The social pressure is real, and the medical consequences are poorly understood. Here’s how I’ve navigated the choices.
I was diagnosed with Crohn’s disease at age 18, a mere 6 months before leaving for college. When I was 24, I fell into a life changing flare-up. There’s no “good” time to be living with the symptoms of inflammatory bowel disease (IBD), but when you’re a young person navigating those symptoms alongside social pressures to drink, it can be extremely difficult.
For many people like myself, cutting back on — or cutting out entirely — their alcohol consumption is a necessary part of managing particularly bad flares. But how do you handle doing what’s best for your health in a culture that is so often centered around drinking?
Alcohol isn’t totally contraindicated with IBD. While research on it is slim, a 2022 research review pointed out that alcohol has been shown to “alter the gut microbiome, disrupt [the] intestinal barrier, and increase intestinal permeability.” Together, these changes can activate IBD symptoms. However, the authors noted that red wine and gin have anti-inflammatory effects that may actually help improve the gut flora. The bottom line? Your mileage may vary.
Personal experience bears this out. As many of my fellow IBD patients will tell you, a lot of us can drink with little to no effect on our IBD. But many others find that reducing or eliminating alcohol intake can help symptoms. Much like food, alcohol’s effect on IBD is an individualized experience, so it’s a good idea to talk with your doctor if you think drinking alcohol could be making your symptoms worse.
According to a 2021 review, alcohol “has been reported to be the most-avoided diet item” by people with IBD. Reasons vary: For some, alcohol aggravates symptoms. For others, it may not interact well with the medications they take to treat IBD and its comorbidities.
I found myself in the second category when I was 24. For almost 2 years, I abstained from alcohol because I was on high doses of prednisone, a steroid with a long list of debilitating side effects — most of which, my doctors promised me, would be made worse by drinking.
Prednisone caused an abundance of unpleasant side effects as it worked to get my Crohn’s flare under control. I was living with joint pain, insomnia, mania, night sweats, weight gain, and more. When my doctor told me alcohol could make those symptoms worse, I was quick to drop it. When you’re in that much pain, it’s easier to let go of anything that might be contributing to it.
Because of that, during the period that I was sober, I did not miss alcohol. I was having such a hard time getting a handle on what food I could safely ingest without causing myself pain. Alcohol was much lower on my list of priorities. But as the steroids started to do their job, and I began feeling better — and going out with friends more — it became harder to stick to what I knew was best for my health.
We most often hear about peer pressure in reference to kids in junior high or high school — pressure to smoke cigarettes, do drugs, and skip class. But there’s also an undeniable societal pressure when you’re in your early to mid-20s to go out and imbibe.
While very few (but not zero) people were actively rude or standoffish to me because of my sobriety, I felt like I was on the outside looking in, watching my friends and professional peers attend happy hours and bachelorette weekends while I tried to put on a happy face about missing out on the fun.
I’d be lying if I said that not being able to go out and have a beer like all of my friends didn’t sometimes feel really isolating. But after a few months of adjusting, I came to realize that it wasn’t the alcohol I was missing.
I could still have fun at a bottomless brunch or a house party — stone-cold sober — as long as I was surrounded by good people whose company I truly enjoyed.
In being sick for so much of my young adulthood, I didn’t have the energy to go do all the things my peers were doing — whether they involved alcohol or not.
I had to pick my outings and conserve my limited energy for the celebrations that really mattered to me. That often meant bypassing a happy hour with co-workers so I could make it to a friend’s baby shower. It’s a calculation chronically ill people constantly have to make, and while I’m grateful for all the important celebrations like the baby showers, the camaraderie of happy hours is important, too — and that’s what I didn’t want to miss out on.
By the time I was a few months into my prednisone-forced sobriety, I was still conserving my energy but finally realized I could still have fun at a bottomless brunch or a house party — stone-cold sober — as long as I was surrounded by good people whose company I truly enjoyed.
At the risk of sounding like an after-school special, my years of not drinking due to IBD taught me valuable lessons about friendship. It taught me that when you’re in your early 20s, some people will disappear from your life if you can’t party. But there are just as many people who will show their true colors as real friends, no matter what, even when that means skipping the bar to do something more tailored to a friend who is low on spoons and can’t drink!
These days, I drink on occasions when I feel moved to: friends’ weddings, after-work happy hours, and holidays. But I know that if my gastrointestinal symptoms are bothering me, I can have just as much fun even if I have to spend the night sipping on a ginger ale instead of a vodka ginger.
Medically reviewed on May 24, 2023
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