Yes, I admit that one of my initial questions when I met with the nutritionist to discuss the low FODMAP diet after being diagnosed with Fructose Malabsorption was, “Can I still drink wine?” I enjoy having a glass of red wine with dinner or a glass of bourbon while relaxing with friends on the weekend. However, I have noticed that there are times after a drink that my stomach is irritated and I begin to bloat. It could be because of what I ate, or the result of stress, but I have started to wonder in general how alcohol affects our digestive systems?
Studies have demonstrated that drinking the recommended amount of wine (1 glass per day for women or 2 glasses per day for men) has benefits. For example, red wine contains polyphenols, which have been shown to reduce the risk of cancer. Additionally, wine can decrease the number of H. pylori, a bacteria known to cause ulcers and can increase the beneficial bacteria, Bifidobacterium. However, there are also studies that have shown that drinking alcohol chronically can result in digestive issues including Irritable Bowel Syndrome (IBS), which affects 11% of people globally.
Our digestive system includes the gastrointestinal tract, which begins with the mouth and ends with the rectum, with the esophagus, stomach, small intestine, and large intestine in between. It also includes the three organs – the liver, pancreas, and gallbladder, which aid in our digestion. So, what are some of the ways that alcohol affects our digestive systems? Let’s start at the top.
- There is a sphincter located where the esophagus and the stomach meet. The role of the sphincter is to prevent the digestive acids that are produced in the stomach to enter the esophagus. Alcohol can cause the sphincter to relax, allowing the acid to enter the esophagus resulting in acid reflux and damage to the esophageal mucosa. Alcohol can also lead to hydrogen ions penetrating into the esophagus causing a more acidic environment, which can additionally damage the esophageal mucosa.
- An increased risk of cancer in the pharynx, esophagus, stomach, and colon.
- Gastritis: When the mucosal lining in the stomach is damaged and inflammation occurs.
- Dysbiosis: When a microbial imbalance occurs in the digestive system. The bacteria in our gut plays an important role in our digestion including protecting our gut from infection and synthesizing vitamins and amino acids from our digested food. Dysbiosis has been linked to inflammatory bowel disease (IBD), IBS, celiac disease, food allergies, diabetes, cancer, obesity, and heart disease.
- Small intestinal bacterial overgrowth.
- Malabsorption of important nutrients, such as vitamin B12, thiamin, folic acid, calcium, zinc, and certain amino acids.
- Increase in intestinal permeability can lead bacteria and toxins leaking out of the gut into our bloodstream causing inflammation. Intestinal permeability may also lead to diarrhea.
- Pancreatitis: The inflammation of the pancreas, which can affect our digestion. The pancreas makes and secretes into our gastrointestinal tract the hormones and enzymes necessary for us to digest our food.
These risks are typically found when there is heavy use of alcohol. Fortunately, these affects can be reversed when people stop drinking alcohol. Overall, one way to avoid these risks is to keep within the guidelines of one drink per day for women or two drinks per day for men and if you have digestive issues, such as IBS or IBD and you are having a bad day or bad week(s) then abstaining from alcohol during that timeframe can reduce the irritation. If you are on the low FODMAP diet or want to be mindful of your FODMAPs, there is a great guide on what to drink by Alana Scott of A Little Bit Yummy. And, I will drink to that!
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3. Hsu, T., et al. Alcohol Use Disorder Increases the Risk of Irritable Bowel Disease. Medicine 2015, 94(51): 1-6.
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Photo taken by Yutacar on Unsplash.