The Dry July campaign started in 2008 as a way to increase awareness and raise money to support cancer organisations around Australia to assist in the comfort and care provided to individuals impacted by cancer. Having a month off alcohol can also be encouraging for numerous health aspects too, such as reducing the risk of cancer, heart and liver disease. [1]
The evidence behind alcohol consumption and its direct relationship with IBS is currently unclear. Despite many types of alcohol being low in FODMAPs, about 1/3 of individuals who have IBS report experiencing symptoms from alcohol based on observation studies. [2,3] It is thought the main reason for this is because alcohol is known to be an irritant to the gut. Alcohol may have an impact on gastrointestinal motility, absorption and inflammation. [2,3] There is currently a lack of high-quality evidence to confirm that reducing alcohol intake may help with controlling symptoms in IBS.
A number of clinical guidelines mention alcohol in their recommendations regarding the dietary management of IBS.
| Name of clinical guideline | Mention of alcohol |
|---|---|
| British Society of Gastroenterology[4] | Recommends screening for excessive alcohol intake when assessing gastrointestinal symptoms, but no specific recommendations regarding adjustment of alcohol intake to manage symptoms of IBS. |
| NICE Guidelines (UK)[5] | Recommends a reduction in intake of alcohol and fizzy drinks. |
| British Dietetic Association[3] | Recommends an assessment of any relationship between alcohol intake and symptoms to help determine whether a reduction may relieve symptoms. Also recommends that alcohol intake should not exceed safe limits for the general population. |
| Rome Foundation[6] | Recommends that in patients with mild symptoms (~40% of patient population), dietary substances that cause symptoms (such as alcohol) should be identified and reduced or eliminated. |
If you suspect alcohol to be a non-FODMAP dietary trigger of your symptoms, we recommend working with your clinician to determine whether there is a relationship or pattern between your alcohol intake and IBS symptoms.
Australian guidelines recommend limiting your intake to <10 standard drinks per week or <4 standard drinks per day. [7] In America, it is even less with the Centre for Disease Control suggesting <2 standard drinks per day for men, and <1 for women. [8] This is to reduce the risk of alcohol-related disease and injury. It is also encouraged to consume alcohol alongside food and drink additional water to avoid dehydration.
If you have IBS and still want to enjoy some alcohol intake, here are some tips to help guide your choices:
Avoid alcohol types tested high in FODMAPs if you are sensitive to their FODMAPs present: (rum, red wine >250mL and sticky wine)
Assess your own relationship between alcohol intake and symptom development as your tolerance will be unique to you.
Avoid mixing alcohol with high FODMAP juices and soft drinks
Alternate alcoholic drinks with non-alcoholic low FODMAP drinks such as water or mineral water.
Try a wine spritzer with mineral or soda water instead of a full glass of wine.
Alcohol is often consumed in social settings alongside food. Be mindful of food choices and stacking FODMAPs.
References:
Dry July. 2022. https://www.dryjuly.com/
El-Salhy M,Hatlebakk J, Hausken T. Diet in Irritable Bowel Syndrome (IBS): Interaction with Gut Microbiota and Gut Hormones. Nutrients 2019, 11, 1824.
McKenzie, Y.A. et al. British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update). J Hum Nutr Diet. 29, 549– 575
Vasant DH, Paine PA, Black CJ, Houghton LA, Everitt HA, Corsetti M, et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut. 2021;70(7):1214
Hookway, C., et al., Irritable bowel syndrome in adults in primary care: summary of updated NICE guidance. BMJ, 2015. 350: p. h701.
Drossman, D.A., Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology, 2016.
Eat for Health. 2020. Alcohol https://www.eatforhealth.gov.au/food-essentials/fat-salt-sugars-and-alcohol/alcohol
Centre for Disease Control and Prevention. 2022. Dietary Guidelines for Alcohol https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm#:~:text=To%20reduce%20the%20risk%20of,days%20when%20alcohol%20is%20consumed.
