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Alcohol

The question of Drinking Alcohol has been a topic of debate on CrohnsForum.com for quite some time. This Wiki Entry attempts to consolidate and clarify the issues related to Alcohol and Inflammatory Bowel Disease.

The Effects of Alcohol in persons with IBD varies by the type of IBD diagnosis (i.e. Crohn's Disease, Ulcerative Colitis, etc.) and what (if any) Medications a patient may be taking.

* Please Post a "Request for Information" at the Bottom of this Page if you are interested in a Topic we have not yet Addressed.

Contents


Alcohol and Aluminum Toxicity

Silicon containing substances, including Beer, have been suggested to reduce the body's levels of Aluminum, a substance with known toxic effects. [19]

Alcohol and IBD

Alcohol can Alter the Types and Total Number of Bacteria in the GI Tract
- Drinking Alcohol can cause a Microbial imbalance, or Dysbiosis in the GI Tract [1]
---- Alterations in the GI Tract microbial balance can reduce numbers of "good bacteria" and allow the "bad bacteria" to invade mucosa (i.e. Clostridium difficile).
- Drinking Alcohol can increase Total Numbers of Bacteria in the GI Tract.[1]
- See how a Dysregulated Microbial Balance Affects Inflammatory Processes HERE
Alcohol Affects Intestine Permeability "Leaky Gut"
Alcohol increases "Leaky Gut Syndrome" by affecting specialized proteins that help intestinal epithelium cells to attach together. [1] These specialized proteins, including Tight Junction Proteins play an important role in the integrity of the Intestinal Mucosal Barrier. [14]
Chronic Alcohol exposure Increases TNF α
The Pro-Inflammatory Cytokine, Tumor Necrosis Factor alpha (TNF α) is often too high in patients with Inflammatory Disease, including Crohn's Disease. TNF α is a powerful mediator of Inflammation, and is the target of several new drug treatments (ex. Cimzia, Humira, Remicade). Chronic exposure of Immune Cells to Alcohol increases production of TNF α and may exacerbate diisease pathology.[20]

Alcohol Effects Specific to Crohn's Disease (CD)

Crohn's Disease (CD) causes symptoms that are typically due to an interaction between an Impaired Immune Response to Infection coupled with an Exacerbated Inflammatory Reaction. Often, once a Crohn's "Flare" begins, a vicious cycle of Inflammation ensues.
Crohn's Patients have Hyper-Active Immunity to Yeast
- Crohn's Patients have Hyper-Immune Response to different strains of Yeast. Crohn's patients had significantly more Antibodies to Saccharomyces cerevisiae (Baking Yeast and Brewer's Yeast Strains) than Ulcerative Colitis patients and persons that did not have IBD. [2]
---- Crohn's Patients Antibody Levels are Increased to the Following S. cerevisiae Strains of Yeast (vs. Controls):
Brewing Yeast: Lager Strains
NCYC 1526 [2][3]
NCYC 1324 [2][4]

Brewing Yeast: Ale Strains
NCYC 1108 [2][5]
NCYC 240 [2][6]
NCYC 1026 [2][7]

Brewing Yeast: Distilling Strains
NCYC 87 [2][8]
NCYC 431 [2][9]

Brewing Yeast: Wine Strains
NCYC 177 [2][10]
NCYC 478 [2][11]

Baking Yeast
NCYC 77 [2][12]
NCYC 79 [2][13]
*NCYC 79 is also known as Fleischmann Baker's Yeast [13]

Alcohol Effects Specific to Ulcerative Colitis (UC)

Ulcerative Colitis (UC) Patients Do Not have Hyper-Immune Reactivity to Yeast
- The Hyper-Immune response to Baking Yeast and Brewer's Yeast seen in Crohn's Disease patients is Not seen in patients with Ulcerative Colitis (UC) [2]

Medication: Steroids / Prednisone and Alcohol

Generally, there is no specific "Drug Interaction" or "Drug Potentiating Effects" between Alcohol and Prednisone like there is for most Pain Medications. However, Drinking Alcoholic Beverages when on Steroids is not recommended (even for patients that do not have IBD) and can lead to multiple different effects:
Alcohol and Prednisone can lead to Gastrointestinal Damage
Alcohol and Steroids (Prednisone) both Increase Risk of Ulcers
- Glucocorticoids have been shown to increase the risk of ulcers especially when taken for long periods of time. [15]
- When Steroids are taken in combination with Alcohol the risk of Gastrointestinal Ulcers and Gastrointestinal Bleeding increases [16]

Alcohol and Steroids (Prednisone) both Increase "Leaky Gut"
The Barrier Cells that help separate material between the Intestinal Lumen (Containing Feces, Microbes, Nutrients, etc.) and the Body's Interior can become slightly "Leaky" due to Alcohol and Steroid intake. This is caused by the connections between the Barrier Cells weakening.[citation]

