I am now 20-years old and the closest I ever got to consuming alcohol was the tablespoon of Grand Marnier my mum used to put in our Christmas fruit salad. As I was diagnosed with Crohn’s so early on in my life when I was only 12, I never got into the habit of drinking alcohol and because I received a lot of mixed information about whether or not I should be drinking with IBD, it became a conscious decision that I was going to be safe rather than sorry; I wasn’t going to drink at all.
The stigma around not drinking
One thing that never fails to surprise me on this subject is the reaction I get from people when I tell them that I don’t drink. It only really became a “big deal” when I went to university, what with fresher’s week being synonymous with the drinking Olympics. My default was to just tell people I was “allergic” and even though I wasn’t even sure if this was a real thing, most people were gullible enough to believe me. But the conversation never ended there, I was always met with questions like “how do you live?!” or statements like “wow, you’re really missing out”. And it wasn’t just vodka-hungry students that reacted this way. Even during a trip to the opticians of all places, my optician (who was at least 35-40 by my estimates) posed a scenario about when I would probably prefer contact lenses over glasses i.e. when I was on a romantic date drinking red wine. He knew all the details of my health issues and yet, when I light-heartedly said that I couldn’t drink red wine and that it would likely be a glass of water instead, he still responded by saying: “What! You can’t drink alcohol? That’s awful!”
Is it just me, or do these people who seem like they can’t function without alcohol in their lives have more problems than I do? It’s not even like I “miss” alcohol as I never really had it in the first place. And I certainly don’t feel like I need a drink to have a good time. It can be challenging sometimes, especially at university, when alcohol seems to be at the centre of student culture, but I was surprised by the number of people I met that didn’t drink either- whether that be for religious, economical or ethical reasons, or that they just didn’t like the taste. So, with that in mind, I’ve never found myself tempted to drink, nor overly left out because of my choice to avoid alcohol.
But other than just being generally sensible, what are the reasons why I don’t drink? For ordinary people alcohol can do more harm than good, but for people with IBD specifically it can be particularly problematic. I myself am on a fine line between choosing not to drink and not being able to drink because of the effect that alcohol may have on my body. So, I have resolved to just say that I don’t drink.
Why I don’t drink
1. I don’t want to get dehydrated
Most people are aware of how dehydrating alcohol can be and when you have IBD, you need to be extra careful that your body is retaining its nutrients properly. The sheer act of drinking takes its toll on the body from this standpoint, but if you overdo it and end up being sick, things can get even worse. This is particularly an issue for ostomates who have to make even more of a conscious effort to avoid dehydration as fluids and minerals are constantly lost through their stomas.
2. I like my liver
Chronic liver disease is a real risk for anyone with IBD and those most at risk include patients on immunosuppressants like azathioprine, mercaptopurine and methotrexate. I had problems with my liver whilst taking the former 2 of these medications and my liver function dropped so much that I was advised to cease taking them immediately. Alcohol puts an extra strain on the liver to remove bodily toxins, it destroys liver cells and can eventually lead to cirrhosis. So, with an already struggling liver, staying sober is the responsible choice for me.
3. I don’t want to trigger my symptoms
For IBD patients, alcohol can also have a similar effect on our digestive system as any other trigger food, from a curry to fish and chips. Studies have shown that alcohol lowers your immune system, it is pro-inflammatory as well as pro-oxidant and it has a damaging effect on gut barrier function. It has even been proven to potentially trigger a full-blown flare up. Whether I am in remission and don’t want to jeopardise it, or I’m already unwell and don’t want to make it worse, drinking alcohol just isn’t worth the risk in my book.
4. It might interfere with my medications
It is well known that drinking can alter the effects of certain drugs. At the most basic level, drugs like antibiotics will be made far less effective when mixed with alcohol and can cause some pretty dangerous side-effects. So, for people taking antibiotics long-term, alcohol can be a real issue. I have been on and off drugs like metronidazole for issues with abscesses and fistulas to prevent septicaemia, so lessening their effectiveness for the sake of a pint could have potentially dangerous consequences for me. Alcohol can also affect immunomodulators and similar medications used to treat IBD and, as stated above, it weakens your immune system further, which certainly isn’t what already vulnerable patients want.
5. I’m anaemic
Drinking has also been associated with anaemia and I have had real problems treating mine as it is, especially after discovering that I am severely allergic to iron infusions and cannot tolerate oral tablets either. Again, in this instance, alcohol would merely make my symptoms worse and make it even more complicated to treat the existing problem.
My advice
So, with all that in mind, here’s what I would like to say to anyone who has, knowingly or not, made an IBD patient feel inadequate for not drinking or anyone who has ever quizzed us about staying sober:
“Deciding to drink, or not drink, is a personal choice which everyone has the right to make. Being sober doesn’t make us less fun, less adventurous or less able to have a good time. It makes us in control of our own lives and our own bodies. What’s more, some of us have legitimate health-related reasons why we don’t drink, and some of us can’t drink at all without putting ourselves at serious risk. So please, be respectful and think before you make a comment or make us feel like we are “missing out”. Chances are we already feel as though we are missing out on a lot in life because of our health and we really don’t need to be made to feel even worse over something as trivial as a beverage, we have bigger things to worry about. Thank you. Oh, and P.S- I would advise that you’re nice to us as, unlike you, we WILL remember all the stupid things you did when you were drunk.”
And a word of advice for those of you who want to stay clear of the drink for the sake of your health: don’t be afraid to say no. I am lucky in the sense that I’ve never had a problem standing my ground and overcoming peer pressure, but if you find yourself in a situation where you feel pressured to drink, remind yourself that you are in control and that you don’t have to do anything you don’t want to. Make the right choice for your health and I doubt you’ll regret it! What’s more, if you’re worried about being uncomfortable or looking awkward i.e. if you’re going clubbing sober, don’t be afraid to let your hair down, a good majority of the other people there will be drunk, so they won’t even notice what you’re doing, let alone remember it the next day!
Me and My Crohn's 