Pattern of alcohol consumption and its effect on gastrointestinal symptoms in inflammatory bowel disease

Abstract

Alcohol consumption is a potential trigger for flare in Inflammatory Bowel Disease (IBD) flare because of alcohol’s pro-oxidant effects and its deleterious effects on gut barrier function. The association with alcohol consumption and IBD flare is unclear. To test this hypothesis, we evaluated the pattern of alcohol consumption and its self-reported effect on gastrointestinal (GI) symptoms in patients with IBD. We recruited 129 consecutive patients: 52 patients with Crohn’s Disease, 38 patients with Ulcerative Colitis, and 39 patients with Irritable Bowel Syndrome (IBS). All participants completed a validated questionnaire on disease activity, the CDAI or UCAI respectively, validated questionnaires to quantify alcohol consumption by NIAAA criteria, and two structured questionnaires we designed to access patients’ perception of the effect of alcohol on their GI symptoms and on overall GI symptom severity. The pattern of current, light, moderate, and heavy alcohol consumption in inactive IBD was similar to the general US population. Specifically, 56 of 90 (62%) of inactive IBD patients were current drinkers, compared to 61% in the general US population. Of current drinkers, 75% of IBD (N=42), and 43% of IBS (N=9) reported a worsening of GI symptoms with alcohol consumption (p=0.01); however, overall GI symptom severity did not differ when compared to quantity of alcohol consumed. Patients with inactive IBD drink alcohol in quantities similar to the general population. Current drinkers with inactive IBD are more likely to report worsening of GI symptoms with alcohol than current drinkers with IBS.

Diarrhoea is not the only symptom that needs to be treated in patients with microscopic colitis

“…Some studies have shown that alcohol impairs symptoms [14], whereas others have shown that alcohol has no effect on functional gastrointestinal symptoms [12]. Alcohol may trigger relapses and pronounced symptoms in patients with already developed IBD [36], which could not be seen in our study for the MC patients. The effect measured on symptoms reasonably has to be connected to the volume consumed.…”

Is Moderate Red Wine Consumption Safe in Inactive Inflammatory Bowel Disease?

“…Indeed, previous studies have already demonstrated that alcohol is a common exposure in patients with IBD, and it is consumed in proportion to the general population [13]. There is no doubt that hazardous/harmful alcohol use (defined as consumption of greater than 40 g of alcohol per day for men and 20 g for women) [26] has numerous deleterious health effects on other organ systems like the liver, intestine, and immune system and incurs annual health costs of USD 100 billion in the United States [27].…”

“…Another study in CD found no difference in alcohol absorption or abdominal pain from five different alcoholic drinks [12], and concluded that it is likely the high sugar content that is responsible for reported symptoms. In addition, we recently reported on a cohort study using a survey analysis of alcohol consumption in inactive IBD, and found that patients with IBD do drink alcohol in a similar pattern to the general population, but were also more likely to report that alcohol worsens their gastrointestinal (GI) symptoms than patients with irritable bowel syndrome [13]. …”

Alcohol consumption after health deterioration in older adults: a mixed-methods study

“…nursing home admission), be prescribed alcohol-incompatible medications, or receive advice to drink less from healthcare professionals (17)(18)(19)(20). In England 71% adults aged 65 years and older report at least one long-term condition (LTC) (21), and alcohol can worsen the symptoms of LTCs (22), influence self-care behaviours (23) and interact with medications (24).…”