Can alcohol trigger inflammatory bowel disease (IBD)?

From the Guidelines

Alcohol can potentially trigger inflammatory bowel disease (IBD) in susceptible individuals, although the exact relationship is still being researched. The current evidence suggests that environmental triggers, including diet, may play a role in the development of IBD, with the "western" diet being proposed as a possible explanation for the increase in IBD incidence 1. While there is limited data on the specific impact of alcohol on IBD, it is known that alcohol can irritate the lining of the stomach and intestines, potentially exacerbating symptoms. Some key points to consider include:

• The spread of the "western" diet, high in fat and protein but low in fruits and vegetables, has been proposed as a possible explanation for the increase in IBD incidence 1
• The bowel lumen is continually exposed to numerous antigens, including the food that we consume and the enormous population of organisms that compose the gut microbiome, which can influence the incidence of IBD 1
• Patients with IBD may need to be cautious with their alcohol consumption, as it may trigger or worsen symptoms, and consider limiting their intake or avoiding it altogether, especially if they have pre-existing digestive conditions. It is essential to note that the relationship between alcohol and IBD is complex and not fully understood, and more research is needed to determine the exact mechanisms by which alcohol may trigger or exacerbate IBD symptoms 1.

From the Research

Alcohol Consumption and Inflammatory Bowel Disease

• Alcohol consumption has been linked to an increased risk of flare-ups in inflammatory bowel disease (IBD) patients, with studies suggesting that it can exacerbate symptoms and susceptibility to infection 2, 3.
• The pattern of alcohol consumption in IBD patients is similar to that of the general population, with many patients reporting a worsening of gastrointestinal symptoms after drinking alcohol 3.
• Moderate daily alcohol consumption, including red wine, has been shown to decrease stool calprotectin levels but increase intestinal permeability in IBD patients, potentially leading to a higher risk of disease relapse 4.

Effects of Alcohol on IBD Symptoms and Disease Activity

• Alcohol use has been associated with worse gastrointestinal symptoms in IBD patients, with many reporting an exacerbation of symptoms after drinking 3, 5.
• The use of alcohol can interfere with the metabolism of certain medications, leading to increased adverse events or loss of efficacy 5, 6.
• Specific alcoholic beverages, such as red wine, may have anti-inflammatory properties that could assist in disease control, but the overall evidence suggests that alcohol use trends toward harmful effects in IBD patients 5, 6.

Mechanisms of Alcohol's Effects on IBD

• Alcohol has been shown to alter the gut microbiome, disrupt intestinal barrier function, and increase intestinal permeability, promoting immune activation and potentially contributing to disease onset and recurrence 6.
• The effects of alcohol on IBD are complex and multifaceted, with both positive and negative effects reported in different studies 2, 4, 6.