Crohn's & Booze: Should You Drink Alcohol?

Most articles about Crohn's disease suggest that should you limit the amount of alcohol you drink as part of your "self-care." Some advise little or no alcohol because it can irritate your intestines and trigger a Crohn's flare or assist in triggering a flare. Others note that alcohol in general can make diarrhea worse, so it should be avoided. Alcohol is also a depressant, and people with Crohn's are often stressed and depressed enough by their symptoms without adding an additional depressant.

Many people who have Crohn's are already concerned about the development of colon cancer. In an article elsewhere on AC, I noted that people with an inflammatory bowel disease (IBD) are five times as likely to develop colon cancer as the general public; that fact aside, 90% of people with an IBD will not develop cancer in their lifetimes. Some Crohn's patients may wonder how alcohol fits into this picture.

If you look at a list of risk factors for developing colon cancer, one of those risks is excessive consumption of alcohol. So how do those list makers define excessive? A presentation by Dr. Gurvinder Sethi, MD, at a 2003 conference in Baltimore described excessive drinking as "nine or more drinks made with distilled spirits a week for 10 years or more." He went on to say that a glass or two of wine a week may cut the risk of neoplastic lesions (dyplasias or adnocarcinomas) by nearly two-thirds. In other words, a glass or two of wine a week may help you to avoid colon cancer. About.com, in their 2007 newsletter, said that a 2001 study showed that those who drink alcohol consistently for 20 years have a greater risk of developing colon cancer, but also noted that the risk "appears to be reduced" when wine is part of that alcohol (About.com).

The American Cancer Society (ACS) also links colorectal cancer to "heavy" use of alcohol; they state that one reason is that heavy drinkers tend to have lower levels of folic acid, also discussed in one of my other AC articles as a problem for Crohn's patients. The ACS advises that men have no more than two drinks a day, and women have no more than one (ACS ). An Australian article, "Recent Research About Alcohol and Colorectal Cancer" ( Stockley, Creina S., The Australian Wine Research Institute, 2005, found here) reviewed a number of medical studies and came to this conclusion: "this recent research suggests that there may be a causal relationship between alcohol consumption and colorectal cancer, especially for heavy and excessive consumers of alcoholic beverages such as beer ... [it] also suggests that the moderate consumption of wine may reduce the risk of colorectal cancer" (p.2).

Interestingly, a recent study by Penn State University showed that a 4.5 milligram dose of naltrexone, a drug used to treat addiction to alcohol and opiods, caused an improvement in quality of life, and a decrease in the severity of symptoms, of Crohn's patients (March 28, 2007, here ). The study was reported in the February online issue of the American Journal of Gastroenterology and funded by the National Institutes of Health (NIH). Whether or not this indicates that Crohn's patients absolutely should avoid alcohol is not clear from the study as presented.

Given that Crohn's is also on the list of risk factors for development of colorectal cancer, especially if you have had it for over eight to ten years and it affects a large portion of your small intestine and colon, it doesn't make sense for those wishing to avoid getting cancer to add another risk factor that they could easily avoid. There have been no studies that I could find, either on-line or in medical journals, that looked at the rate of colon cancer in Crohn's patients who consumed alcohol, but most studies say that the more risk factors you have, the more likely you are to develop colon cancer.

It is clear that excessive consumption of alcohol by Crohn's patients should be avoided, but many of them already avoid it because it triggers unpleasant symptoms. Should Crohn's patients who occasionally drink worry about development of colon cancer? Probably no more than they would otherwise, and probably not at all considering the effect worry and stress has on most of us. Instead, we should discuss our diets, including our alcohol consumption, openly with our doctors, get regular colonoscopies after we've had Crohn's for 8 or more years and try to live a lifestyle that is as healthy as possible.