How Can Drinking Alcohol Affect Ulcerative Colitis?
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How Can Drinking Alcohol Affect Ulcerative Colitis?

Can you drink alcohol with ulcerative colitis? Learn how alcohol may affect your symptoms and what to avoid if you do drink.
How Can Drinking Alcohol Affect Ulcerative Colitis?
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Published on May 27, 2025
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While research on alcohol is evolving, the Centers for Disease Control and Prevention says drinking less or not at all is better for your health.

If you have ulcerative colitis (UC), you probably have a good idea of what foods and drinks to avoid to keep your symptoms at bay. But where does alcohol fit into that mix?

How alcohol affects people with UC varies from person to person. Research shows many people with UC steer clear of alcohol because they feel it worsens their symptoms and could even lead to a flare. It’s important to know how alcohol and UC interact and whether it’s safe to drink with this condition.

How Alcohol Affects Ulcerative Colitis

More research is needed to know exactly how alcohol interacts with UC, says Jill Gaidos, MD, a gastroenterologist at Yale Medicine in New Haven, Connecticut.

But what is known is that alcohol can damage the intestinal lining and inhibit the immune system from functioning well.

 It can also disrupt the balance of good bacteria in your gut, says David Gardinier, RD, a registered dietitian with the Cleveland Clinic Center for Human Nutrition and a member of the National Scientific Advisory Committee (NSAC) of the Crohn’s & Colitis Foundation. “All of these shifts negatively affect ulcerative colitis.”
“[Alcohol] may worsen symptoms such as diarrhea, bloating, abdominal pain, and acid reflux,” Dr. Gardinier adds. And drinking consistently over a long period can cause bacterial overgrowth in the gut, which may be connected to increased gut inflammation and can lead to flares and more intestinal damage.

The alcohol in these beverages may not be the only symptom-causing culprit. “Alcohol often contains sulfur compounds, especially beer and white wine. These compounds have been linked with disease relapses for patients with ulcerative colitis, and may contribute to the increased risk of flare-up seen with high alcohol consumption,” says Gardinier.

Added sugars in alcoholic beverages can also worsen symptoms, says Dr. Gaidos.

Not only can alcohol heighten your UC symptoms, but it may also further increase your risk of cancer. “Alcohol is classified as a class 1 carcinogen by the World Health Organization due to its link to increased risk of cancer, including colorectal cancer,” says Gardinier. UC itself already increases your risk of colorectal cancer,

 and decreasing alcohol consumption can help mitigate that risk, he adds.

Is It Safe to Drink During an Ulcerative Colitis Flare?

If you’re having a UC flare, it’s best to avoid alcohol. “In the setting of a flare, the intestines can be even more sensitive to food and drinks that are not normally troublesome,” says Gaidos. Drinking during a flare can even elevate your risk of bleeding and malnutrition.

Alcohol can also increase diarrhea during a flare, says Gaidos. Diarrhea, as well as alcohol consumption itself, can both lead to dehydration. “[Instead], focus on hydration with electrolyte drinks or rehydration solutions and avoid alcohol in the setting of a flare,” says Gaidos.

Does Alcohol Interact With Ulcerative Colitis Medication?

Some medications may not work as well when you drink alcohol.

 Medications with a higher likelihood of negative interactions with alcohol include:

  • acetaminophen (Tylenol)
  • methotrexate (Rheumatrex)
  • metronidazole (Flagyl)
  • cyclosporine (Sandimmune)
  • diazepam (Valium)
  • phenobarbital (Luminal)
  • propranolol (Bedranol)
  • warfarin (Coumadin)
Other groups of medications can be disrupted by alcohol, including cephalosporins (an antibiotic class), as well as IBD medications including 5-aminosalicylates like mesalamine (Asacol) and tumor necrosis factor (TNF) inhibitors (a class of biologics).

“Some medications can cause an increase in liver enzymes (such as azathioprine), but more concerning is that we have seen a frightening increase in the number of young people with severe liver disease due to alcohol consumption over the past few years. For that reason, I recommend limiting alcohol intake for all of my IBD patients,” says Gaidos.

Are Some Drinks Safer for Ulcerative Colitis Than Others?

Not all drinks pose the same risk for UC. Some studies show a potential benefit of drinking red wine if you have this condition. “Red wine can provide antioxidants and promote the growth of beneficial bacteria,” says Gardinier. Although red wine is not entirely risk-free for people with UC, some research also suggests red wine may help decrease inflammation and serve as a protective factor against UC flares in some cases.

On the other hand, it’s a good idea to choose drinks low in added sugars and sulfites. “Some types of alcohol like alcoholic beverages higher in sulfites, often beer and white wine, may be worse options than those that are lower in sulfites such as distilled liquor such as gin, whisky, and vodka,” says Gardinier.

Safe Drinking Practices for People With Ulcerative Colitis

It may be safe to drink alcohol in moderation with UC, but overall you should limit how much you drink because of alcohol’s potential impact on symptoms, UC medications, and cancer risk. If you do drink, it’s important to monitor your symptoms and adjust your drinking according to how it affects you. When in doubt, ask your healthcare provider for their recommendation.

The Takeaway

  • Ulcerative colitis and alcohol may not mix well: Drinking can worsen symptoms, especially during a flare, and can also interact with ulcerative colitis medications.
  • Some drinks may be safer than others. Research suggests red wine may be linked to decreased inflammation, but alcoholic beverages high in added sugars, sulfites, and carbonation can make symptoms worse.
  • If you’re not sure if it’s safe for you to drink with ulcerative colitis, ask your healthcare provider.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Ramos GP et al. Alcohol Use in Patients With Inflammatory Bowel Disease. Gastroenterology & Hepatology. May 2021.
  2. Living Well With Crohn’s Disease: 8 Self-Care Tips. Cleveland Clinic. February 5, 2024.
  3. Martinho-Grueber M et al. Alcohol and Cannabis Consumption in Patients With Inflammatory Bowel Disease: Prevalence, Pattern of Consumption and Impact on the Disease. European Journal of Gastroenterology & Hepatology. October 2022.
  4. White BA et al. The Impact of Alcohol in Inflammatory Bowel Diseases. Inflammatory Bowel Diseases. March 2022.
  5. What Should I Eat? Crohn's & Colitis Foundation.
  6. The Risk of Colorectal Cancer in Crohn’s Disease and Ulcerative Colitis Patients. Crohn’s & Colitis Foundation.
  7. McLean C et al. Malnutrition, Nutritional Deficiency and Alcohol: A Guide for General Practice. Australian Journal of General Practice. April 2024.
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Yuying Luo, MD

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Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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