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Drinking Alcohol With Axial Spondyloarthritis

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

Research on the effects of alcohol on axial spondyloarthritis (axSpA) is limited. Some studies have shown that drinking a moderate amount of alcohol can reduce inflammation. Other studies have linked drinking to increased disease activity of some inflammatory conditions, including axSpA.1,2

These conflicting results make it hard to know if it is okay to drink alcohol with axSpA. So, what should you do?

The best advice is to talk to your doctor. Your doctor can review the research and answer any questions or concerns you have about drinking alcohol with axSpA. Everyone is different, and there is no one-size-fits-all solution for everyone. In the meantime, learning more about the possible downsides to drinking with axSpA can help you make informed decisions.3

Drug interactions

Mixing alcohol and medicine can be dangerous. For example, pain medicines like opioids can be more powerful when combined with alcohol. This can lead to serious or life-threatening side effects.3,4

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On the other hand, some drugs do not work as well when taken at the same time as alcohol. This can make them less effective. Always talk to your doctor before taking any medicine with alcohol.3,4

Liver stress

Drinking alcohol can put a lot of stress on the liver, especially if it is already working hard to process medicines. Damage caused by drinking can lead to scarring (called cirrhosis), which affects how well the liver works. As this scarring gets worse, it can cause serious health problems.5

Gut health

People with axSpA often also have inflammatory bowel diseases, like Crohn’s disease or ulcerative colitis. This makes their body extra sensitive to alcohol.6-9

Also, first-line treatment for axSpA is usually anti-inflammatory drugs called NSAIDs. These drugs can irritate the gut and make it harder for your body to take in or use nutrients. Drinking alcohol can make this worse.6-9

Bone health

Heavy drinking increases your chances of having weak bones, known as osteoporosis. Alcohol makes it harder for the body to use calcium and vitamin D. These are important elements for healthy, strong bones. Having axSpA already increases the risk of osteoporosis, so avoiding alcohol can help keep your bones healthy.2

Weight gain

Drinking alcohol can add a lot of calories to your diet, making it easy to gain weight. Being over a healthy weight can make your axSpA symptoms worse. This is because the extra weight puts more strain on your joints, which are already inflamed.10

Overuse problems

Drinking may temporarily reduce pain, but only if you go beyond what is considered a moderate daily amount. Otherwise, it can actually make your pain worse.1,11

Chronic drinkers who stop using alcohol become more sensitive to pain. Drinking too much over a long time can cause painful damage to nerves, including those in your arms and legs. Excessive drinking can also cause inflammation throughout the body, worsening axSpA symptoms.1,11

If you have axSpA and want to drink alcohol, talk to your doctor. Everyone is different, but overall, drinking can put a lot of stress on the liver and worsen symptom flare-ups. It can also interfere with drugs used to treat axSpA. Learning more about the possible effects of drinking with axSpA will help you manage your condition as well as possible.1-3