Can you drink alcohol on the low FODMAP diet?

Yes, you can drink alcohol on the low FODMAP diet. 

This post will explain the advice on alcohol when you have IBS, including which alcoholic drinks and mixers are low FODMAP.

WHAT IS ALCOHOL?

Like fat, protein and carbohydrates, alcohol is a macronutrient. When we drink alcoholic drinks, we are drinking the type known as ethanol. Alcoholic drink production has been going on for centuries and is made through the fermentation of grains, fruits or vegetables.

THE IMPACT OF ALCOHOL ON IBS

Around 1 in 3 people with IBS find that alcohol worsens their symptoms (7). Sadly, we do not have any specific research on how alcohol impacts IBS symptoms but we do have research looking at alcohol and gut health in general.

The information given below is based on studies that do not specifically look at IBS but in the general population (1, 2).

Changes in the speed of gastric-emptying

Alcohol consumption changes the rate at which stomach contents are emptied (known as gastric emptying). Some research has shown that gastric emptying is delayed when the alcohol content is above 15%, but sped up for drinks such as beer and wine (3). 

Rapid gastric emptying is linked to symptoms such as bloating and diarrhoea, which is a commonly reported IBS symptom after drinking alcohol (4).

Reduced nutrient absorption 

Alcohol can reduce the absorption of nutrients, such as B vitamins and zinc (5). Over time, alcohol can also damage the lining of your gut (6), which may further reduce nutrient absorption.

Effect on gut microbiota 

Alcohol can alter the microbiota in your gut, as there have been correlations seen between alcohol consumption and gut bacteria (7, 8).

Some studies have shown that for regular drinkers there is a decrease in Clostridiales, while Bifidobacterium, Lactobacillus and Enterobacteriaceae are increased (9).

Causes dehydration

Alcohol acts as a diuretic, meaning it can draw water from your body and increase urination.

It does this by decreasing how much vasopressin your body makes (10) Vasopressin normally helps your body hold onto more water, so when its levels are decreased you need to urinate more frequently, losing water and leading to dehydration.

The colour of your urine is a good indicator of how hydrated you are, and you should be aiming for a clearer colour.

Which alcoholic drinks contain FODMAPs?

This section will discuss which alcoholic drinks you can enjoy whilst on the low FODMAP diet.

Is wine low FODMAP?

Most wines are low FODMAP for 150ml serving sizes, including red, white, rose, and sparkling (11). However, there can be high fructose levels in fortified wines like sherry and port, so you should avoid these if you are on a low FODMAP diet. 

Is beer low FODMAP? 

One can of beer (375ml) counts as a low FODMAP option (11). 

Beer is made from ingredients that contain FODMAPs. However, the beer-making process breaks down the fructans, leaving a low FODMAP alcohol option.

For some people, the bubbles in beer can affect symptoms such as bloating and gas (non-FODMAP related).

Other low FODMAP alcoholic drinks

You may be surprised that you can still drink some wine and beer while on the low FODMAP diet, but the options do not end there. If spirits are your tipple of choice, the following options are low FODMAP (11):

• Gin 
• Vodka
• Tequila 
• Whisky
• Brandy

Low FODMAP alcoholic mixers  

It’s not just the alcohol part that you need to consider! Many popular mixers are also high in FODMAPs.

Mixed drinks often use fruit juices or fizzy drinks, triggering IBS symptoms due to the fact that they contain FODMAPs. 

Some low FODMAP options are (11):

• Cranberry juice (check for added fructose)
• Club soda
• Schweppes diet ginger ale
• Fever-Tree Indian Tonic Water
• Tomato juice
• Lime juice

It is also worth noting that the UK’s guidelines on IBS management suggest decreasing fizzy drinks to reduce IBS symptoms (12). This advice is not based on FODMAPs, but since the bubbles in fizzy drinks can cause bloating and gas in those who are sensitive.

Long term effects of alcohol on the digestive system

We have provided you with some useful information and tips on how to enjoy alcohol with IBS in the long term. However, it is important to highlight that alcohol can damage the parts of your digestive system, including the mouth, oesophagus, and stomach. 

It can put you at greater risk of developing certain types of cancers, such as mouth and throat cancers. It may also cause damage to the lining of the digestive system and damage the muscles that prevent food from coming back up – this means you can get acid reflux (14).

IBS and alcohol – what is the overall advice?

The British Society of Gastroenterology advises that people with IBS should reduce their alcohol intake. The evidence suggests that people with IBS should try to have less than two units of alcohol per day, having at least two alcohol-free days per week (13).

Please note though, these are general guidelines and will depend on your tolerance, as some people may have a reduced tolerance to others.

Some top tips to reduce alcohol-induced IBS symptoms are: 

1. Avoid drinking alcohol at home
2. Appreciate that the UK alcohol guidelines are general may be too high for someone with IBS.
3. Have alcohol free days or try non-alcoholic alternatives.
4. Drink on a full stomach – this avoids a rapid increase in absorption of alcohol.
5. Opt for flat drinks rather than carbonated – this will reduce the rate at which alcohol is absorbed and may help prevent bloating (1).
6. Try ‘low alcohol’ content drinks.

And of course, if FODMAPs are a problem for you, then pick the low FODMAP options listed above.

Summary 

Moderating alcohol consumption is vital for general health and managing IBS symptoms. 

If you are on a low FODMAP diet, you can still enjoy a drink if you want to. Low FODMAP alcohol options include most wines, beers and many spirits. But don’t forget about mixers – you will need to choose low FODMAP options there too! 

Written by Annabelle Green, Student Dietitian and reviewed by Beth Willson BSc Hons RD, Specialist Dietitian