The answer could be both. Excessive drinking for a long period can cause a range of problems including alcoholism, cirrhosis, and neurological problems.
On the other hand, people who drink modest amounts of alcohol have a lower risk of developing heart disease.
The issues surrounding ulcerative colitis (UC) and drinking alcohol are even trickier. The answer, just like the disease itself, is complicated.
On one hand, a very large older study examining the outcomes of more than 300,000 patients suggested that alcohol may actually have a protective effect. The study came to two main conclusions:
- Coffee intake doesn't relate to UC flares.
- Alcohol consumption before a UC diagnosis may lower a person's risk for developing the disease.
Although the study had its limitations, it did raise an interesting question: Can alcohol have a protective effect on UC?
On the other hand, one study found that alcohol and alcoholic byproducts aggravate inflammatory responses in the gut and make UC worse.
The same researchers in another study found that one week of alcohol consumption decreased protective molecules in the gut and increased bowel permeability, both of which are markers of worsening UC.
An older study in Japan found that smoking and alcohol were both independently associated with UC flares.
People who drink alcohol with UC will experience different outcomes. Some people experience relapse in the form of a severe, acute attack. Others will be at a higher risk of chronic liver injury and ultimately liver failure. A buildup of toxins that damage the gut and liver lining, can cause a substantial liver injury.
Others experience an increased risk of symptoms such as:
- nausea
- vomiting
- upper gastrointestinal bleeding
- diarrhea
Alcohol may also interact with the medication you're taking. This means it can alter the excretion of active drug molecules, leading to liver damage and complications.
The current recommendation is that people with UC should avoid alcohol and smoking.
That said, it's not entirely clear from the existing data that modest alcohol consumption is a major trigger for relapse. It's likely best to avoid alcohol consumption when possible and limit consumption when you do drink.