Did you know the average UK person drinks approx 18 units of alcohol per week. This is 4 units above the recommended amount. 

The UK government recommends that both men and women drink a maximum of 14 units per week, preferably spread across the course of the week, having at least two days without any alcohol⁽¹⁾. 

If you are like me, I never know how many units are in a drink. The below diagram gives a clearer idea of what 14 units could look like.

You can see how drinking more than is recommended is easily done.  I am certainly enjoying pub gardens being open and celebrating being able to meet my friends and family again. But if you have IBS, how might these drinks be effecting you? 

We all know irregardless of any other conditions, alcohol can come with some nasty side effects, including⁽²⁾: 

• depression/ anxiety 
• stomach ache 
• headaches 
• dehydration
• nausea and vomiting 
• indigestion
• long term problems with alcohol misuse including – raised blood pressure, liver disease, cancer

Some of those definitely overlap with IBS type symptoms. But does that mean alcohol will definitely be an IBS trigger? Well the evidence varies and there isn’t a ton of research. 

However, the British Dietetic Association found that alcohol is a gut irritant and can lead to vomiting and diarrhoea in some people. As well as causing inflammation in the gut! If you are already having pain in your bowels from IBS, alcohol can exacerbate this⁽³⁾. 

Another study has found that those who had IBS and binge drink (in this study they counted that as 4+ drinks in a day) had more gastrointestinal symptoms the next day than the healthy counterparts. Symptoms included diarrhoea, stomach pain and indigestion. Associations between drinking and IBS symptoms were also higher in those with diarrhoea predominant IBS⁽⁴⁾.

Alcohol can also affect peristalsis (your bowel movement). Depending on the alcohol content can affect if your bowels work slower or faster. Beverages with a lower alcohol content (e.g beer) can increase peristalsis which means you might suffer from diarrhoea. On the flip side, higher alcohol content (e.g vodka) can slow your bowels down leading to constipation. 

It is also worth baring in mind the mixers you are drinking. Fizzy drinks are a known irritant for those of us with IBS due to the carbonation which can cause bloating and gas. So if you are drinking lots of rum and cokes you may find your symptoms worsening. If you are a fruity cocktail drinker these also might be aggravating you as fruit juice can be high in FODMAPs. Try switching to some red wine or a vodka soda. 

Each persons alcohol sensitivity also varies and in turn this can vary how much of an affect alcohol will have on you and your gut.  

Can you drink alcohol if you are following a Low FODMAP diet⁽⁵⁾? 

The simple answer is yes, you absolutely can drink alcohol if you are following a low FODMAP diet. It is a question of picking the right alcohols and being aware which drinks contain FODMAP’s

LOW FODMAP DRINKS	HIGH FODMAP DRINKS
Beer	Dessert wine
Red wine	Sherry
Dry white wine	Port
Gin	Run
Vodka	Cider
Tequila
Whisky

Top Tips for Drinking with IBS: 

• For each drink you have, drink a glass of water – this will slow down your drinking, keep you hydrated and reduce the irritation to your digestive system 
• Eat before drinking and preferably not a salad – choose something you enjoy that doesn’t aggravate your stomach and something with carbohydrates
• Reduce the amount you drink in one go – I know it can be hard, the UK has a big drinking culture but finding alcohol free alternatives can help reduce your symptoms. Have an elderflower cordial or tonic water with lime. Low alcohol or alcohol free drinks are gaining in popularity and pubs are now selling the likes of alcohol free gin. No one has to know you are going without alcohol. 
• Reduce the frequency of drinking – limit yourself to drinking only one or two days of the week 
• Mind what you eat the next day – when you are hungover it’s easy to reach for your comfort foods and the greasier the better, but if possible it’s good to try and make good food choices that won’t irritate your IBS after a night of drinking alcohol
• Hydrate – reach for your water the next day to help rehydrate your body and reduce the irritation in your stomach, ginger tea is great if you are feeling nauseas and helps you rehydrate. 

At the end of the day the important thing to do it to listen to your body. Personally due to my IBS I try to limit alcoholic drinks to one day a week, maybe two. And I avoid beer. Even gluten free beers gives me stomach ache the next day! Find the way that works for you.

References: 

1. UK Gov: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf
2. NHS alcohol: https://www.nhs.uk/conditions/alcohol-misuse/risks/
3. McKenzie, Y.A., Bowyer, R.K., Leach, H., Gulia, P., Horobin, J., O’Sullivan, N.A., Pettitt, C., Reeves, L.B., Seamark, L., Williams, M. and Thompson, J., 2016. British Dietetic Association systematic review and evidence‐based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update). Journal of Human Nutrition and Dietetics, 29(5), pp.549-575.
4. Reding, K.W., Cain, K.C., Jarrett, M.E., Eugenio, M.D. and Heitkemper, M.M., 2013. Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients with irritable bowel syndrome. The American journal of gastroenterology, 108(2), p.270.
5. Monash alcohol: https://www.monashfodmap.com/blog/more-fodmaps/

Photo by Kobby Mendez on Unsplash