Department Digestive Diseases, Rush University Medical Center, Chicago, IL 60612-3824, USA.
Digestion. 2011;84(3):238-44. doi: 10.1159/000329403. Epub 2011 Aug 26.
Alcohol consumption is a potential trigger for inflammatory bowel disease (IBD) flare because of alcohol-induced oxidative stress and its deleterious effects on gut barrier function. Additionally, we have recently shown that alcohol consumption is associated with more symptoms in IBD. However, it is not known whether moderate daily alcohol consumption can modify IBD disease activity. To test what effects alcohol may have on patients with IBD, we evaluated the effect of moderate daily red wine for 1 week on two factors associated with recurrent IBD disease activity: intestinal permeability and stool calprotectin.
To assess the effects of moderate daily alcohol consumption on intestinal permeability and inflammation, we recruited 21 patients: 8 with inactive ulcerative colitis (UC), 6 with inactive Crohn's disease (CD), and 7 healthy controls. All participants with IBD completed a validated questionnaire on disease activity (Crohn's disease activity index or ulcerative colitis clinical activity index), to confirm they had inactive disease. All subjects then underwent a baseline assessment that included a blood draw, urine collection after sugar challenge, and stool collection. Subjects then consumed 1-3 glasses of red wine a day for 1 week (approx. 0.4 g EtOH/kg), and repeated the three measures.
No subjects flared during the study. Moderate alcohol consumption did not significantly change either clinical disease activity scores or C-reactive protein. In contrast to healthy subjects, daily consumption of red wine significantly (1) decreased stool calprotectin in IBD subjects from baseline (p = 0.001) and (2) increased intestinal permeability as measured by urinary lactulose/mannitol excretion (marker of small bowel permeability) in CD (p = 0.028) or urinary sucralose secretion (marker of large bowel permeability) in UC (p = 0.012).
One week of moderate consumption of red wine in inactive IBD was associated with a significant decrease in stool calprotectin and a significant increase in intestinal permeability. Our data suggests that patients with inactive IBD who drink red wine daily may be at an increased long-term risk for disease relapse.
饮酒可能会引发炎症性肠病（IBD）发作，这是因为酒精引起的氧化应激及其对肠道屏障功能的有害影响。此外，我们最近发现，饮酒与 IBD 患者更多的症状相关。然而，目前尚不清楚适量的日常饮酒是否会改变 IBD 的疾病活动度。为了研究酒精对 IBD 患者可能产生的影响，我们评估了 1 周内适量饮用红酒对与 IBD 疾病活动度反复出现相关的两个因素（肠道通透性和粪便钙卫蛋白）的影响。
为了评估适量饮酒对肠道通透性和炎症的影响，我们招募了 21 名参与者：8 名溃疡性结肠炎（UC）缓解期患者、6 名克罗恩病（CD）缓解期患者和 7 名健康对照者。所有 IBD 患者都完成了一份关于疾病活动度的有效问卷（克罗恩病活动指数或溃疡性结肠炎临床活动指数），以确认他们处于疾病缓解期。所有受试者都进行了基线评估，包括采血、糖负荷后尿液收集和粪便收集。然后，受试者每天饮用 1-3 杯红酒，持续 1 周（约 0.4 g EtOH/kg），并重复这三项测量。
在研究期间，没有受试者出现疾病发作。适量饮酒并没有显著改变临床疾病活动评分或 C 反应蛋白。与健康对照组相比，每天饮用红酒会显著：1）降低 IBD 患者的粪便钙卫蛋白（与基线相比，p = 0.001）；2）增加肠道通透性，表现为 CD 患者的尿乳果糖/甘露醇排泄（小肠通透性标志物）增加（p = 0.028）或 UC 患者的尿三氯蔗糖分泌增加（大肠通透性标志物）（p = 0.012）。
在缓解期 IBD 患者中，1 周适量饮用红酒与粪便钙卫蛋白显著降低和肠道通透性显著增加有关。我们的数据表明，每天饮用红酒的缓解期 IBD 患者可能会增加长期疾病复发的风险。
