The Connection Between Alcohol and Digestion Problems

Alcohol’s impact on the brain and liver is well-documented. What you may not know is that alcohol and digestion are also closely related. A healthy digestive system is vital for your overall health, and heavy alcohol use can increase the risk for digestive problems. You can reduce these risks by using safer drinking practices and seeking treatment for alcohol misuse.

Alcohol and Digestion Problems

Research indicates that heavy alcohol use is a risk factor for problems associated with your entire digestive tract.1 The Centers for Disease Control and Prevention (CDC) lists excessive alcohol use as a risk factor for long-term digestive problems.2

Excessive drinking is defined as:

  • 4 or more drinks on one occasion for women
  • 5 or more drinks per occasion for men

Heavy drinking, an extreme form of excessive drinking is defined as:

  • 8 or more drinks per week for women
  • 15 or more drinks per week for men

Excessive alcohol use directly impacts various parts of your digestive system, including the stomach, pancreas, liver, kidney, and intestines.1, 3

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Stomach Problems

When the food you eat reaches your stomach, digestive juices secreted by the stomach break it down. High levels of alcohol can irritate the stomach and increase the digestive juices.

If this irritation happens regularly, it can damage the stomach lining. This can lead to: 3

  • Ulcers
  • Stomach bleeding
  • Irritation
  • Inflammation of the stomach lining

Pancreatitis

Your pancreas is the organ that sends enzymes to your small intestine. These enzymes produce chemical changes so that the small intestine can fulfill its role in metabolizing food.3 Pancreatitis is inflammation of your pancreas that prevents it from functioning normally.

Alcohol disrupts this process so your pancreas creates enzymes prematurely. The enzymes build up in your pancreas instead of being sent to the small intestine. These enzymes actually damage the pancreas and, if you drink heavily over a long period, the continual overproduction and storage of enzymes in the pancreas can cause swelling of tissues and blood vessels.3

Liver Diseases

Most of the processing of alcohol in your body happens in the liver. The liver diseases most closely related to alcohol use are fatty liver and cirrhosis. When the liver breaks down alcohol, the chemicals damage liver cells.1

Chronic heavy drinking causes the dangerous liver inflammation. Constant inflammation increases tissue in the liver, preventing the necessary blood supply from reaching the liver cells. Without the nutrients that the blood supplies to the liver, cells eventually die and are replaced by scar tissue, a condition known as cirrhosis.3

Advanced cirrhosis causes liver failure. Mild cirrhosis can be repaired. Abstinence from alcohol can help prevent further injury to the liver and make alcohol-related liver disease controllable.3

Kidney Dysfunction

Liver disease at an advanced stage can affect how kidneys filter fluids. This prevents electrolytes like sodium and potassium from being absorbed in your body. This is because alcohol can either significantly amplify or reduce blood flow rates through the kidneys.

Alcohol can increase your urine volume and disturb your body’s electrolyte balance.3

Intestinal Inflammation and Hyperpermeability

A healthy gut has a balance between “good” and “bad” bacteria. Research shows that alcohol creates an imbalance of bacteria and bacterial overgrowth. This overgrowth leads to an increase in the release of toxins.

Some research indicates that people with alcohol addiction have increased intestinal permeability. 4

Intestinal permeability means that the barrier between the intestines and the bloodstream becomes weaker. This barrier is important for allowing the absorption of nutrients and preventing the absorption of harmful substances. A weaker barrier can allow fewer nutrients and more harmful substances into the bloodstream.

Alcohol damages the cells of this barrier, making that barrier weaker and causing what’s called a leaky gut. Research indicates that those with alcohol addiction and leaky gut are also more likely to have liver disease. While researchers do not know if intestinal permiability causes or contributes to organ damage, they speculate that there could be a connection between the development and progression of the two conditions.4

Preliminary research also points to a connection between gut inflammation and cancers of the stomach and colon.4

Signs and Symptoms of Alcohol-Related Digestive Issues

While not all alcohol and digestive issues cause observable signs and symptoms, certain warning signs. Inform your doctor if you experience any of these signs and symptoms. Your doctor can perform tests to confirm if you have any alcohol-related digestive health issues and begin treatment.

