Alcohol and Gut Health: Finding Your Balance

Alcohol. The eternal conundrum: is it healthy, or not? Well, the Global Burden of Disease study recently weighed in, calling all previously touted health benefits into question. The study found that the harm resulting from alcohol intake outweighs any benefit to heart health. AKA: a little bit of alcohol isn’t “healthy” anymore. (Or, rather never was). I imagine that jaws dropped around the world, red wine lovers indignant and heartbroken at the same time.

This study got me thinking about alcohol and gut health. We all know that alcohol isn’t great for our overall health. We know it’s best to enjoy in moderation. But how in tune are we with alcohol and our gut? If the goal is to maximize digestive health through diet and lifestyle, talking about alcohol is an important piece of the puzzle!

Why is that? What exactly does the research say about alcohol and the gut? Well, I have some answers for you! Here’s my take on the art and science of drinking and gut health and how to find the balance that’s best for you.

Alcohol and Gut Health

That mimosa may be ooooh so good, but it’s also ooooh not so innocent. Studies have shown that alcohol can cause inflammatory changes in the gut in a few ways:

1. Weakens the structure of the gut lining itself (causing increased “intestinal permeability”).
2. Disrupts the balance of “good” vs. “bad” bacteria within the gut microbiome.

Intestinal Integrity

Experts agree hands-down that alcohol damages the intestinal mucosal membrane. This is the intestinal lining that prevents harmful substances from moving from your gut into your circulation. When damage occurs, toxic compounds are more likely to penetrate that barrier and can cause damage throughout the body, specifically the liver.

In layman’s terms: alcohol can contribute to structural gut damage.

Microbiome

Alcohol also has the potential to throw gut microbiota off balance, altering the population of various strains of gut bacteria. Studies have shown that alcohol’s specific impact on the microbiome depends on the species of bacteria you have and the type of alcohol exposure (for example, an acute binge-drinking event vs. chronic alcohol exposure).

Some research suggests that alcohol can promote growth of the pro-inflammatory “bad” bacteria and hinder the “good” bacteria in your colon. Others have noted that certain types of alcohol (such as resveretrol-rich red wine) may have a different, positive impact on gut bacteria compared to other types of alcohol (such as gin).

Probiotics can help normalize off-kilter bacterial populations in people with alcoholic liver disease. I still wouldn’t recommend excessive drinking with a side of probiotics, but definitely an interesting finding!

So, alcohol has the potential to change your microbiome, usually for the worse.

Alcohol and IBS

The research on IBS and alcohol intake has been inconsistent, partly because IBS is such a variable condition. But, it has been shown that alcohol has a stronger impact on GI symptoms for those with IBS-D (IBS-Diarrhea subtype), and that people with IBS who binge drink experience worse GI symptoms than those without IBS.

If you have IBS, you may have noticed this for yourself! Alcohol is considered a “gut irritant” and has the potential to trigger symptoms for anyone with a troubled digestive system.

How Much is Too Much: Limitations of Available Studies

It’s important to take studies on alcohol intake and gut health with a grain of salt. Most of the studies observe subjects with alcoholism or alcoholic liver disease. There aren’t really studies that evaluate the effects of moderate drinking on the gut. So we have to extrapolate the results and assume that if a LOT of alcohol causes damage to the intestine and microbiome, then a smaller amount of alcohol over time could cause damage too.

So how much alcohol can you drink without harming your gut? We don’t know for sure. The answer is very likely zero!

The bottom line is, it’s best to make an informed decision. We do know alcohol isn’t ever going to be “good” for your gut. But it’s also important to enjoy your life and not worry about every single thing you eat and drink.

Balancing alcohol and gut health is very individual and totally depends on your own digestive system- how it feels, what it can handle, and where you are in your gut health journey. Finding that balance is up to you! If your goal is to eat and drink your best while feeling your best, you’ll likely find that moderation is your friend.

How to Find Your Balance

If you have IBS, IBD, or any other digestive condition it’s probably best to avoid alcohol altogether. If you’re not sure where alcohol fits in with your gut, the best way to figure it out is to LISTEN. Pay attention to how you feel during and after you drink alcohol. Ask yourself:

1. How does your stomach feel during and after a few drinks?
2. Does you regularly feel hung over in your stomach?
3. Does alcohol derail the gut symptom relief you’d previously achieved?
4. Do you notice changes in your digestive system after consuming alcohol (ie different or uncomfortable bowel movements)?

If you answer “yes” to most of those questions: it may be time to rethink your approach. Your gut is feeling the strain! But, if you are able to tolerate alcohol without significant side effects, here are a few tips for maximizing your gut health balance:

1. Don’t overdo it, the hangover (for you and your gut) are not worth it!
2. Build up your microbiome with probiotics and prebiotics.
3. Stay hydrated.
4. Don’t skip a meal.
5. Minimize other gut irritants (such as stress and caffeine, for example).
6. Save alcohol for special occasions rather than including it in your daily routine.

Gut health is so individual. It’s all about you: what you enjoy and what makes you feel YOUR best. Alcohol doesn’t do that for you? That’s okay! Order that virgin margarita. It’s not worth a ruined weekend or a temperamental stomach. Or, on the flip side, if you are able to enjoy a drink or two without tummy troubles, that’s okay too. You’re the best person to make that decision for yourself (I’m just here to explain the science and ask lots of questions) 😉

As for me, I haven’t really had much alcohol in the last year and a half due to pregnancy and nursing, and I must say I miss my occasional cocktail a lot less than I thought I would. My stomach has enough challenges, and it’s been really nice that alcohol hasn’t been one of them.

You may be surprised, too!

 

References

• Bode, et al. Effect of alcohol consumption on the gut. Best Pract Res Clin Gastroenterol. 2003;17(4):575-92. Available here.
• Engen, et al. The gastrointestinal microbiome: alcohol effects on the composition of intestinal microbiota. Alcohol Res. 2015;37(2):223-36. Available here.
• Patel, et al. Alcohol and the intestine. Biomolecules. 2015;5(4):2573-88. Available here.
• Purohit, et al. Alcohol, intestinal bacterial growth, intestinal permeability to endotoxin, and medical consequences. Alcohol. 2008;42(5):349-361. Available here.
• Reding, et al. Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients with irritable bowel syndrome. Am J Gastroenterol. 2013;108(2):270-76. Available here.
• Wang, et al. Lactobacillus rhamnosus GG culture supernatant ameliorates acute alcohol-induced intestinal permeability and liver injury. Am J Physiol Gastrointest Liver Physiol. 2012;303(1):G32-41. Available here.