Can Drinking Alcohol Cause or Worsen Diverticulitis?

Sometimes, you just want to enjoy an ice cold beer or a glass of wine with dinner. But if you've been diagnosed with diverticulosis, you may be wondering if you can drink alcohol.

The short answer? It depends. You most likely shouldn't if you're taking antibiotics to treat ‌diverticulitis‌, an infection that can occur with diverticulosis.

Here, learn whether alcohol causes diverticulitis, if alcohol makes the condition worse and other lifestyle changes you can make to manage diverticulitis flares.

Diverticulitis is a complication of a condition called diverticulosis. The two terms are similar, but there's an important distinction.

‌Diverticulosis‌ is a condition marked by pouches or stretched-out areas in the digestive tract. When these pouches become infected or inflamed, it's called ‌diverticulitis‌, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Many people have ‌diverticulosis‌, including about one-third of Americans 50 and older and more than half over age 60, per the NIDDK.

Fortunately, the vast majority of people who have diverticulosis never go on to develop ‌diverticulitis‌, per the NIDDK. In fact, many people who have diverticulosis have no noticeable symptoms.

When people develop diverticulitis, it can sometimes be serious. About 200,000 people in the U.S. are hospitalized each year because of the condition, per a May 2020 study in ‌JAMA Surgery‌.

Though often corrected with antibiotics, diverticulitis can cause problems for some people, either because it's severe or leads to complications. These include bleeding, more serious infections in other areas of the abdomen, a small hole in the colon (perforation) and intestinal blockage, according to the NIDDK.

"If you have active diverticulitis, it's often treated with antibiotics and a bland, low-fiber diet until the infection resolves," says Arun Swaminath, MD, director of the inflammatory bowel disease program at Lenox Hill Hospital in New York City and an associate professor at Hofstra Northwell School of Medicine.

"Typically, that's a good time to stay away from alcohol, especially as some antibiotics, like Flagyl (metronidazole), can cause a nasty drug interaction," he says.

The good news? Once the infection clears and you've finished your prescription, it's usually fine to drink moderate amounts of alcohol, including beer and wine.

Of course, talk to your doctor for exact recommendations for alcohol consumption after your symptoms subside. If you're able to include alcohol back into your diet, drink moderately to avoid further complications.

Moderate consumption of alcohol means no more than two standard beverages a day, according to the Centers for Disease Control and Prevention (CDC). A standard serving of beer is 12 ounces and a standard serving of wine is 5 ounces. The standard serving for liquor, or distilled spirits, is 1.5 ounces, per the 2020-2025 Dietary Guidelines for Americans.

If you already have ‌diverticulosis‌ without signs of infection, Dr. Swaminath says alcohol doesn't have to be completely off the menu.

Yet there are still plenty of reasons to limit alcohol or avoid it altogether if you're sensitive to its effects.

"Alcohol, depending on your threshold and your individual sensitivities, can act as a toxin to the stomach, causing alcoholic gastritis (stomach inflammation), injury to the pancreas (pancreatitis) and, most well-known, injury to the liver," he points out.

The research on diverticulosis, diverticulitis and alcohol has been somewhat mixed.

Some studies suggest drinking alcohol is linked to a higher risk of developing diverticulosis and diverticular disease.

But a research review in August 2017 in the ‌Hawaii Journal of Medicine and Public Health‌ concluded that alcohol doesn't seem to be a risk factor for developing diverticular disease. (The review authors do note that the previous research has limitations and that additional research is needed.)

When it comes to ‌diverticulitis‌, it's possible that alcohol (especially excessive amounts) could cause intestinal irritation and trigger a flare-up or attack. But keep in mind that diverticulitis triggers may vary from person to person.

The exact cause of diverticular disease is not fully understood, but factors that could contribute to diverticula formation include a low-fiber diet, obesity, smoking, genetics and aging, per the Mayo Clinic.

A lack of physical activity has also been implicated in both diverticulitis and diverticulosis, per the NIDDK.

Likewise, some medications, such as aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen, seem to increase the odds of these digestive woes, per the Mayo Clinic.

