This Is How Alcohol Affects Your Gut
Can you drink without destroying your insides?
Of all the vices in the world, not many seem to promote your social status as much as a love of good alcohol. From family gatherings to happy hour after work to summer float trips and afternoons at the winery, there are many options for you, depending on your ideal mode of consumption. Many people are curious, “Is there any level of alcohol consumption that could be good for my gut? Or will any of it send it into a spiraling abyss?” Get comfy, find some good red wine, and hold on to our discussions about alcohol and gut health.
My Love for Gluten
I am a huge fan of really hoppy, bitter-tasting Indian Pale Ales (IPAs). Add a touch of citrus flavor, boom! You’ve got me hooked for at least an hour. One potential issue here: They’re loaded with wheat and gluten. Thankfully in moderation, I can tolerate one or two IPAs. I may get scolded for consuming gluten by some in my field, but hey, I like to enjoy life.
Now it’s not just the wheat that could be the issue. If you’re drinking an adult beverage that’s made from rye or barley, FODMAPs could be problematic for you. These drinks include beer, whiskey, gin, bourbon, and vodka. Those with Celiac Disease should avoid these drinks altogether. Even those with Non-Celiac Gluten Sensitivity — NCGS, 10% of the population at most — could get some gut symptoms from ingesting minor amounts of gluten.
Adding sugars to make wine and certain liquors and sugars to mixed drinks could directly flare up digestive issues. That’s why some Paleo Diet enthusiasts will say tequila made from 100% agave is ok because it’s made without added sugar. I say digestive issues because we know high-sugar consumption, in combo with low fiber, does lead to changes in the microbiome.
If you only have one drink a month in the presence of an overall healthy lifestyle, you’re probably fine. Several drinks a day? Probably not so much.
The trick, if consuming alcohol is in your practice, is finding the middle ground where you can drink for enjoyment without it spilling over — pun intended — and causing gut distress. We all want to have our cake and eat it too, maybe with a shot of RumChata.
Alcohol and GI Conditions
Leaky Gut
Walk into any natural/functional health care provider, and you’ll probably hear some fear-mongering statement like: “Alcohol causes leaky gut!” While yes, that is true, there’s a lot more to unpack with that statement. Much of the research on alcohol and leaky gut focuses on disease states associated with excess alcohol consumption, such as alcoholics or alcoholics that develop liver disease — cirrhosis.
So it’s hard to tell if the “social drinker” — someone having a few drinks/week — will get a leaky gut.
In one study, only alcoholics with liver cirrhosis showed significant markers of leaky gut compared to alcoholics without liver disease (1). Not saying the alcoholics without disease were healthy, but rather they showed no objective evidence of leaky gut. It seems as though excess oxidative stress from too much alcohol leads to a leaky gut. If you don’t drink excessively, you may not cause enough oxidative stress to cause a leaky gut.
Another study in alcoholics with liver disease — drinking 4–6 alcoholic beverages a day for nearly 30 years — showed that one week of alcohol abstinence led to significant reductions in levels of endotoxin — one marker of leaky gut — along with a reduction in liver enzymes (2). What does this tell me? The alcoholics got healthier, but we all could have guessed that from the start. Here’s the rub: The alcoholics’ endotoxin levels decreased, but still not to the same level as healthy individuals. Stopping alcohol for a week helped, but when you’ve accumulated 30 years of heavy drinking, I wouldn’t expect one week to correct that fully.
What’s the tipping point of alcohol consumption that causes it? Great question! One that probably differs vastly from person to person.
Small Intestinal Bacterial Overgrowth (SIBO)
There’s evidence to show that alcoholics have a greater incidence of SIBO. There’s also evidence that alcoholics with liver disease have a greater abundance of “not-so-good” bacteria, which can cause much of the bloating and abdominal pain you see with SIBO. This leads to the idea that excess alcohol consumption can lead to negative changes in our gut microbiome. If you think about it, what’s the primary ingredient used in many of the antimicrobial and antibacterial cleaning products: alcohol.
Alcohol doesn’t discriminate in which bugs it destroys, both “good” and not-so-good microbes. As alcohol destroys more of the “good” microbes, not-so-good microbes start to come out from hiding and begin to take up residence in your gut. As they start to overgrow, particularly in the small intestine, you begin to experience those hallmark signs and symptoms of SIBO.
Gastritis
Gastritis is a disease characterized by inflammation in your stomach. With how crucial your stomach’s role is in food digestion and protection against pathogens, you can see how stomach inflammation might be a problem. Wouldn’t ya know that excess alcohol is incredibly damaging to our stomach lining?
