COVID-19 and Alcohol: Am I drinking too much?

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Let’s take a look at how Covid-19 and Alcohol consumption can aggravate GI issues (or create new issues altogether). Since the beginning of the COVID-19 pandemic in 2020, people everywhere saw their lives and daily routines change significantly. One of these shifts has proven to be a tendency to drink more alcohol, and while drinking in moderation can be fairly harmless, excessive consumption can lead to a plethora of bodily problems, especially in the gastrointestinal system. Irritable bowel syndrome, for example, is an extremely common functional gut disorder, and the prevalence of IBS in Canada is quite high (18% versus 11% globally).

How does alcohol affect my gut?

Alcohol can have a different effect depending on the individual, as everyone has different drinking habits, as well as different IBS triggers. For some, an evening including a few drinks can be no issue, while for others, a sip of wine can be enough to send them running for the washroom.

Drinking alcohol is known to slow the digestion of carbohydrates in the digestive system, much the same way high FODMAP foods do, producing gas and other irritating byproducts. Additionally, alcohol interferes with gastric acid secretion and with the activity of muscles surrounding the stomach. Alcohol can even impair muscle movement in the large and small intestine, often contributing to diarrhea as a result. Lastly, alcohol limits nutrient absorption in the small intestine and increases transportation of toxins across the intestinal wall (Bode, 1997). While drinking is societally accepted, it is so important to remember that alcohol is in fact a neurotoxin, with direct effects on nerve cells and the brain itself (The Neurotoxicity of Alcohol, n.d.).

It’s quite the list of negative effects from drinking, isn’t it? While abstaining completely is ideal, that idea doesn’t necessarily fit the lifestyle of most. Just remember to be mindful of your consumption.

How has the pandemic affected alcohol use and alcohol-related GI and liver diseases?

Waihong Chung, MD, PhD, of the Warren Alpert Medical School at Brown University in Providence, Rhode Island conducted a system-wide hospital audit during the lockdown and subsequent reopening phases of the pandemic. Inpatient consults surged significantly for alcohol-related GI and liver diseases when COVID-19 began in 2020, and these numbers still remain high. The number of endoscopic interventions required increased as well, suggesting a worsening trend in severity. Many people struggled with a number of negative psychosocial impacts as a result of the pandemic and the lockdown orders.

“When we went into lockdown, many people experienced significant negative impacts, such as social isolation, job loss and an increase in anxiety and depression,” said Chung. “These experiences may have led people to increase their alcohol consumption, which could explain why we are seeing a surge in the volume of consultations for alcohol-related diseases.” Chung’s team used the data gathered during the pandemic and compared it to data gathered in 2019 from the same time period in order to find the changes in disease burden for alcohol-related GI and liver conditions.

Interestingly enough, the total number of GI consults dropped by 27% during lockdown, due to the restrictions in hospital visits (if people weren’t in severe pain or discomfort, they were unlikely to go to the hospital). When it comes to alcohol-related consults for GI and liver diseases, there was a sharp increase by 59.6% (this includes disorders like hepatitis, cirrhosis, pancreatitis, and gastritis). During the initial reopening phase of lockdown, these consults remained even more significantly elevated at 78.7%.

The majority of admissions for these alcohol-related issues were clustered around weeks five, six, and seven of lockdown. This is roughly the length of time it takes for symptoms to appear for these diseases, indicating that excessive drinking began for most people at the beginning of the lockdown. Additionally, while these numbers are high, they may still be underrepresented. Many people might not show symptoms right away, and may not be admitted to a hospital as soon as they should be (Chung et al., 2021).

COVID-19 and Alcohol: Can Alcohol Affect my Immune System?

Research has proven that alcohol disrupts immune pathways in a number of different ways. These disruptions can reduce the body’s ability to defend itself against infection. They can also be a contributing factor for organ damage associated with alcohol consumption. Lastly, these disruptions can also slow down recovery from tissue injury.

Alcohol has a very specific effect in the gastrointestinal system which affects the immune system. Alcohol alters the relative abundances of microbes in the gut microbiome, which is an extensive community of microorganisms in the intestine that aid in normal gut function. These organisms affect the function of the immune system. Alcohol actually disrupts the lines of communication between these organisms and the intestinal immune system. If you are already suffering from an autoimmune disease such as Inflammatory Bowel Disease, complete abstinence from alcohol is highly recommended, so as not to exacerbate this existing issue (Sarkar, D., 2015).

Is it Safe to Drink Alcohol after the COVID-19 Vaccine?

There is no official government recommendation on drinking alcohol before or after any of the COVID-19 vaccines. However, while there is no evidence that drinking alcohol affects the efficacy of the COVID-19 vaccine or causes any unwanted health effects, some doctors advise against drinking alcohol 48-72 hours after vaccination as this is the usual period one might expect common and usually mild after effects of vaccination, like fatigue, muscle aches, injection site pain, and the like.

How can I ensure I’m drinking responsibly?

While there are general guidelines applicable to most people, it’s important that you listen to your own body first and foremost.

  • Always remember that ultimately, alcohol isn’t good even for completely healthy people. If you already have GI issues, abstaining entirely is best.
  • If you choose not to abstain, keep your drinking to a minimum. Track your standardized drinks, and try not to exceed one per hour.
  • For every alcoholic beverage you have, drink a glass of water to match it. Staying hydrated helps dilute the alcohol content and ease some of the irritating effects on your stomach.
  • Be sure to eat something before (and during) your consumption, to slow the absorption of alcohol and allow your body to process it more efficiently (CDHF, n.d.).

During these strange pandemic times, it’s more important than ever to be mindful of your alcohol consumption. Be smart – your gut will thank you later!

References

Alcohol and IBS. (n.d.). CDHF. https://cdhf.ca/health-lifestyle/alcohol-and-ibs/

Bode, C.(1997). Alcohol’s Role in Gastrointestinal Tract Disorders. https://pubs.niaaa.nih.gov/publications/arh21-1/76.pdf

Chung W, et al. (2021). Increased burden of alcohol-related gastrointestinal and liver diseases during the COVID-19 pandemic: A hospital system-wide audit. DDW; Abstract 436.

Sarkar, D. et al. (2015). Alcohol and the Immune System. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/

The Neurotoxicity of Alcohol. (n.d.). https://pubs.niaaa.nih.gov/publications/10report/chap02e.pdf