Gastrointestinal (GI) disorders may affect around 40% of people worldwide, according to one recent study. GI disorders can include several conditions, including celiac disease, gastritis, Crohn’s disease, ulcerative colitis, irritable bowel syndrome and others. It also includes disorders affecting intestinal motility that result in constipation or diarrhea. 

In the U.S. alone, about 60 to 70 million people are living with a gastrointestinal disorder, according to the National Institute of Diabetes and Digestive and Kidney Diseases. But it’s not just that GI disorders are common—they can also be very frustrating for folks experiencing them.

For those with a gastrointestinal disorder, food and beverages can become the bane of their existence. It can be difficult to know sometimes which foods and drinks are the real culprits, since we usually eat several foods, spices, ingredients and beverages together. 

Then there’s alcohol. Research is mixed on its overall health effects. Regarding how it affects people with GI disorders is just as confusing. That’s why researchers from Italy and France wanted to take a closer look—specifically, at wine and GI disorders. They recently published their findings in Nutrients. Let’s break down what they discovered.

How Was This Study Conducted?

This study is a narrative review. This means that researchers set certain criteria, searched databases for studies that met those criteria, and then reported on what the studies found. Researchers wanted to determine if wine positively or negatively influences the incidence and severity of disorders associated with gastrointestinal diseases.

The challenge with this topic—wine and GI disorders—was that there are very few studies done to date. However, some of the ones that met their criteria included large populations, which helps provide some useful information. 

What Did This Study Show?

Researchers broke this review down according to specific gastrointestinal conditions. Though they weren’t able to find much research on the connection between wine and celiac disease, the team was able to observe connections for those with gastritis, colitus and other conditions. Here’s what they found:

• Gastritis includes conditions related to inflammation of the stomach lining due to a variety of reasons, from infections to stress. Based on one study, researchers observed that moderate beer and wine intake was associated with a lower risk of chronic atrophic gastritis in elderly people compared to those who don’t drink beer or wine at all.
• Gastroesophageal reflux disease (GERD), it’s a condition in which stomach acid sloshes up into the esophagus. Of the four studies in this review, only one used participants with GERD. The others tested healthy people without the condition. Based on the findings, researchers recommend abstaining from alcoholic beverages, especially in the absence of treatment—and even then, it’s a good idea to avoid alcohol. 
• Inflammatory bowel diseases (IBD) include Crohn’s disease and ulcerative colitis. Studies on IBD and wine intake are all over the place—some claiming no effects from wine consumption, others claiming it has negative consequences and still others saying that it may have positive effects. With that said, there is more evidence leaning toward alcohol intake exacerbating GI symptoms for folks with Crohn’s or ulcerative colitis.
• Irritable bowel syndrome (IBS) symptoms related to wine and other alcoholic beverages seem to depend on the amount and type of alcohol you drink. Some studies found that light to moderate consumption had little to no effects, but binge drinking led to worse symptoms the next day. Other studies showed that 31% to 43% of participants with IBS had worsening GI symptoms after consuming alcoholic beverages, regardless of the type and amount consumed.
• Microscopic colitis is a chronic inflammatory disease of the intestine that requires microscopic examination of the tissue for diagnosis. Based on the included studies, alcohol consumption was found to be proportionally associated with the risk of microscopic colitis, with the risk being greater with wine. 
• Gastrointestinal motility refers to the movement of the digestive system. Several conditions, including dyspepsia, fall under this umbrella, but the researchers found conflicting evidence for just about all of them. In particular, studies are mixed on whether alcohol worsens or relieves symptoms like constipation. But it’s worth noting that alcohol can influence the gut microbiota—the colony of bacteria and other microorganisms living in your gut. When your microbiota is out of balance, it can promote constipation or diarrhea.

Based on their analysis, these researchers concluded that for people with GI disorders, consumption of any alcoholic beverage, including wine, must be carefully considered based on disease, symptoms and tolerance. They add that for some, complete abstinence is recommended, while others may be able to imbibe occasionally in moderation. 

Any time several studies are reviewed on the same topic, there will be mixed results. This is because no two studies are done exactly the same, with the exact same population, demographics, confounding factors and study design. The best researchers can do is to find studies that most closely meet their criteria, analyze the data and report what they find. 

Limitations of this review include the small number of studies that met the criteria. Researchers also state that it’s nearly impossible to eliminate all biases, including lifestyle and genetic factors that can skew results. Then there’s recall bias—how people remember how much they drank—many of us tend to low-ball it. 

How Does This Apply to Real Life?

One area these researchers were surprised was not covered more in the included studies was the gut microbiota (also referred to as the microbiome) and how alcohol consumption affects it. We know that the gut plays a starring role in many aspects of health and disease. Researchers point out a small study that found those with ulcerative colitis had dysbiosis—an imbalanced gut microbiota. 

While it’s a sort of a chicken-and-egg dilemma figuring out which came first—the GI condition or dysbiosis—the other question is, how does alcohol affect both of those? This review provides some answers regarding GI diseases, though they are far from being clear-cut. 

Whether or not to imbibe is a personal choice. Having an occasional beer, glass of wine or cocktail is probably not a problem for many—though “occasional” is a relative term. You must assess your own situation, health and history, including why you’re drinking. 

Whether you include alcohol in your life or not, taking care of your gut’s microbiota is important. There are two main categories of foods you want to include: fermented foods, which place beneficial bacteria (probiotics) into your gut, and fiber-rich foods (prebiotics), which provide food for those bacteria to eat so they thrive and multiply. 

Fermented foods include yogurt, kefir, sauerkraut, kimchi, miso and tempeh. Make sure the sauerkraut comes from the refrigerated aisle, not the shelf-stable kind. Or make it yourself. The yogurt and kefir are ideally plain, with no added sugar. Add them to your smoothies or sweeten them with fresh fruit or a little bit of pure maple syrup or honey if needed. 

To feed your beneficial bacteria,eat plenty of foods containing fiber, including fruits, vegetables, whole grains, nuts, seeds and legumes. Need some inspiration or guidance? Try our 30-Day Gut-Healthy Meal Plan for Beginners. You can follow it as designed, or pick and choose recipes and ideas that fit your lifestyle and preferences.  

Foods to avoid or limit for a healthy microbiota include added sugars, highly processed foods and processed and red meat.

The Bottom Line

A new review of studies found conflicting evidence regarding a connection between wine and GI disorders, though researchers recommend limiting your alcohol consumption to be on the safe side. If you have a GI disease, it’s important to identify foods, spices and beverages that exacerbate your condition. If you’re unsure, make an appointment with a healthcare professional—if possible, one who specializes in your condition—to help you untangle the confusion.