How does alcohol affect Crohn's disease?

Written by Nicole Galan, RN

A big part of managing Crohn’s disease is making dietary changes to prevent symptoms from flaring. Alcohol is a common trigger for Crohn’s, and some people with the disease need to avoid, or at least restrict, their intake.

Crohn’s disease is a type of inflammatory bowel disease (IBD). It can affect the entire gastrointestinal tract, from the mouth to the anus, but it most commonly affects the small and large intestines.

Crohn’s symptoms vary from person to person, and they can change over time. There is no cure for the condition.

Treatment focuses on getting the disease into remission, when a person experiences very limited symptoms, if any.

Keep reading to learn more about the relationship between Crohn’s and alcohol.

Can someone with Crohn’s disease drink alcohol?

Alcohol can affect the immune system, prompting changes to chemicals that cause inflammation in the gut. This can trigger or worsen symptoms.

These chemical changes can disrupt the functioning of the gut. People with Crohn’s disease are particularly susceptible to this type of intestinal damage.

Because each person with Crohn’s has a different experience, there is no simple rule about how to handle alcohol. Alcohol may cause no Crohn’s symptoms in one person, but severe reactions in another, who may need to eliminate it completely from their diet.

Also, people with Crohn’s can react differently to different types of alcohol. For example, hard liquor may be easy to tolerate, while beer is a strong trigger for symptoms.

It is important for anyone with Crohn’s to take time and speak with their doctor about symptoms and how they evolve.

Avoiding alcohol for a while and reintroducing it slowly can help a person get a better idea of how their body responds.

What does the research say?

Few studies have looked at alcohol use among people with specific types of IBD, such as Crohn’s.

A 2010 study in Alcohol found that drinking alcohol may worsen Crohn’s symptoms. However, it only looked at 129 people with IBD, 52 of whom had Crohn’s, and relied on responses to a questionnaire.

A 2018 study in the Journal of Gastroenterology arrived at similar conclusions. As in the earlier study, the authors found that people who drank alcohol were more likely to report increased Crohn’s symptoms.

The study authors acknowledge that much more research is needed before a definitive conclusion can be reached.

Published in the Annals of Gastroenterology in 2018, one large review looked at results from 12 studies that had investigated the effects of alcohol in people with an IBD.

Most of those studies also concluded that Crohn’s symptoms worsened with alcohol consumption. The authors likewise noted that confirming the findings will require further research.

What are the best and worst drinks for people with Crohn’s?

The best drinks are those that do not cause symptoms to flare up.

It may be helpful to stay away from alcohol for a while until the disease is in remission. A person could then try small amounts of one type of drink and pay close attention to how their body is tolerating it.

One study looked at the effects of five alcoholic drinks in people with Crohn’s disease: red wine, white wine, a bottled mixed drink with vodka, a brand of beer, and pure ethanol.

The researchers found that the participants absorbed these drinks similarly, but that the bottled cocktail and the beer led to more abdominal pain than the other three types of drink.

The team attributed this reaction to the higher sugar contents in the mixed drink and beer.

Another study looked specifically at red wine consumed during IBD remission. The authors found that drinking even moderate amounts of red wine can cause increased permeability, or leakiness, in the intestines, which could lead to flare-ups and aggravated symptoms.

What are the signs of a flare-up?

A flare-up is a period of increased inflammation in the tissue that Crohn’s affects. This can lead to a host of other symptoms, including:

• diarrhea
• abdominal pain, cramping, or both
• rectal bleeding
• constipation that may lead to a bowel obstruction
• bowel movement urgency

Some people also have symptoms in other parts of the body. These can include:

• joint pain
• a rash
• sores in or on the mouth
• fatigue
• a loss of appetite
• weight loss

Managing flare-ups

Anyone with Crohn’s should discuss ways of managing flare-ups with a doctor. If they have identified a trigger, they should remove it from their diet as quickly as possible.

Be sure to take all medications exactly as prescribed, even if symptoms are in remission. It is important never to miss a dose because this can increase the risk of a flare-up.

It is a good idea to keep anything that can help with a flare-up handy. For some people, this means:

• pain relievers
• a heating pad
• hygienic wipes
• antidiarrheal medication
• mild soap to clean irritated or sensitive anal tissue
• medicated mouthwash for sores
• barrier ointment

Speak with a doctor if flare-ups occur frequently or are difficult to manage.

Summary

Crohn’s disease is a chronic inflammatory disease. It primarily affects the intestinal tract and can cause serious discomfort during flare-ups.

While alcohol is a known Crohn’s trigger, this may not mean that a person with the disease needs to eliminate alcohol from their diet.

Crohn’s affects people differently, and people can have different reactions to various alcoholic drinks and other triggers.

Working with a doctor can help a person understand what triggers their symptoms and how best to approach alcohol.

SOURCE: MEDICAL NEWS TODAY