Ibs And Beer: Is It Safe To Drink?

Alcohol is known to irritate the gut and can affect intestinal motility, intestinal absorption, and permeability. It can also cause acid reflux, increase acid secretion in the stomach, and slow down stomach emptying, leading to irritation and nausea. As a result, many people with irritable bowel syndrome (IBS) avoid alcohol altogether, perceiving it as a trigger for their symptoms. However, there is no clear consensus on whether people with IBS should abstain from alcohol completely. While some individuals may experience IBS symptoms after just one drink, others can consume larger quantities before their symptoms flare up. The key is to understand your body's triggers and sensitivities and adjust your alcohol intake accordingly.

Alcohol is a gut irritant

Alcohol is a toxin and has many effects on the digestive tract. It can irritate the gastrointestinal (GI) system and may worsen gut symptoms. It affects different GI organs in different ways. For example, in the small intestine, alcohol reduces the absorption of nutrients in the gut. This malabsorption of nutrients can cause IBS symptoms when these substances interact with bacteria in the gut. Alcohol can also speed up motility (the speed at which matter moves through the digestive tract), increasing the risk of diarrhea.

Alcohol can also weaken the esophageal sphincter (the ring of muscles that prevent stomach contents from coming back up the esophagus), triggering acid reflux. In the stomach, alcohol can increase acid secretion and slow down stomach emptying, causing nausea and vomiting.

Additionally, alcohol can impact our gut microbiota (gut bacteria), and regular drinking can lead to a disruption of our balance of good gut bacteria.

Alcohol affects the small intestine

Alcohol can have a range of detrimental effects on the small intestine. Firstly, alcohol impairs the function of the muscles in the small intestine, contributing to the occurrence of diarrhoea. It also inhibits the absorption of nutrients in the small intestine, which can cause IBS symptoms when these substances interact with bacteria in the gut.

Alcohol can also speed up the rate at which matter moves through the digestive tract, increasing the risk of diarrhoea. This is due to alcohol's impact on the small intestine's impeding wave motility, which helps to retain food for digestion.

In addition, alcohol can cause mucosal injury in the small intestine, increasing the mucosa's permeability. This can lead to the destruction of the tips of the villi, which are small projections that increase the intestinal surface area.

The small intestine is also where alcohol is converted into acetaldehyde by the enzyme alcohol dehydrogenase (ADH). Acetaldehyde is a toxic chemical that can damage DNA and prevent cells from repairing any damage.

Overall, alcohol's effects on the small intestine can contribute to digestive problems such as nausea, abdominal pain, and diarrhoea.

Alcohol affects the esophageal sphincter

Alcohol, also referred to as ethanol, is associated with a variety of health problems. When consumed in large amounts, it acts as a central nervous system depressant, producing sedative, pleasurable, and relaxing side effects. Over time, chronic ethanol abuse can cause permanent damage to the liver, kidneys, pancreas, and even the throat.

Alcohol can weaken the oesophageal sphincter, triggering acid reflux. The oesophageal sphincter is the ring of muscles that prevent stomach contents from returning up the oesophagus. When this is weakened, it can cause a backwash of acid to come back up and damage the lining of the oesophagus. This is known as gastroesophageal reflux disease (GERD).

GERD is characterised by the sensation of substernal burning caused by the abnormal reflux of gastric contents moving up the oesophagus. Symptoms include a burning sensation in the chest (often called heartburn) and irritation of the oesophagus. According to a 2019 review, drinking alcohol can increase the risk of developing GERD, with higher intake and frequency more strongly linked to the condition.

However, a 2022 review found that drinking three or fewer alcoholic beverages a week may be associated with GERD. A small 2006 study found that beer and wine triggered reflux in men and women compared to drinking water. On the other hand, research from 1993 suggests that spirits with a high ethanol content, like gin, whiskey, and cognac, may be better for people with acid reflux.

Alcohol affects the stomach

The effects of alcohol on the stomach are part of its broader impact on the entire gastrointestinal tract. Alcohol can impair the function of the muscles separating the oesophagus from the stomach, leading to heartburn. It can also damage the mucosal lining of the oesophagus, increasing the risk of oesophageal cancer. In the small intestine, alcohol inhibits nutrient absorption and increases the transport of toxins into the bloodstream, which can contribute to liver damage. Alcohol also affects the large intestine, impacting motility and contributing to diarrhoea. Overall, alcohol's effects on the stomach and digestive system can cause a range of abdominal complaints, including nausea, vomiting, and abdominal pain.

Beer is a common trigger

Alcohol as a gut irritant

Alcohol is a known gut irritant and can affect intestinal motility, intestinal absorption, and permeability. It can irritate the gastrointestinal (GI) system and worsen gut symptoms. Alcohol affects different GI organs in different ways:

• In the small intestine, alcohol reduces the absorption of nutrients, leading to malabsorption of nutrients, which can cause IBS symptoms when these substances interact with bacteria in the gut. Alcohol can also speed up motility, increasing the risk of diarrhea.
• In the esophageal sphincter, alcohol can weaken the muscles that prevent stomach contents from coming back up the esophagus, triggering acid reflux.
• In the stomach, alcohol can increase acid secretion and slow down stomach emptying, causing nausea and vomiting.

FODMAPs and IBS

FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are a group of carbohydrates that have been associated with contributing to digestive symptoms in people with IBS. Alcohol contains FODMAPs, which may trigger IBS symptoms such as bloating, pain, and gas.

Tips for drinking with IBS

If you choose to drink alcohol, there are some tips that may help reduce the risk of triggering IBS symptoms:

• Drink in moderation, sticking to one drink per day for women and two drinks per day for men.
• Drink water between alcoholic beverages to stay hydrated and dilute the alcohol.
• Eat food before or while drinking to protect the lining of the digestive tract.
• Choose low FODMAP alcoholic beverages and mixers, such as gluten-free beer, red or white wine, vodka, gin, and soda water.
• Avoid high FODMAP juices and mixers, carbonated drinks, and drinks with added sweeteners.
• Monitor your symptoms and adjust your alcohol intake accordingly.

Frequently asked questions