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Gastrointestinal Bleeding

Symptoms of gastrointestinal (GI) bleeding include:5

  • Fatigue
  • Abdominal cramps
  • Dizziness, faintness, or paleness
  • Shortness of breath
  • Black or tarry stool or blood mixed with stool
  • Blood in vomit or vomit that looks like coffee grounds

Pancreatitis

Symptoms of a pancreatitis attack include:3

  • Abdominal pain that may radiate up the back
  • Sweating
  • Rapid heart rate
  • Fever
  • Nausea, vomiting, and/or diarrhea

Alcohol-Related Liver Disease

Signs of early liver cirrhosis may include:6

  • Nausea and vomiting
  • Pain or discomfort in the upper right side of your abdomen
  • Fatigue
  • Poor appetite
  • Losing weight without suddenly and without an obvious explanation

As liver function worsens, you may have other symptoms, such as:6

  • Bruising and bleeding easily
  • Swelling in lower legs, ankles, or feet
  • Bloating
  • Darkened urine
  • Severe itchy skin, or yellowish skin and whites of your eyes (jaundice)
  • Confusion, memory loss, difficulties thinking, personality changes, or sleep changes

Leaky Gut

There have been some claims that symptoms of leaky gut include pain, diarrhea, or bloating. However, there is no scientific support that an individual can tell that they have leaky gut based on any symptoms without testing by a physician. These symptoms can be associated with various causes, not just leaky gut.7

How to Reduce Alcohol-Related Digestive Issues

The progression of alcohol-related digestive issues can often be reversed or repaired through treatment and lifestyle changes.

Practice Safer Drinking

Reducing your alcohol use and using safer drinking practices can reduce the risks to your digestive health.

Safer drinking practices include:2

  • Avoiding binge drinking, which is 4 or more drinks per occasion for women and 5 or more drinks per occasion for men.
  • Avoiding heavy drinking, which is 8 or more drinks per week for women and 15 or more drinks per week for men.
  • Drinking moderately, defined as 1 drink or less per day for women and 2 drinks or less per day for men.
  • Drinking no more than 1 standard drink per hour as that is what the liver can handle. A standard drink is defined as:
    • 12 oz of beer
    • 8 oz of malt liquor
    • 4-5 oz of wine
    • 5 oz of spirits or liquor
  • Avoiding shots and drinking games because they make it easier to drink excessively. Instead, sip and savor your favorite wine or beer.
  • Following your physician’s alcohol use recommendations based on your medical history and medications.

Safe drinking could also improve your sleep quality. Drinking alcohol close to bedtime might make you feel sleepy, but it keeps you from getting the deep sleep that you need because your body is active in processing the alcohol.8

Chronic alcohol use can lead to disruption of your internal clock. Studies suggest that this can worsen alcohol-related gut leakage.4

Modify Your Diet

If you have digestive complaints, whether or not you know that they are directly related to alcohol use, work closely with a registered dietician (RD) or registered dietician nutritionist (RDN) and your doctor ensure that your diet meets your current health needs.

Preliminary research suggests that oats can reduce gut inflammation and may help counteract some of alcohol’s harmful effects on your digestive system.4

Getting enough vitamins and minerals is also important because heavy alcohol use can reduce your body’s ability to absorb nutrients. This, in turn, harms gut health. Researchers report than people with alcohol addiction are often deficient in zinc, thiamine (B1), and vitamin D.4

Be mindful that while modifying your diet may improve your gut health, changing what you eat cannot stop or repair the effects of chronic heavy drinking without medical intervention, especially if you continue to misuse alcohol.

Get Treatment for Alcohol Misuse

If you have trouble stopping or reducing your alcohol use, seek help. Patterns of problematic heavy drinking often require outside help to change, especially if you are physically dependent on or addicted to alcohol.9

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Alcohol and digestion issues can often be addressed together. Damage from the early stages of liver cirrhosis, for example, can be repaired, and treatment can help you to maintain abstinence or reduced drinking moving forward. About one third of people treated for alcohol misuse have no symptoms of early cirrhosis 1 year later. Many others who get treatment significantly reduce their drinking and report fewer health problems resulting from alcohol.9

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Resources

  1. Shield, K.D., Parry, C., & Rehm, J. (2014). Chronic diseases and conditions related to alcohol use. Alcohol Research: Current Reviews, 35(2), 155-171.
  2. Centers for Disease Control and Prevention. (2021, December 29). Alcohol use and your health.
  3. National Institute on Alcohol Abuse and Alcoholism. Alcohol and you: An interactive body. College Drinking Prevention.
  4. Bishehsari, F., Magno, E., Swanson, G., Desai, V., Voigt, R.M., Forsyth, C.B., & Keshavarzian, A. (2017). Alcohol and gut-derived inflammation. Alcohol Research: Current Reviews, 38(2), 163-171.
  5. National Institute of Diabetes and Digestive and Kidney Issues. (2016). Symptoms and causes of GI bleeding.
  6. National Institute of Diabetes and Digestive and Kidney Issues . (2018). Symptoms and causes of cirrhosis.
  7. Camilleri, M. (2020, August 01). The leaky gut: Mechanisms, measurement and clinical implications in humans. Gut, 68(8), 1516-1526.
  8. Harvard Medicine Division of Sleep Medicine. (2007, December 18). Sleep, learning, and memory.
  9. National Institute on Alcohol Abuse and Alcoholism. (2021, August). Treatment for alcohol problems: Finding and getting help.
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