What are the effects of alcohol consumption on Crohn's Disease (CD)?

From the Guidelines

Moderate alcohol consumption may be permitted for patients with Crohn's Disease (CD), but it is essential to consider individual tolerance and potential effects on the disease course. According to the ESPEN guideline on clinical nutrition in inflammatory bowel disease 1, there is some evidence to suggest that patients with CD who habitually consume more meat and alcohol have a higher relapse rate. However, the guideline also notes that general advice on healthy eating can be given to patients with UC and Crohn's, probably aiming for a Mediterranean-style diet rich in fruit and vegetable fibre, and even small amounts of red wine may be permitted.

The Canadian Association of Gastroenterology clinical practice guideline for the management of luminal Crohn's disease 1 emphasizes the importance of considering the patient's perspective and quality of life when making treatment decisions. While this guideline does not specifically address alcohol consumption, it highlights the need for individualized management strategies that take into account the patient's unique needs and circumstances.

In terms of specific recommendations, it is advisable to limit alcohol consumption to 1-2 drinks per day for men and 1 drink per day for women, as excessive alcohol can irritate the intestinal lining and potentially worsen symptoms. Patients with CD should also be aware that alcohol may interfere with nutrient absorption, which is already a concern for those with CD, especially during the healing phase after diagnosis.

Key considerations for patients with CD who consume alcohol include:

• Individual tolerance to alcohol and potential effects on the disease course
• The importance of a balanced diet rich in fruit and vegetable fibre
• The need to limit alcohol consumption to moderate levels
• The potential for alcohol to interfere with nutrient absorption and worsen symptoms
• The importance of consulting with a healthcare provider about alcohol consumption, especially for those with advanced intestinal damage or ongoing symptoms.

From the Research

Effects of Alcohol Consumption on Crohn's Disease

• The study 2 investigated the effect of ethanol and sugar content in five different alcoholic drinks on abdominal discomfort in patients with Crohn's disease (CD) and found that the alcoholic drinks Smirnoff Ice and Elephant beer have an increased effect on self-reported abdominal pain in CD patients, probably due to the high sugar content in these drinks.
• A meta-analysis 3 of 16 epidemiological studies found no significant association between alcohol intake and CD risk.
• Dietary guidelines for CD patients often recommend avoiding alcohol 4, as it may worsen symptoms.
• Nutritional management of CD 5 focuses on addressing nutritional deficiencies and malabsorption, but does not specifically address the effects of alcohol consumption on the disease.

Comparison of Alcoholic Drinks

• The study 2 compared the effects of five different alcoholic drinks (red wine, white wine, Smirnoff Ice, Elephant Beer, and pure ethanol) on CD patients and found that Smirnoff Ice and Elephant beer caused more abdominal pain due to their high sugar content.
• The meta-analysis 3 did not compare the effects of different types of alcoholic drinks on CD risk.

Overall Effects of Alcohol on CD

• The current evidence suggests that alcohol consumption may not be directly associated with an increased risk of CD 3, but may worsen symptoms in some patients 2, 4.
• Further research is needed to fully understand the effects of alcohol consumption on CD, as the current evidence is limited and inconsistent.