IBS and Alcohol: Is It Ever Okay to Indulge?

It's well known for even those who don't suffer from IBS or another digestive or GI-related disorder or disease: too much alcohol can have adverse effects on the gut, at least in the short term. While most studies haven't found any strong correlation between alcohol consumption and developing IBS, some did find that those with IBS who do drink alcohol tend to experience more frequent IBS symptoms, particularly from binge drinking – and especially women.^1,2

Family history

As I was raised in a family where addiction – both to alcohol and other illicit substances – was a commonplace affliction, I actually didn't drink my first couple of years of college. In fact, I didn't start drinking until I was about the legal age to and already had my IBS diagnosis, only to discover how badly booze impacted my IBS. Like everything else, I had to learn through trial and error, what I could and couldn't get away with.

Again, because of my family history, I was never a heavy drinker because I wanted to be cautious not to repeat patterns of behavior I grew up with. To this day, I have never blacked out, had a serious hangover, or vomited from excessive drinking. If anything, I think I have my IBS to thank at least in part for this, because even if I wanted to drink more than a few drinks a night, I knew I couldn't because it would have me running to the bathroom (not the kind of impression you want to make at 21 while flirting with people as a party).

My tips for IBS and alcohol

Yet, it took me a few years to realize certain drinks bothered me much more than others, that quality mattered more than quantity when it came to enjoying alcohol, and that in my case, the time of the month also matters. Here's what I learned for myself:

1. Stay away from most mixed drinks, especially fruity or sugary ones. I just don't drink these at all and now that I am not a college kid anymore, I've long lost my taste for them anyway. Additionally, sugary drinks tend to be high FODMAP, which can be a no-no for many/most IBS sufferers.
2. Stay away from hard liquor, at least in anything but very minimal amounts. Supposedly, some hard liquor--like gin, vodka and scotch--are also low FODMAP due to their distillation process, so in theory won't aggravate IBS as much as some other options. But I personally find whiskey and scotch (which, yes, I used to drink) terrible triggers in my experience. Even when they don't flare my IBS, they definitely flare my GERD and cause painful reflux and heartburn. It just wasn't worth it to keep drinking them. I did, however, like vodka – esp in a dry martini, and as long as I only had a small helping, it didn't bother me. Yet, in the past year or so, I find that has changed as well. So, as a good IBS patient, I adapted accordingly and don't really drink martinis or vodka much anymore either.
3. Wine and beer, which are mostly the only kinds of alcohol I really drink anymore, the general rule for me is one serving is all I need. Both wine and beer are low FODMAP. However, most low-FODMAP diet recommendations I've reviewed usually only advise one beer or glass of wine, and definitely no more than two in a sitting. I used to be able to get away with a couple of glasses of wine or beer in an evening, but I find nowadays even more than one is pushing it. So, I enjoy my one glass of chosen drink when I decide to indulge.
4. Dry over sweet, light over heavy or dark. I also tend to favor dry white wines over sweet whites (again, this usually indicates less sugary content) or most reds (and anecdotal evidence suggests white is often better tolerated by IBS patients – maybe because sugar and sulfite content can be higher in reds). For beer, I also tend to prefer lighter or medium beers – pilsners/lagers, Kolsch, or ales like amber or maybe brown. For those with gluten-intolerance or Celiac, they may need to avoid beer altogether (though there are now some gluten-free beer options out there). While I can handle gluten in moderation, I try to avoid high-wheat beers. I also avoid hoppy beers (no IPAs or pale ales), and those that are very dark-bodied and heavy (no porters or stouts).
5. Don't drink on an empty stomach. This one should be a given, but needs to be said anyway. I usually only have a drink with a meal (usually dinner) or if it is a pre-dinner drink, I will make sure to at least have a snack or small appetizer with it. I will also try to make sure that snack is low-FODMAP and high in soluble fiber.
6. Drink water. Whenever I order a glass of wine or beer at a bar or restaurant, I also make sure to ask for a glass of water in addition to a snack and then alternate sips between my water and alcoholic beverage until both are finished. I do this when I am drinking at home as well. The water helps keep me hydrated and counters the effects of alcohol, especially its acidity in my gut.
7. Avoid drinking any alcohol right before or during my period. This one is especially important for me. As someone with endometriosis as well as IBS, I try to make sure to abstain from alcohol entirely at least a few days before the onset of my period (as it can also make my cramps worse) and definitely avoid all alcohol while I am menstruating. People who menstruate can experience GI issues even if they don't have IBS, so avoiding alcohol during this time can be helpful even if you don't have IBS.
8. I also avoid drinking any alcohol during an active flare or when I am under high stress – such as when I am in the middle of traveling, or under a major deadline, or have a stressful event I am preparing for or undergoing. Stress can exacerbate IBS, so I don't need to add another trigger. I reserve a drink for when I am relaxed and enjoying myself, and for when I don't need to be anywhere important later that evening or the next morning.

Have you found tips for drinking or types of drinks that don't bother your IBS? Or have you found it's best to just avoid alcohol altogether?