Symptoms of diverticulitis include the following, according to the Cleveland Clinic:

• Lower abdominal tenderness
• Nausea
• Vomiting
• Gas
• Bloating
• Bowel irregularity (like constipation or, less commonly, diarrhea)
• Rectal bleeding
• Fever

For some people, these symptoms can worsen and require hospitalization for treatment.

But typical cases of diverticulitis can be treated with antibiotics, a temporary low-fiber and high-fluid diet and limitation of certain irritants — like alcohol, or anything acidic, per the Cleveland Clinic.

The first line of treatment requires visiting the doctor and getting a course of antibiotics and other medications to help clear the infection, per the Mayo Clinic.

Once that has been resolved, you may have lingering symptoms of diverticulosis, which, with lifestyle changes, can be managed. Here are some changes you can make:

A diverticulitis diet does not treat or prevent the condition, but it can help during symptom flares. The goal of a diverticulitis diet during symptom flares is to give your digestive tract a break from irritants while you're being treated by your doctor, according to the Mayo Clinic.

A two-to-three day clear, liquid diet including broth, pulp-free fruit juices, plain gelatin and water can help during a painful attack.

After a few days of clear liquid you can reintroduce low-fiber foods slowly, which include the following, per the Mayo Clinic:

• Eggs
• White bread
• Milk
• Cheese
• Tender chicken or fish
• Well-cooked vegetables
• White rice

Once your symptoms subside, you can increase your fiber intake to normal levels. And of course, during the liquid and low-fiber phase of this diet, try not to drink alcohol, as it may cause symptoms to worsen.

After your diverticulitis flare subsides, you can begin to reintroduce more foods, especially those with fiber.

Some high-fiber foods you can gradually include are brown rice, fresh fruits, bean varieties and bran cereal. You can also return to eating steamed or raw vegetables, too, once you no longer experience symptoms. Or, you can try adding a fiber supplement to your daily routine.

The average adult should aim to get at least 25 grams of fiber per day, according to a July 2022 report in ‌The BMJ‌.

Eventually, a high-fiber diet may even help to minimize diverticulitis symptom recurrence and duration, per UCSF Health.

Try to stay away from foods that are known to trigger diverticulitis development and flare-ups.

For instance, eating a diet high in red meat, refined grains and high-fat dairy is associated with a higher risk of developing diverticulitis, according to a September 2022 review in ‌Gastroenterology Insights.‌

By contrast, a diet high in fruit, vegetables and whole grains may be protective, as it's linked to a decreased risk of diverticulitis, per the Mayo Clinic.

People who smoke cigarettes are more likely than nonsmokers to experience diverticulitis, but thankfully, once you quit smoking, you significantly reduce your risk of developing diverticulitis, according to the Mayo Clinic.

Quitting smoking can also improve your gut health in general and reduce your risk for things like ulcers, gallstones, Crohn's disease and even colon cancer, per Johns Hopkins Medicine.

Prolonged use of non-steroidal anti-inflammatory drugs or NSAIDs, like ibuprofen (Advil, Motrin IB) and naproxen (Aleve), can increase your risk for diverticulitis, according to the Mayo Clinic.

Try to reduce the amount of NSAIDs you take, and talk to your doctor if you need alternative pain medication recommendations.

Lack of physical activity can increase your risk for diverticular disease, per the NIDDK. But having a regular exercise routine could help you avoid diverticulitis development and flares.

In fact, a February 2012 study in the ​‌American Journal of Gastroenterology‌​ followed 40,000 women over 12 years to study the effects of exercise on diverticulitis rates. Those who had overweight and exercised fewer than 30 minutes a day were more likely to develop diverticular disease than those who did not have overweight and exercised more frequently.

Adults should aim to get at least 150 minutes of moderate-intensity activity (think: walking, biking) or 75 minutes of vigorous-intensity activity (like running or HIIT) each week, along with two days of strength-training activities, per the Physical Activity Guidelines for Americans.

Yes, you can drink — in moderation — if you have diverticulosis. However, you should not drink if you're having an active ‌diverticulitis‌ flare, especially if you're being treated with antibiotics. Plus, you may choose to stop drinking if it worsens your pain and cramping symptoms.

If you're unsure about when you can start drinking after a diverticulitis flare, or how much you can drink, talk to your doctor, who can help make some realistic suggestions.