IBS and alcohol - how drinking affects your gut

For those suffering from medically diagnosed IBS, dining out with friends and family can be tricky and sometimes stressful – especially when you are still unsure of your main triggers. 

Alcohol consumption is a common trigger for individuals with IBS, causing pain, bloating, urgency and diarrhoea. Not so good when you just want to have a few drinks with your friends on a special occasion, right? We know, it’s not fair!

When it comes to foods and drinks, people’s IBS symptoms can vary from person to person. Some may have adverse effects on foods that other people can tolerate well and vice versa. 

However, alcohol is a particularly common trigger.

So to help, we’ve pulled together some information about IBS and alcohol, including some options that may be better tolerated for individuals with FODMAP sensitivity.

Alcohol and symptoms of IBS

Alcohol itself is a gut irritant, so it may worsen IBS symptoms regardless of which type you choose.  For those who suffer from IBS, alcohol commonly exacerbates symptoms.  

Alcohol can also impact our gut microbiota (gut bacteria), so regularly drinking can lead to a disruption of our balance of good gut bacteria.

Is alcohol low FODMAP?

The type of alcoholic beverage will determine whether it is low or high FODMAP.

Some high FODMAP alcoholic beverages to avoid are:

• Rum
• Sticky/fortified wine and liqueurs (often includes cocktails)
• Some fruit-based beverages such as cider

Some low FODMAP alternatives include:

• Red wine, dry white wine, sparkling wine/champagne
• Vodka, gin, tequila and whisky
• Beer (choose a gluten-free beer if coeliac)

It is important to note that even if you choose a low FODMAP alcohol, it may still exacerbate symptoms due to alcohol itself being a gut irritant.

What alcohol to avoid if you have IBS

1. Carbonated beverages

Carbonated beverages will naturally add gas and air into the digestive system by their very nature. This can cause gut spasms and distention (swelling of the abdomen). So, if bloating and pain are common symptoms for you, try to avoid fizzy drinks like mixers, ciders and sparkling wine.

2. High fructose beverages

Fructose, which is the sugar found in fruit, is a simple sugar that is poorly digested by the body (i.e. a FODMAP). In 2008, a study found that almost one-third of IBS patients within the study were fructose intolerant.

As fructose passes through our gut, it is poorly digested and so passes mostly straight through to our colon, where it ferments. This may lead to pain and bloating. One study found that a lower fructose diet may help to improves symptoms in some individuals.

Examples include:

• Fruit-based beverages like ciders, mixers and cocktails, especially those that contain watermelon, cherry, mango, apples and pear.
• Sweet wines, such as dessert wines, port and sparkling wine.
• Beverages that include high-fructose corn syrup.
  
  Be sure to check out the ingredients list to find out if it includes high amounts of fructose or any with high-fructose corn syrup.

3. ‘Diet’ drinks

Artificial sweeteners, usually found in diet drinks contain polyols, which are FODMAPs that can trigger gastrointestinal distress. Try to avoid drinks containing artificial sweeteners ending in – 'ol' such as sorbitol, xylitol, mannitol and maltitol.

Check the ingredients list to make sure you are avoiding these drinks.

So, after that list you may be saying to yourself…well, what alcohol can I drink with IBS?

What to try

1. ‘Dry’ wines

Wine is made from grapes, which is a well-tolerated fruit from a FODMAP diet perspective, usually 1-2 glasses is tolerable for most individuals.

2. Distilled spirits

Spirits such as vodka, gin and whiskey are low in FODMAPs, in small quantities. Make sure to pick ‘unflavoured’ varieties as the others may have sweeteners.

Try mixing them with soda water & lime. Cranberry juice may be appropriate, as the only fruit juice that is low in FODMAPs. However, check the label on your shop-bought carton to make sure it does not contain high-fructose corn syrup or artificial sweeteners.

3. Beer & prosecco

Although beer and prosecco are carbonated, they are actually low in FODMAPs. So, if you can tolerate drinks with gas then either of these two beverages may be okay. Usually one can of beer or one glass of prosecco is advised.

IBS is not about restricting what you can do or enjoy but it is about what is finding the best for you. It just may take some time to figure this out!

Tips for managing IBS symptoms when drinking

If you choose to drink alcohol, here are our top tips that may reduce gut upset:

• Choose low FODMAP alcoholic beverages such as vodka/gin and soda water and try to limit to 2 drinks a day. 
• Drink a glass of water between each alcoholic beverage.
• Eat low FODMAP foods. Often we don’t make the best food choices when drinking so sticking to low FODMAP options can help to make a difference for overall FODMAP load.
• Get to bed early if you can and have a good night's sleep.

And remember: always be responsible when drinking alcohol and ensure to stay hydrated and eat prior.

Updated and reviewed by Healthylife health experts August 2024