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Is Alcohol Good or Bad For Gut Health? A Dietitian Explains

If you’ve ever watched the Simpsons before, you probably know that Homer Simpson loves his beer. And you might have even heard him drop this famous line: "Alcohol is the cause of and solution to all of life's problems". And while that may be true for our beloved cartoon character - for those of us living in the real world it might not always be the best advice to follow. And this is especially true when it comes to our gut health. So in this short article, we’re going to look at the 10 main ways alcohol can hurt your gut health and 1 way it may actually help based on the latest scientific research. And if you’re worried that after watching this you won’t be able to enjoy any more vodka beach parties, fear not because we’ll also look at the smartest ways to consume alcohol in a gut friendly way.

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    So is alcohol good or bad for our gut health...and how does it impact acid reflux, leaky gut, IBS and our gut bacteria (the microbiome)?  Well, to answer this question, let's first look at...

    Which parts of the digestive system are impacted by alcohol?

    Now in case you don’t know, when I say digestive system I’m referring to the entire GI tract. It starts in your mouth, continues onto your esophagus, and then your stomach. It then goes to your small and large intestine. And of course, it includes other organs like your liver.

    So pop quiz time…where do you think alcohol is likely to cause damage?

    Not sure…well, here’s the answer…alcohol is a bit like Jordan Belfort in the Wolf of Wall Street: meaning it can disrupt every single thing it comes into contact with. In other words, alcohol has the potential to damage ALL parts of your digestive system.

    And for any of us that have ever drunk a little more than we should, we probably know this. But just to recap them quickly…

    Common gut issues caused by alcohol

    1. Alcohol can cause acid reflux. And this is because it relaxes the esophageal sphincter…which is like the door between your esophagus and stomach. And when it is too relaxed it can send partly digested food and stomach acid…back up to your mouth.
    2. Next up…alcohol can damage the stomach lining,which can lead to inflammation and a painful disorder known as gastritis. And this can potentially even lead to stomach ulcers.
    3. Equally dangerous, alcohol can inhibit production of digestive enzymes & gastric juices. Meaning digestion slows down and food sits around for longer, leading to bloating, gas and even constipation.
    4. On a related note, alcohol can impair nutrient absorption. Which means our bodies have less fuel to keep us energized.
    5. And of course alcohol can damage organs involved in the detoxification process, such as your liver.

    And while all of that sounds pretty bad…guess what?

    In recent years, scientists - ever the party poopers - have discovered even more reasons why alcohol is bad for gut health.

    Other gut issues caused by alcohol

    So in this 2022 paper published in the journal Frontiers in Microbiology 7 researchers reviewed all the existing research on alcohol and gut health. And when our research team here at Essential Stacks was reviewing their findings 3 things stood out that had us both intrigued and a little bit disturbed.

    Alcohol & Intestinal Barrier (Leaky Gut)

    So the first big takeaway was just how much alcohol can damage the intestinal barrier, and potentially lead to leaky gut. And the scary part is that it can do this in 2 different ways…

    • Firstly, alcohol can damage the intestinal mucosa, which is the mucus layer that lines your intestinal tract and acts as the first line of defense in your gut. You can think of it like the protective moat surrounding a castle.
    • And secondly, it can disrupt the tight junctions, which are the gatekeepers of your intestinal wall - they help decide what goes through into your bloodstream and what stays out. And you can think of it like the door or drawbridge into this castle.

    And the big thing for you to know here is that if we drink enough alcohol it can damage the intestinal barrier and potentially create leaky gut syndrome. And this is something to be concerned about.

    After all, leaky gut can lead to an increase in anxiety and depression, as well as bacteria entering the bloodstream, which can in turn cause immune system issues and even mental health issues. Not to mention digestive distress like bloating, diarrhea and gas.

    Alcohol & Microbiome / Good Bacteria (Dysbiosis)

    The next big takeaway we found from analyzing the 2022 paper is that alcohol can mess with your microbiome.  Meaning the good bacteria in your gut.

    As the researchers noted: “alcohol intake is highly correlated with changes in the composition of the gastrointestinal microbiota”. Leading to alcohol induced gut dysbiosis. Meaning a decrease in beneficial bacteria and an increase in harmful bacteria.

    In other words, just like at an office christmas party, alcohol can screw up the internal order of things very quickly!

    Alcohol & Digestive Disorders (eg IBS & IBD)

    And now the third big takeaway and perhaps even more frightening: alcohol might directly cause digestive disorders like IBS and IBD.

    As the researchers noted: “Alcohol may cause IBD and IBS by changing the gut microbiome, disrupting the intestinal barrier, and directly, and indirectly promoting immune activation”.

