ALCOHOL & THE GUT: THE WHAT, THE WHY, AND THE WHAT TO DO ABOUT IT.
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IS ALCOHOL BAD FOR YOUR GUT?

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A lot of us like to participate in “dry” January or a temporary fast from alcohol, and this trend is growing across continents. Here's a little more about how a little break from booze might have other benefits—besides just recovering from the holiday season!

I’d like to start by saying that I DO love alcohol. I’d even go so far to say that alcohol is the thing I try to scale back from the most in my diet when I feel like it’s time for a reset (me + pinot have a hot and cold relationship, my husband likes to say). OK, after that context, here it goes: read on for a high-level review of alcohol and your gut.


HOW DOES ALCOHOL CONSUMPTION AFFECT THE GUT?

When you drink alcohol, your intestinal tract is the first point of contact.1 From there, it goes through your circulation (making a fun stop at our brains, giving us that “feel good” feeling that keeps us coming back for more) and eventually ends up taking the portal vein to your liver, where it gets metabolized or broken down.1 

In general, if you are drinking 2 or less drinks in a 3-4 hour period a few times a week (called in the science world as “social drinking”) the research indicates that alcohol does minimal damage to a healthy gut.1,3 Your body has a normal way of executing the pathway above and, as long as your liver makes enough ADH (alcohol dehydrogenase – the enzyme that helps metabolize alcohol),3 it can support periodic social drinking. But when we drink MORE than 2 drinks in a night, that’s where it starts to get ugly1...

Simply put, excess alcohol affects the gut in 4 ways.

  1. Alcohol changes the microbiome makeup.2,3,4 Studies have shown that after just 2-3 days of excess drinking in a row, a meaningful change in the gut flora takes place. Specifically, there is a significant increase in pathogenic bacteria and bacteria that produce inflammation, and a significant decrease in bacteria that fight infection and inflammation. In other words, with excess alcohol consumption, your body’s defenses are compromised and “open” for attack, and it happens pretty quickly. Uh oh!
  2. Alcohol injures the intestinal wall, causing “hyperpermeability.”1,3 Your stomach and gut lining are extremely high-tech, and serve a number of important and sophisticated functions. One of the most important things your intestinal wall does is guard against the unwanted intruders by not letting them enter. Alcohol impairs the lining, and after even a couple drinks it starts to do some real damage, especially if you do this a few days in a row. When the wall gets injured, it doesn’t do its job as well (duh), so things like bad bacteria are able to enter (aka you are at increased risk for getting sick) AND compounds get into your bloodstream that can trigger and ignite inflammation when they land (which could be anywhere in your body!). This inflammation is called “chronic inflammation,” and it can cause all kinds of non-specific symptoms overtime, like chronic sore joints and swelling around the belly. People often don’t connect this with the alcohol they’re drinking, and write it off as “normal aging” when it really isn’t.
  3. Alcohol inhibits normal production of digestive enzymes and juices1,3 (BTW, I wish science could have found another name for this bodily fluid besides “juices,” don’t you?) Your gut releases these enzymes and juices to break down food. Without them, your food would just sit there undigested. Undigested food not only damages the stomach lining on its own (see point #2 above for why THAT’S harmful), it also ferments quickly, kind of like a cut up apple on the counter. When that happens, your body will produce unwanted gases as a byproduct. That’s why after a night of excessive fun you may experience loose stools, smelly gas, and bloating – not so fun anymore is it! Ewwwwwwww…
  4. Alcohol disrupts normal expression of “circadian clock genes” in the gut.1,3 As if loose stools weren’t enough, excess alcohol really takes the cake as your most toxic relationship because of what it does to your sleep.  Circadian clock genes and proteins manage your sleep patterns, and the majority originate in your gut. Not surprisingly, since alcohol meaningfully disrupts this process, you just can’t get a good rest after a long night of drinking. Worse, it can take days for your body to “reset” and get back to normal. And for some more sensitive individuals, even moderate drinking can cause sleep disruptions. How wonderful!

In summary, as much as it's not a truth many of us want to hear, too much alcohol wreaks havoc on the gut. It causes inflammation in and outside the digestive tract, it increases the risk of infection and indigestion, and it even messes with your sleep. Luckily, it looks like all these deleterious things only happen when you drink more than a few times a week and/or more than 2 drinks at a time. (Though the exact amount will be different for every individual – some may experience these effects with even less). So, there’s no question we should all be drinking in moderation if we want to have a happy, healthy gut. 

DISCLAIMER – how your individual body responds to alcohol might be different. Not everyone has the same response, so you might only be able to stomach 1 drink OR you might be able to push it to 3 with minimal side effects. Two drinks was the average in these studies, so figure out what it is for you by listening to what YOUR body tells you and watching your symptoms when you imbibe. #followyourgut

OK, SO WHAT CAN WE DO ABOUT IT?

