Sun, sea, sangria…and IBS!
Can alcohol cause my IBS to flare up?
Summer is the season to have fun al fresco, venture further afield on holiday and relax in the garden with a refreshing drink or two with friends. Although, for many people with Irritable Bowel Syndrome (IBS), this may not be quite so simple. Being aware of what can trigger your symptoms, whether it’s alcohol, stress, social situations, going somewhere new or a combination of these, is an essential starting point to avoid a flare-up of this debilitating condition.
Knowing the measure of alcohol
For the general population, the recommended weekly alcohol intake should not exceed 14 units and be spread evenly over a few days (equivalent to six, 175ml glasses of 13% wine or six pints of 4% lager or ale). [i] However, for those with IBS and a sensitive gut, even this can be too much.
Although everyone with IBS experiences different symptoms, often at different times, whether its bloating and constipation, abdominal pain and/or diarrhoea, what works for one person won’t necessarily apply to another. So, general advice is difficult to give, yet simple dietary changes can often help relieve symptoms. The British Dietetics Association (BDA) recommends trying to limit alcohol intake to no more than two units per day and having at least two alcohol free days a week.[ii]i For some though, avoiding alcohol altogether is the only answer to managing their symptoms.
However, if you don’t want to miss out on social gatherings and would still like to enjoy a drink or two with friends, you could consider trying a mocktail as a refreshing alternative. A few simple recipe ideas to make up your own are available via The IBS Network charity website, such as Cran Daddy Cooler and Mock Champagne. Take care not to overindulge even with mocktails and limit your intake of fizzy drinks and fruit juices, even the low FODMAP (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols) versions.
Alcohol and the gut
A review by the BDA highlighted alcohol as an irritant to the gut lining.ii Drinking even a small amount of alcohol can result in pain and vomiting in some people. In extreme cases, alcohol can loosen the stools and trigger diarrhoea. It can have an effect on the movement of food through the intestines and increase intestinal permeability – ie the passage of foreign bodies, such as alcohol, through the lining of the gut into the bloodstream which can cause inflammation in the gut.
The FODMAP research group from Monash University (Australia) advises those with IBS against consuming high FODMAP alcoholic drinks such as cider, rum, sherry, port and sweet dessert wine.[iii] Low FODMAP alcoholic drinks include beer, red, sparkling, sweet, white and dry white wine, gin, vodka, whisky, however, this doesn’t mean they can be consumed in abundance! When choosing wine, sweeter varieties are generally higher in fructose and are not low FODMAP diet friendly. Moderation and understanding your body to know what makes your IBS symptoms worse is crucial, and avoiding alcohol completely may be, in some cases, the best solution.
Confiding in friends, family or colleagues that you have IBS is not always easy, for fear of embarrassment and their reaction. Yet, this also may be key in helping you to overcome your feelings of anxiety and stress when you go out.
It might take an element of trial and error to find what works for you but it is still possible to enjoy social gatherings, and get out and about this summer without letting the symptoms of your IBS take over.
About the author
Vesta Simkute is in the final stages of completing an MSc Nutrition in Practice course at Leeds Beckett University. She has a keen interest in the effects of nutrition on digestive health and is undertaking a placement at The IBS Network in June/July. Her Master’s dissertation is aiming to explore dietary decision-making in people living with IBS.
Drinkaware. What is an alcohol unit? Available from: https://www.drinkaware.co.uk/alcohol-facts/alcoholic-drinks-units/what-is-an-alcohol-unit/
British Dietetic Association (2016) British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update). Available at: http://onlinelibrary.wiley.com/doi/10.1111/jhn.12385/full?campaign=HSBestof16_Medicine
Monash University App. Available from: https://itunes.apple.com/gb/app/monash-university-low-fodmap/id586149216?mt=8