    And I know all of this sounds pretty depressing, but don’t worry, because now we have some good news. It is possible to drink alcohol, without sacrificing your gut health completely. And to help you do this, we’ll now look at 5 ways to consume alcohol in a gut friendly way.

    1. Drink In Moderation

    Okay, so first up…we want to make sure we drink in moderation. And I know this sounds like the type of boring advice your parents probably gave you when you turned 21. But here’s the thing…

    Most of the studies we’ve looked at in this article detailing the damage of alcohol were describing the damage done by EXCESS alcohol consumption. In other words, if we can avoid binge drinking and chronic heavy drinking, then we are less likely to experience problems in our digestive system.

    So how much alcohol is okay?

    Well, the simplest way to answer this is to look at the USDA’s 2020-2025 Dietary Guidelines for Americans and what we can see is that…

    • Binge drinking is 5 or more drinks within 2 hours for men or 4 drinks for women.
    • Heavy or chronic drinking is more than 4 drinks a day or more than 14 drinks a week for men, and for women 3 drinks a day or more than 7 drinks a week.
    • Meaning if we can drink less than this, we are less likely to experience alcohol induced gut issues.

    Ideally we want to limit our alcohol intake to 2 or less drinks a day for men and 1 or less drinks for women.

    2. Eat Before & During Drinking

    And now the second big idea to make drinking gut friendly is to always eat before you drink and even eat while drinking. This is really important because it slows down alcohol absorption. Meaning it takes longer for alcohol to leave your stomach and enter your small intestine and then bloodstream.

    Not only does this offer some protection for your stomach lining, but it also helps shield the small intestine from the effects of alcohol.

    3. Drink Red Wine

    Another great idea is to choose red wine over other drink options. And that’s because it might actually offer some benefits for our gut health. You see…I told you I had some good news!

    In fact our research team found this 2018 study published in Food Research International, where researchers found the polyphenols in red wine can have a positive impact on the bacteria in your gut and deliver health benefits. And I think we can all cheers to that.

    4. Limit Painkillers

    Next up, it is wise to limit painkillers the day after drinking. In other words, try to avoid taking Ibuprofen and aspirin for a hangover, since they can damage the stomach lining.

    Of course, if you’re following our first idea of drinking in moderation then this naturally shouldn’t be a problem.

    5. Try Probiotics

    And the 5th idea for limiting the impact of alcohol on your gut health is to try probiotics. And this is a very interesting idea, because the researchers from the 2022 paper published in the journal Frontiers in Microbiology found certain probiotics can significantly help with gut inflammation and alterations of bacteria in the microbiome.

    In fact, if you look at the studies they analyzed, there are many different probiotic strains that might help: from Lactobacillus plantarum LC27 to Lactobacillus rhamnosus GG, and even the most famous one of them all Lactobacillus acidophilus NCFM.

    And while some of these studies were only done on animal models, many were done on human subjects. Which gives us a lot of optimism for the future of probiotics and alcohol.

    Fecal Microbiota Transplants

    Speaking of the future in the 2022 paper we’ve looked at there was one more option the scientists recommended. And it’s a little out there, but we felt it worth sharing. 

    Say hello to fecal microbiota transplants or FMTs for short.

    For those of you that don’t know, this involves taking the fecal matter of a healthy subject, and transplanting it to someone with poor gut health - either orally or rectally.

    And when it comes to how it might help with the impacts of alcohol the researchers found FMTs may help with inflammation, digestive disorders like IBS, as well as brain function.

    And I think this is a great idea to finish on because it might just be the best motivation to drink in moderation.

    Evidence Based

    An evidence hierarchy is followed to ensure conclusions are formed off of the most up-to-date and well-designed studies available. We aim to reference studies conducted within the past five years when possible.

    • Systematic review or meta-analysis of randomized controlled trials
    • Randomized controlled trials
    • Controlled trials without randomization
    • Case-control (retrospective) and cohort (prospective) studies
    • A systematic review of descriptive, qualitative, or mixed-method studies
    • A single descriptive, qualitative, or mixed-method study
    • Studies without controls, case reports, and case series
    • Animal research
    • In vitro research

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    1. Chen G, Shi F, Yin W, Guo Y, Liu A, Shuai J, Sun J. Gut microbiota dysbiosis: The potential mechanisms by which alcohol disrupts gut and brain functions. Front Microbiol. 2022 Jul 29;13:916765. doi: 10.3389/fmicb.2022.916765. PMID: 35966709; PMCID: PMC9372561.
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