Doctors may recommend that people with ulcerative colitis (UC) avoid drinking alcohol or limit how much they consume. Drinking alcohol with UC can worsen symptoms.

While drinking alcohol doesn’t seem to increase a person’s risk of developing ulcerative colitis, drinking alcohol if you have ulcerative colitis may worsen symptoms or increase flare-ups.

A 2022 study of 237,835 participants did not identify a relationship between overall alcohol consumption and the risk of inflammatory bowel disease (IBD).

Some types of alcohol, such as red wine, have antioxidant properties which may reduce the effects of oxidative stress on the digestive system. However, recent data suggests that there’s no entirely safe amount of alcohol, including red wine.

A 2021 review of research notes that drinking alcohol can raise the risk of relapse in people with UC.

Alcohol can also affect the gut microbiome. It can negatively affect the protective molecules in the gut and increase bowel permeability, both of which are markers of worsening UC.

Additional research suggested that alcohol can aggravate inflammatory responses in the gut and make UC worse.

Alcohol consumption can also have a negative effect on UC medications. In some medications, it can increase the amount of side effects you may have. In others, it reduces their effect. Some of the affected medications can include:

  • mesalamine (Delzicol, Canasa)
  • azathioprine (Azasan)
  • methotrexate (Otrexup (PF), Xatmep, Rasuvo)
  • biologic medications

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 liver damage.

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.

Does alcohol make ulcerative colitis worse?

Drinking alcohol may worsen symptoms of ulcerative colitis, increase the risk of relapse, and may negatively affect medications for ulcerative colitis.

What is the life expectancy of someone with UC?

Many people with UC have a similar life expectancy to people without UC.

What is the last stage of ulcerative colitis?

A person may have severe ulcerative colitis if they have more than 4 episodes of rectal bleeding per day along with other systemic symptoms.

What causes ulcerative colitis flare-ups?

Not taking medication as prescribed may trigger UC relapse.

While some forms of alcohol may have antioxidant properties, drinking alcohol may negatively affect well how UC medication functions and contribute to increased side effects. Alcohol can also have negative effects on the digestive tract that may worsen UC symptoms.

It’s likely best to avoid consuming alcohol when possible and limit intake when you do drink.