Cocktails and chronic disease: Is alcohol making my AS worse?

A columnist wonders if she should imbibe, given her ankylosing spondylitis

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by Jemma Newman |

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The drizzle swept down on us during a stormy night in Perth, Western Australia, last month as my husband, Dave, and I joined some friends outside a cozy downtown bar. The babysitter was paid for, our stomachs were full of grilled steak from a lovely restaurant dinner, and we weren’t ready to head home just yet.

Spotting the dimly lit sign for a cocktail lounge, Bobeche, we nodded at the serious-looking bouncer who had his collar popped up against the dripping rain. Warm light emanated from a lower-level doorway, and our little group descended the slippery stairs to escape the inclement weather and enjoy a drink with good company.

As I flipped open the heavy, leather-clad drinks menu, my eyes feasted on the exotic names of the libations within. My fancy was ticked by cocktails with names like Magenta Sunset, Joy of Life, and Hemingway Daiquiri. Despite the creative and no-doubt delicious cocktails available, I chose a simple glass of red wine, and Dave stuck to lemonade.

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To drink or not to drink?

The choice to drink alcohol when you have a chronic disease like ankylosing spondylitis (AS) is something I’ve mused about in the years since my diagnosis.

In a regular week these days, I sometimes enjoy a glass of red wine while I’m cooking dinner, and I might have a gin and soda on the weekend. I’d call myself a light to moderate drinker, though there have been many periods in my life when I’ve gone alcohol-free, such as when I was pregnant and breastfeeding.

After being diagnosed with AS in 2018, I went without alcohol for a while in an attempt to curb the pain and stiffness in my back. I’d also commenced a strict elimination diet, which removes all potential foods and drinks that might be causing gut issues and inflammation.

I found that diet to be incredibly successful in reducing my AS symptoms, as long as I didn’t consume anything starchy. Slowly, I started testing the reintroduction of alcohol by having an occasional small glass of red wine, or clear spirits without sugary mixers. If I limit my alcohol intake to one or two drinks a day, I don’t seem to experience any additional stiffness or discomfort.

I’m not here to tell you whether consuming alcohol is right for you, but I’m interested to explore my own choice to imbibe a few alcoholic drinks even though I have AS. My online research seems to suggest that alcohol does more harm than good for people with AS, which makes me wonder if I should rethink my next glass of red wine.

A study of 278 patients with axial spondyloarthritis at Seoul St. Mary’s Hospital in South Korea showed that alcohol consumption may be associated with spinal structural damage. According to the 2019 research article published in Arthritis Research & Therapy, “drinking alcohol showed a significant relationship with the progression of spinal structural damage.”

In addition to potential disease progression, there are medication interactions to consider. As the Arthritis Foundation notes, “Many of the medicines your doctor prescribes to relieve sore joints don’t mix well with alcohol.”

My choice

For now, my personal approach to alcohol is to be mindful, practice moderation, and avoid sugary alcoholic drinks or cocktails. I don’t have more than one or two at a time, and I only imbibe if I’m experiencing low AS disease activity and am not in a flare. My choice is to enjoy an occasional glass of red wine as part of a very healthy lifestyle, which includes daily exercise and a wholesome diet rich in protein and fresh green vegetables.

Our individual freedom to make choices for our life is important (though I certainly wish we could choose not to have AS), and I feel I’ve weighed the pros and cons when it comes to alcohol. It’s your choice, too, but please always discuss alcohol consumption with your doctor.

If I ever feel that my AS is getting worse, I change medications, or if I’m feeling additional stiffness or joint pain, alcohol will be the first thing I ax to try to stay healthy and happy for as long as possible.

What are your thoughts on alcohol and ankylosing spondylitis? I always appreciate comments and ideas.

Note: Ankylosing Spondylitis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Ankylosing Spondylitis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to ankylosing spondylitis.


George avatar


Even being a person with AS, I assume that advising someone not to drink alcohol if they have AS is about the same even if they didn't have AS. That's because most people will do want they want regardless of the advice. However, if they never started something in the first place, then advice can definitely matter. People have to be strongly internally motivated to change most effortless habits, and similarly need strong motivation to continue beneficial habits like exercising.

Myself, I believe I would still drink alcohol to some degree had I not been forced to stop altogether a couple decades ago, long before AS significantly kicked in. I had never been able to drink a lot but I had long drank a little, even though sometimes even one drink could make me feel bad. Eventually, serious after-effects became 100% after just a fraction of a glass. So it was easy to stop, even when surrounded by people drinking. The tastes of wine, beer, cocktails is missed and never forgotten but I only rarely take even the smallest sip for pleasure. I had no choice in this matter so I deserve and claim no high road. But as an observer and former light indulger, I know that the less all people drink, the better off they are.

Perhaps having a sweet tooth is killing me which proves I am better at giving advice than taking it. It's not just alcohol that makes me sick as I have extreme sensitivities to a bizarre number of foods and medicines. Not allergies though, as those for me are limited to constant strong environmental allergies. I smoked cigarettes for just a few years until I was about 22 I think. I was forced to quit because they were making me sick. I've otherwise been a fitness enthusiast my entire life, of course the AS restrictions withstanding.

Everyone's body is different. Tolerances are different.

So drink a little if you want to or must. But don't drink if you haven't started.

Joe Vernice avatar

Joe Vernice

Several years ago I noticed that after an evening of drinking more than 3 alcoholic drinks I would awake the following morning with severe flare-up of my AS. Mind you, that I am in advanced stages of the disease with my entire spine essentially totally fused.
I did an experiment and cut out drinking alcohol completely. Well, after two years I can tell you that alcohol had a significant effect on my pain levels. Even now, if I have an occasional drink or two, I feel it the next day. I am not sure if this applies just to me, or the disease in general.


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