It’s obvious, but staying sober for most of the week and, when you do drink, keeping your drinks to less than two is probably the best option. Though these haven’t been hugely studied, I’d imagine taking breaks from drinking (Hello, Dry January!) wouldn’t be a bad idea either, provided you don’t overcompensate with 10 drinks the night you dive back into your old ways. But there are other ways you can boost gut health too. There ARE foods that can likely help your gut recover after a big night out:

  • The probiotic lactobacillus.1,6,8 After alcohol, this is the bacteria that seems to be the most “annihilated,” and its metabolites (these are the compounds the bacteria make) are known to be very protective against “bad” bacteria, inflammation, and infection. You can find lactobacillus in many probiotic supplements, but probably the best place to get them (because there will be varying types) is from fermented foods – water kefir, kombucha, sauerkraut, and dairy kefir usually ALL have significant lactobacillus or lactobacillus metabolites in them. This may very well be why people report a feeling of “post-alcohol” benefit when drinking kombucha. 
  • Prebiotics.1,5,6,7 Prebiotics are the foods that your native gut bacteria (the good guys) eat, like fruits and veggies, fibers, and fermented foods. By eating prebiotics, you’re basically creating a supple environment for the good bacteria to grow and thrive. This may also be a big reason people report a feeling of “post-alcohol” benefit when drinking kombucha. 
  • Oats.1,6,7,8 Studies have only been done in rats, but there is quite a bit of evidence that demonstrates oats can significantly reduce the harmful impacts of too many doses of booze. This needs more exploration, but perhaps there’s just something about oats?
  • Coconut oil and butter.1,5,8 This one may sound counter-intuitive, but in general the research supports that certain SATURATED fats, like real butter and coconut oil, seem to offer protection to the stomach lining after alcohol and protect it from being overly disrupted. Greasy breakfast, anyone?
  • Zinc and Vitamin D.1,5 As far as I know, there haven’t been a ton of studies on supplementing with zinc and vitamin D post alcohol exposure, but we DO know that 1) these nutrients are associated with reducing inflammation and infection, and 2) the days AFTER drinking are correlated with significantly lower levels of these nutrients in our blood. Perhaps supplementation could help with the deleterious effects of alcohol, at the very least bringing us back to our “normal” pre-bender numbers.

Alright, I hope you learned a thing or two about alcohol and the gut. Looks like we have good reason to keep consumption around 2 drinks when we “holiday” this holiday season. And if we don’t, drink your ‘booch, take your zinc + vitamin D, and make some coconut- butter oatmeal in the morning. And, join us for Dry January!  

As always, FOLLOW YOUR GUT! We are all different, so you gotta tap into YOU to find out what makes your gut happy and healthy.  

**

  1.  Sheena Patel, et al. Alcohol and the Intestine. Biomolecules. Dec 2015; v.5(4).

  2. Mutlu E.A., et al. Colonic microbiome is altered in alcoholism. Am. J. Physiol. Gastrointest. Liver Physiol. 2012;302:G966–G978. 

  3. Faraz Bishehsari, M.D., Ph.D et al,. Alcohol and Gut-Derived Inflammation. Alcohol Research Magazine. 2017; 38(2): 163–171.
  4. Bull-Otterson L, et al. Metagenomic analyses of alcohol induced pathogenic alterations in the intestinal microbiome and the effect of Lactobacillus rhamnosus GG treatment. PLoS ONE. 2013;8:e53028. 
  5. Roberfroid M., et al. Prebiotic effects: Metabolic and health benefits. Br. J. Nutr. 2010;104:S1–S63. 
  6. Nanji A.A., et al. Lactobacillus feeding reduces endotoxemia and severity of experimental alcoholic liver (disease) Proc. Soc. Exp. Biol. Med. 1994;205:243–247.
  7. Yan A.W., et al. Enteric dysbiosis associated with a mouse model of alcoholic liver disease. Hepatology. 2011;53:96–105. 
  8. Forsyth C.B., et al. Lactobacillus GG treatment ameliorates alcohol-induced intestinal oxidative stress, gut leakiness, and liver injury in a rat model of alcoholic steatohepatitis. Alcohol. 2009;43:163–172. 

Today’s blog written by our very own Daina Trout, MS, MPH

Daina is our not just our Co-Founder and Chief Mission Officer, she is also our in-house nutritionist that has spent her adult life dedicated to finding and sharing health and wellness through food. With 2 masters’ degrees in nutritional biochemistry and public health, Daina has called upon her education often while leading the way at Health-Ade – from how we make every batch of kombucha, to how we talk about gut health to consumers, to even how healthy our employee workplace is! She even writes a few blogs here and there. Happy reading! :)

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