title: Is moderate red wine consumption safe in inactive inflammatory bowel disease?
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department Digestive Diseases, Rush University Medical Center, Chicago, IL 60612-3824, USA. garth_r_swanson@rush.edu
authors.forename: Garth R
authors.initials: GR
authors.lastname: Swanson
authors.forename: Vanessa
authors.initials: V
authors.lastname: Tieu
authors.forename: Maliha
authors.initials: M
authors.lastname: Shaikh
authors.forename: Chris
authors.initials: C
authors.lastname: Forsyth
authors.forename: Ali
authors.initials: A
authors.lastname: Keshavarzian
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D003424:Crohn Disease / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000503:physiopathology; D007792:Lactulose / Q000652:urine; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis / Q000378:metabolism; D008297:Male; D008353:Mannitol / Q000652:urine; D008875:Middle Aged; D010539:Permeability / Q000187:drug effects; D012720:Severity of Illness Index; D013395:Sucrose / Q000031:analogs & derivatives / Q000652:urine; D011795:Surveys and Questionnaires; D014920:Wine / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D039841:Leukocyte L1 Antigen Complex; D008353:Mannitol; D007792:Lactulose; D013395:Sucrose; D002097:C-Reactive Protein; C026285:trichlorosucrose