A common question I get asked is whether it’s safe to drink alcohol when you have Irritable Bowel Syndrome (IBS) and you’re following a low FODMAP diet. Fair question too. I quite enjoy a glass of wine occasionally, sometimes a beer, and every now and again I’ll have a different type of alcoholic beverage. So it may seem like alcohol is a safe choice given that I also have IBS and follow a low FODMAP diet.
Unfortunately, it’s not quite that simple…
First we need to look at alcohol from a FODMAP perspective, to see whether any of the alcoholic beverages are high in FODMAPs. Next we need to think about any mixers that might be used with the alcohol and whether they’re high or low in FODMAPs.
That takes care of the FODMAPs.
But it doesn’t answer the full question in relation to IBS, because IBS can be triggered by more than FODMAPs. And one of those potential triggers is alcohol, which is a known gut irritant. That means this question needs a two-part answer.
The first part of the question… Is alcohol low FODMAP and how much is safe to drink on a low FODMAP diet?
High FODMAP alcohol
Rum: high FODMAP at a serving of 30ml, or one shot, due to high amounts of excess fructose. Note: if you can tolerate excess fructose, rum can be consumed since a 30ml serving is low in the other FODMAPs.
Wine, low glycaemic index (low GI): high FODMAP at a serving of 150ml, or roughly one restaurant-size wine glass, due to high amounts of excess fructose. Note: if you can tolerate excess fructose, low GI wine can be consumed since a 150ml serving is low in the other FODMAPs.
Wine, sticky: high FODMAP at a serving of 150ml, or roughly one restaurant-size wine glass, due to high amounts of excess fructose. Note: if you can tolerate excess fructose, sticky wine can be consumed since a 150ml serving is low in the other FODMAPs.
Low FODMAP alcohol
Beer: low FODMAP at a serving of 375ml, or one can.
Gin: low FODMAP at a serving of 30ml, or one shot.
Vodka: low FODMAP at a serving of 30ml, or one shot.
Whiskey: low FODMAP at a serving of 30ml, or one shot.
Wine, red: low FODMAP at a serving of 150ml, roughly the size of a restaurant-size wine glass.
Wine, white: low FODMAP at a serving of 150ml, roughly the size of a restaurant-size wine glass.
Wine, white, dry: low FODMAP at a serving of 150ml, roughly the size of a restaurant-size wine glass.
Wine, sparkling: low FODMAP at a serving of 150ml, roughly the size of a restaurant-size wine glass.
Wine, sweet: low FODMAP at a serving of 150ml, roughly the size of a restaurant-size wine glass.
Note that for wine, a ‘standard drink’ is only 100ml, so a 150ml serving is equivalent to 1 and ½ standard alcoholic drinks.
Alcoholic beverages that haven’t yet been tested for FODMAPs
Spirits: Given that rum is high FODMAP, while gin, vodka and whiskey are low FODMAP, it’s difficult to predict whether other spirits will be high or low FODMAP.
Liqueurs (non-dairy based): Liqueurs are based on spirits, but they also have other ingredients added, possibly including sweeteners that are high in FODMAPs. Given this, it’s very hard to predict how the final liqueur will rate in terms of FODMAPs.
Liqueurs (containing dairy): Any liqueur that contains cream is likely to be high (or moderate) FODMAP because of the lactose provided by the cream. However, if you’re not sensitive to lactose, or if you have a moderate tolerance to lactose, you may be able to handle small amounts of these liqueurs since the amount of cream included will be small for the portion size consumed. That being said, it still depends on the FODMAP content of the other ingredients in the liqueur, which may make it high FODMAP anyway.
Ciders: Most ciders are made from apple juice or pear juice. Given that both apples and pears are exceptionally high in both excess fructose and sorbitol, it’s highly likely that ciders will be high FODMAP.
Alcohol-removed wines (or non-alcoholic wines): While most wines have been found to be low FODMAP, alcohol-removed wine is made with a slightly different process. Initially they’re made the same as regular wines, but when the alcohol is removed, wine producers add back concentrated grape juice to make up for the volume of the alcohol that’s removed. While this is only a few percent, the effect of this concentrated juice on total FODMAP content is hard to predict.
But let’s not forget the mixers that you add to your alcoholic beverages and how they can affect the FODMAP content…
High FODMAP alcoholic mixers
Fruit juice: Most fruit juices are high FODMAP and should be avoided, with the exception of the low FODMAP choices listed in the section below.
