There are two issues to consider in regards to alcohol as a potential trigger for IBS symptoms: its effects on the gut (independent of FODMAPs components) and the FODMAP content of different alcoholic beverages.
Let’s dig in! Here are 5 things to know about alcohol and IBS symptoms:
1. Alcohol is a gut irritant
Whether you have IBS or not, alcohol can irritate the gut, increase intestinal motility (that is, make you run to the bathroom), and diminish the absorption of nutrients. There are no clinical trials on the effects of alcohol in people with IBS but anecdotal reports and observational studies have revealed that about a third of IBS patients feel that alcohol does trigger their symptoms (especially for those with the diarrhea-predominant type of IBS).
2. Alcohol contains FODMAPs
The most common potential problem with alcoholic beverages is their fructose content. A standard serving (5 fluid ounces) of most types of wine is not a problem but sweeter/”dessert” wines are too high. Rum is also high in fructose but other spirits, such as vodka or whiskey are low in FODMAPs. Beer contains acceptable levels of wheat but cannot be consumed by people who may also have celiac disease or are sensitive to gluten. Cider (made from apples and pears) has not been tested but may be too high in fructose and sugar alcohols. The Monash App is a great tool to find out which types of alcohol beverages are ok while following a low FODMAP diet.
3. Moderation is key
As it is true with many other things, moderation is the key. There are no set guidelines for alcohol consumption specifically for people with IBS. The most common recommendation is to follow the guidelines for the general population. In the U. S.: no more than 1 drink per day for women or 2 drinks per day for men. A “drink” is defined as 5 oz. of wine, 12 oz. of beer or 1. 5 oz. of 80-proof distilled spirits. Monash University also recommends that people who suspect that alcohol may be a trigger for their symptoms test their tolerance under the guidance of an expert dietitian (who will help them make this change in isolation and monitor its effects). And, of course, if found to be a trigger, you will need to reduce it or eliminated it altogether.
4. Context is important
Other lifestyle choices may help diminish the effects of alcohol on the gut: drinking water with alcohol will help you keep hydrated; eating some food will help slow down the release of alcohol from the stomach; watching out for other high-FODMAP ingredients consumed with alcohol - such as fruit juices or sodas/tonic waters in mixers, or desserts. Finally, keep in mind that alcohol can stimulate your appetite and make you more relaxed about eating in general, and you may be less likely to adhere to a low-FODMAP diet, especially at parties.
5. Bottom line
People with IBS can enjoy a drink or two and don’t have to feel left out on social occasions. There is no need to avoid alcohol completely (unless you have tested your tolerance and found it is a definite trigger) but be careful in choosing a low FODMAP beverage.