Stress or Glucocorticoids (Prednisone) can Increase Likelihood of Alcoholism or Drug Addiction
Exposure to Alcohol or Drugs during periods of Stress and/or during high dose Steroid (Prednisone) Administration increases the risk of Dependence on the Alcohol (or Drug). The suggested mechanism of this Alcohol or Drug Dependence is though to be due to an interaction between the Stress Hormones and the Brain's "Reward Pathway". [18]

Alcohol and Antibiotics

Certain Antibiotics should not be taken with Alcohol because they might interact with each other and/or the body systems that detoxify the alcohol or medication. This can lead to different effects depending on the medication involved. For more information on specific Antibiotic interactions with Alcohol please click the medication of interest below:
Flagyl - Metronidazole

References

1. Szabo G, Bala S, Petrasek J and Gattu A. Gut-Liver Axis and Sensing Microbes. Digestive Diseases: Pathomechanisms of Alcohol Induced Damage. 2010;28:737744. http://content.karger.com/ProdukteDB...=000324281.pdf
2. McKenzie H, Main J, Pennington CR, and Parratt D. Antibody to selected strains of Saccharomyces cerevisiae (baker's and brewer's yeast) and Candida albicans in Crohn's disease. Gut. 1990; 31(5): 536-538. Accessed June 2012. http://www.ncbi.nlm.nih.gov/pmc/arti...00599-0060.pdf
3. Saccharomyces cerevisiae NCYC Strain 1526. http://www.ncyc.co.uk/yeast-ncyc-1526.html
4. Saccharomyces cerevisiae NCYC Strain 1324. http://www.ncyc.co.uk/yeast-ncyc-1324.html
5. Saccharomyces cerevisiae NCYC Strain 1108. http://www.ncyc.co.uk/yeast-ncyc-1108.html
6. Saccharomyces cerevisiae NCYC Strain 240. http://www.ncyc.co.uk/yeast-ncyc-240.html
7. Saccharomyces cerevisiae NCYC Strain 1026. http://www.ncyc.co.uk/yeast-ncyc-1026.html
8. Saccharomyces cerevisiae NCYC Strain 87. http://www.ncyc.co.uk/yeast-ncyc-87.html
9. Saccharomyces cerevisiae NCYC Strain 431. http://www.ncyc.co.uk/yeast-ncyc-431.html
10. Saccharomyces cerevisiae NCYC Strain 177. http://www.ncyc.co.uk/yeast-ncyc-177.html
11. Saccharomyces cerevisiae NCYC Strain 478. http://www.ncyc.co.uk/yeast-ncyc-478.html
12. Saccharomyces cerevisiae NCYC Strain 77. http://www.ncyc.co.uk/yeast-ncyc-77.html
13. Saccharomyces cerevisiae NCYC Strain 79. http://www.ncyc.co.uk/yeast-ncyc-79.html
[pos][14a][/pos][14] Laukoetter MG, Nava P and Nusrat A. Role of the intestinal barrier in inflammatory bowel disease. World J Gastroenterol. 2008; 14(3): 401-407. http://www.wjgnet.com/1007-9327/pdf/v14/i3/401.pdf
15. http://www.jpp.krakow.pl/journal/arc...s7_article.pdf
16. Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007., p. 946
17.
18. Wand G. The influence of stress on the transition from drug use to addiction. Alcohol Research & Health 2008; 31(2): 119-136.
19. Toxic Substances Portal. Aluminum. ATSDR. Agency for Toxic Substances and Disease Registry. CAS#: 7429-90-5. Updated September 2008. Accessed September 2012. http://www.atsdr.cdc.gov/toxprofiles/tp22.pdf
20. Gobejishvili L, Barve S, Joshi-Barve S, McClain C. Enhanced PDE4B expression augments LPS-inducible TNF expression in ethanol-primed monocytes: relevance to alcoholic liver disease. Am J Physiol Gastrointest Liver Physiol. 2008; 295(4): G718G724. http://www.ncbi.nlm.nih.gov/pmc/arti...port=printable

Popular Threads Discussing Alcohol



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06-27-2013, 08:44 PM   #1
kss
Senior Member
 
Join Date: Oct 2011
Location: Fort Collins, Colorado
I'd like to point out some results from Crohnology.com about beer. In the survey they conduct on new users it was found that "No Beer" is the most effective of all the questions asked about diet. "No Beer" was even more effective than "no spicy food" and "no dairy". At the time of this writing the data was based on 753 responses. I belive they update every time someone new joins the site. You can see the results here:
https://www.crohnology.com/treatments
__________________
Crohn's Disease diagnosed in 2001
Remicade + Azathioprine until 2006
Small bowel resection in 2007
Currently no prescription meds just vitamins and low gluten and nearly vegan diet + exercise
Erythema nodosum 2012-2013
11-06-2013, 03:46 PM   #2
crow
 
crow's Avatar
 
Join Date: Nov 2013
Location: Wellington, New Zealand
I can't drink at all now. I don't even risk the occasional glass of red wine or G&T, much as I'd love the latter with summer approaching. Sigh. But all in all I don't miss it much. Probably healthier for it, perversely.
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