Soft drinks/sodas (sweetened with high fructose corn syrup): Anything sweetened with high fructose corn syrup is high FODMAP, regardless of flavour. Thankfully in Australia, most soft drinks are sweetened with sugar.
Dairy-based mixers (not lactose-free): If you like to add milk or cream to your drinks or cocktails, regular dairy products will be high FODMAP. That can be easily fixed though by using lactose-free options.
Low FODMAP alcoholic mixers and add-ins
Cranberry juice: low FODMAP at a serving of 1 glass or 250ml.
Orange juice, blend of reconstituted and fresh: low FODMAP at a serving of ½ glass or 125ml.
Lemon or lime juice: Both lemon and lime juice are low FODMAP at a volume of 1 tsp, or 5ml. Since only trace amounts of FODMAPs were detected in that portion size, consuming slightly larger amounts from a squeeze or two of a lemon or lime is likely to still be low FODMAP.
Slice of lemon/lime/orange: A single slice of citrus fruits added to your drink won’t affect the FODMAP content.
Lactose-free dairy-based mixers: Lactose-free milk or cream are both low FODMAP and so won’t increase the FODMAP content of your drink.
Water/ice: Water doesn’t contain FODMAPs, so adding it to your drinks won’t be a problem. The same goes for regular ice made from water.
Soda water: Soda water is regular water that’s been carbonated by adding in carbon dioxide. Since neither one of those options contain FODMAPs, soda water by default will be low FODMAP.
Alcoholic mixers that haven’t yet been tested for FODMAPs
Soft drinks/sodas (sweetened with sugar): Based on what we currently know about FODMAPs, it’s highly likely that soft drinks sweetened with sugar (i.e. sucrose) are low FODMAP, since they’re water, carbon dioxide, sugar and flavour (most sweet flavouring additives are low FODMAP). But if you’re in doubt, try adding soda water instead, which will at least add bubbles to your drink.
The second part of the question… Is it safe to drink alcohol when you have IBS, given that alcohol is a gut irritant?
Alcohol is a known gut irritant, although it’s affects will vary between people. The main effect that alcohol has is to stimulate the digestive system. This means that it increases the speed that the contents of the gut move through the digestive system. So if your IBS makes you prone to diarrhoea or loose bowel movements, drinking alcohol could trigger these events in you.
But what if you aren’t prone to diarrhoea but instead are prone to constipation? Well, alcohol is still a gut irritant and while it may not promote diarrhoea in you, it can still lead to cramping and pain as your gut is stimulated. Also, stimulation of the gut can instead lead to increased contractions (spasms) in the bowels that disrupt the formation of bowel movements. When you add that to the dehydrating effects of alcohol, constipation can occur in some people.
So most people with IBS are better off minimising the amount of alcohol that they drink, or avoiding it altogether, regardless of the FODMAP content of the alcohol.
This is particularly important during the initial elimination phase of the low FODMAP diet when you’re trying to get to the bottom of what’s triggering your symptoms.
What about using alcohol in cooking?
Most cooking methods cause alcohol to evaporate from alcoholic beverages as they’re heated. But it depends on how long the food is cooked for, the heat that it’s cooked at, and how much alcohol was added as to whether all of the alcohol will be removed. So it’s a bit of a gamble, but a splash or two of alcohol in a serving of casserole won’t be a big issue for most people.
From another perspective, adding low FODMAP alcohol (such as wine) to your cooking won’t affect the FODMAP content, but it can add a lot of flavour. There are many other ways to flavour low FODMAP foods though, so alcohol isn’t necessary in most cases, unless of course the unique flavour of a particular type of alcohol is needed for that particular dish. Personally I still like to add wine to some casseroles, risottos and pasta dishes, but I don’t do it as often as I used to.
So is it safe to drink alcohol if you have IBS and follow a low FODMAP diet?
Like most things with IBS, the answer is based on personal tolerance. Some people can manage drinking small amounts of alcohol without it irritating their gut, while others will have their IBS triggered during the first glass. So you’re going to have to test it out for yourself to see how you go.
Here are some guidelines to help you:
- Start by choosing low FODMAP alcoholic beverages (and mixers). Or if you’ve already done reintroductions, choose options that suit your personal FODMAP tolerances.
- Drink the alcoholic beverage while you’re eating food since this can help to buffer the gut irritating effects of alcohol.
- Limit yourself to one drink in a day, or at most two.
Note: the information about FODMAP content of alcoholic beverages and associated mixers was obtained from the Monash University Low FODMAP Diet app and was correct at the time of publication. The Monash app is regularly updated with newly tested foods so be sure to check the app for new information or changes, as well as portion sizes.