers. Choose gin over rum. Go for a dry red instead of a dessert wine. Try cranberry juice instead of apple juice mixers.
• Don’t drink every day. For your digestive health, take at least a couple days off each week from drinking any alcohol. If your IBS symptoms don’t flare up on your off days, consider eliminating alcohol altogether.
• Eat before you drink alcohol. Your body absorbs more alcohol faster if there’s no food in your stomach. Eating before you drink can slow alcohol’s absorption into your bloodstream.
• Slow down your drinking. Drinking too quickly can shock your digestive system, including your liver. Make the few alcoholic beverages you do have last longer, and slow down your drinking. Remember to sip plenty of water between drinks.
• Take note of your IBS symptoms. Write down which IBS symptoms occur and when, and indicate if you were drinking alcohol. These notes can help you and your doctor address your IBS.
• Discuss drinking alcohol with your healthcare provider. Talk with your doctor about your unique situation. Some people can handle more alcohol while others should avoid it altogether — whether due to IBS flare-ups, alcohol addiction, or mental health concerns.

Other lifestyle changes to reduce the risk of IBS include lowering stress, regular exercise, and getting consistent, high-quality sleep.

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Alcohol Alternatives to Consider

Heavy drinking leads to IBS symptoms. Moderate drinking may cause IBS in certain individuals. Fortunately, there are alternatives to alcohol that can fulfill those cravings while avoiding IBS flare-ups.

Read More: How Long Does IBS Last?

What are some drinks with lower levels of alcohol? Non-alcoholic wines like Surely and Fré are considered low-FODMAP and have less than 0.5% alcohol content (the FDA’s threshold for a “non-alcoholic” label).

Nootropic drinks mimic alcohol’s soporific qualities while using healthy ingredients and no alcohol. Some nootropic blends like Kin Euphorics contain FODMAPs, but others like Seedlip avoid FODMAPs.

Below are the best alternatives to alcohol that you should consider drinking to avoid IBS flare-ups:

• Everyday Dose nootropic blend
• Botanic Tonics kava soothing and calming beverage (use code primehealth40 for 40% off)
• Seedlip zero-proof spirits
• Surely alcohol-removed wines
• Fré zero-alcohol wines
• Ariel dealcoholized wines
• Athletic Brewing Co. NA beers*
• Kin Euphorics*
• Ritual non-alcoholic spirits*
• Lyre’s NA spirits*

*some varieties may not be low-FODMAP

Talk to a Healthcare Professional for Guidance

If you need help overcoming gastrointestinal disorders like IBS or need medical advice concerning alcohol’s effect on your whole body health, our experts at PrimeHealth clinic in Denver, Colorado, are ready to help you.

Dr. Soyona Rafatjah and her highly qualified team are available to work with you on an evidence-based IBS treatment plan that addresses your unique health situation. Schedule your free phone consultation today!

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