Colorectal Cancer
I am by no means a cancer expert, so if you’re dealing with it, please make sure you communicate with your oncologist before making any changes to your health routine.
However, based on my reading of the research, there’s an increased risk of colorectal cancer in a dose-dependent manner — the more you drink, the greater your risk(4). There are probably not many cancers out there that you’re less likely to get the more alcohol you drink. The moral of the story, drinking more alcohol isn’t protective against cancer.
The Hangover
Need I say anything else? You know it. You hate it. And your trash can, toilet, and local diner have become best friends with it. What role does the gut play in making us feel like we’ve been run over by a wagon?
If consuming alcohol to the point of being “drunk” is in your practice, you may have experienced a morning after, or that same night, where you felt like there were spirits — sometimes literally — coming out of your stomach. Combine that with some nausea and mild stomach pain, and you’ve got yourself the triple threat of GI discomfort.
Not only does alcohol cause inflammation to the stomach lining, as we discussed earlier, but it also delays the time it takes for food material to pass from the stomach to the small intestine — gastric emptying. Delayed gastric emptying can cause food to get “backed up” into the esophagus, potentially leading to acid reflux or “heartburn” type symptoms. If you’ve ever felt heartburn from alcohol consumption, now you know why. Alcohol also increases the production of stomach acid and other secretions — enzymes — from the gut, leading to the symptoms of pain, nausea, and vomiting (5).
Can Probiotics Help Hangovers?
There is currently a probiotic supplement, ZBiotics, that is marketed to “seize the day after last night.” Basically, it’s designed to break down a toxic component of alcohol, acetaldehyde, thus hopefully making you feel less/not hungover. I personally haven’t tried it, but I think it’s a pretty innovative approach to hangover remedies. The probiotic supplement market is also incredibly trendy at the moment, which probably isn’t hurting them.
But Won’t It Make Me Live Longer?
Go to any event, wedding, or social gathering, and you might hear something along these lines “You should drink red wine. I heard it makes you live longer!” People are referring to the potential health benefits of a molecule called resveratrol, which is present in the skins of red grapes.
But we know that to get a therapeutic effect from resveratrol, you’d have to drink 500 glasses of red wine a night! (6).
Sounds like a fun time for all of 30 seconds.
I believe much of the health benefits of red wine come from the social aspect of drinking it. We know how impactful and important social engagement is for our health. So to answer the question, yes, you might live longer because you attended the gathering, but it’s likely not because of the red wine but because of the person offering it to you. Go ahead and tell your friend their presence makes you live longer; you’ll probably have a friend for life.
As is everything in life, determining how much alcohol your gut can handle is context-dependent. Listen to your body. If you live gut-symptom free, that one glass of red wine you have monthly might be OK. But if you’re dealing with chronic gut issues and alcohol is a part of your regular practice — say more than once/month — consider a trial without it for eight-twelve weeks. Your gut will give you all the feedback you need.
As always, Trust in Your Gut.
Disclaimer: The contents of this article are for educational purposes only and are not intended to diagnose or treat any condition. Do not apply any of the information in this article without first speaking with your doctor.
References
- Keshavarzian A, Holmes EW, Patel M, Iber F, Fields JZ, Pethkar S. Leaky gut in alcoholic cirrhosis: a possible mechanism for alcohol-induced liver damage. Am J Gastroenterol. 1999;94(1):200–207. doi:10.1111/j.1572–0241.1999.00797.x
- Jung F, Burger K, Staltner R, Brandt A, Mueller S, Bergheim I. Markers of Intestinal Permeability Are Rapidly Improved by Alcohol Withdrawal in Patients with Alcohol-Related Liver Disease. Nutrients. 2021;13(5):1659. Published 2021 May 14. doi:10.3390/nu13051659
- Engen PA, Green SJ, Voigt RM, Forsyth CB, Keshavarzian A. The Gastrointestinal Microbiome: Alcohol Effects on the Composition of Intestinal Microbiota. Alcohol Res. 2015;37(2):223–236.
- Song M, Chan AT. Environmental Factors, Gut Microbiota, and Colorectal Cancer Prevention. Clin Gastroenterol Hepatol. 2019;17(2):275–289. doi:10.1016/j.cgh.2018.07.012
- Swift R, Davidson D. Alcohol hangover: mechanisms and mediators. Alcohol Health Res World. 1998;22(1):54–60.
- Pyo IS, Yun S, Yoon YE, Choi JW, Lee SJ. Mechanisms of Aging and the Preventive Effects of Resveratrol on Age-Related Diseases. Molecules. 2020;25(20):4649. Published 2020 Oct 12. doi:10.3390/molecules25204649
