Does alcohol withdrawal cause diarrhea?

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Does alcohol withdrawal cause diarrhoea? 

Yes, some people experience diarrhoea when they stop drinking. Diarrhoea is a symptom of alcohol withdrawal. It also causes gastrointestinal upset, triggering health issues such as bloating, indigestion, excess gas, constipation, and diarrhoea. 

Alcohol withdrawal symptoms vary depending on an individual. Basically, factors such as age, sex, genetics, coexisting conditions, and a history of previous withdrawals can affect the severity of the withdrawal symptoms. 

Alcohol withdrawal is a set of health issues that you experience when you suddenly stop drinking or significantly lower your alcohol use. This condition is also known as alcohol withdrawal syndrome.

People with alcohol abuse, dependency, or alcohol use disorder (AUD) are likely to experience severe withdrawal symptoms and diarrhoea. 

Alcohol withdrawal symptoms range from mild to severe symptoms. In most cases, people experience mild issues such as:

  • Anxiety 
  • Headaches 
  • Vomiting and/or nausea 
  • Sleep problems 
  • Depression 
  • Changes in body temperature 
  • Fatigue 

The withdrawal symptoms can last about a week. But, chronic drinkers and binge drinkers are likely to experience alcohol withdrawal symptoms that persist for more than a week.

People who frequently drink and have a history of taking alcohol for an extended period of time are at risk of developing severe withdrawal symptoms.

These symptoms include: 

  • Withdrawal seizures 
  • Delirium tremens 
  • Hallucinations (visual hallucinations, auditory and tactile hallucinations) 
  • Excessive sweating 
  • Difficulty in making decisions 
  • Mood swings 
  • Anxiety 
  • Agitation 
  • High blood pressure 
  • Increased heartbeat 
  • Rapid breathing 
  • High blood pressure 
  • Poor motor coordination

The withdrawal symptoms can begin with mild signs e.g., agitation or mood swings. After the mild signs, the severe issues may occur. Alcohol withdrawal symptoms are likely to occur within hours after your last drink. 

Is diarrhoea a symptom of alcohol withdrawal? 

Diarrhoea is a symptom of alcohol withdrawal that may require medical attention.

There's international medical research that shows diarrhoea is a symptom of alcohol withdrawal[1, 2].

Also, complaints about diarrhoea symptoms are common among people suffering from acute and chronic alcoholism. However, the exact cause of this condition is still unknown. 

Any type of drug addiction, including alcohol intake alters the normal functioning of the body and the central nervous system. Being a depressant, alcohol disrupts the chemical balance in the central nervous system.

It mimics the major inhibitory neurotransmitter in the brain known as the gamma aminobutyric acid (GABA) and binds itself to GABA. This process limiting the function of GABA.  

Drinking also inhibits a major excitatory neurotransmitter known as glutamate. This effect of alcohol in the brain is a big deal since these two neurotransmitters constitute 90% of the brain.

Alcohol also interferes and affects the digestive system, starting from the mouth, throat, oesophagus, small and large intestines [3]. Once the alcohol is metabolized, it damages the liver and other organs. 

The body does not handle alcohol the same way it takes other foods. When you drink, your body works extra hard to eliminate the alcohol toxins.

Alcohol is converted into a toxic chemical known as acetaldehyde. Unlike other nutrients, alcohol is absorbed directly through the stomach lining.  

The stomach's acid production is affected when you take alcohol regularly. This destroys the stomach's ability to destroy harmful bacteria that enter the stomach. The harmful bacteria proceeds to the small intestines.

Alcohol intake also damages the stomach's lining, thus exposing it to acid and digestive enzymes. Excessing alcohol consumption results in a disruption of the digestive system. 

If you consume alcohol, you are likely to experience acute diarrhoea. This is because of the harmful nature of alcohol in the digestive system.

Studies show that an alcohol hangover can result in acute diarrhoea due to the toxic nature of alcohol in the body. 

Alcohol hangovers are, in part, due to [2]:

  • Anatomic and motility changes to the stomach and small intestines 
  • Impaired nutrient absorption 
  • Mucosal barrier disruption 
  • Disruption to pancreatic secretion 
  • Hormonal/cytokine abnormality 
  • Changes in body temperature as the liver tried to break down the toxins. 

When you go into alcohol detox, the body goes into shock as it attempts to reverse the effects of alcohol in your body.

The body has to change the morphologic and motility changes in the gastrointestinal tract resulting from excessive alcohol consumption.

Drinking also leads to nutrient and vitamin deficiencies. It interferes with the digestive juices and enzymes. All these effects lead to chronic diarrhoea during alcohol withdrawal. 

The symptoms of alcohol withdrawal are likely to be severe is you are mixing drinking with other substance abuse drugs.

In such a situation, it would be best to visit a alcohol detox centre or seek medical care to help manage the severe withdrawal.

How long can alcohol withdrawal diarrhoea last? 

The duration of alcohol-related diarrhoea symptoms varies as the withdrawal symptoms affect each person differently.

Research shows that 50% to 64% of withdrawal cases are influenced by genetics [3]. Alcohol addiction is a complex interplay between biological, psychological, and socio-environmental factors.

Therefore, the severity and the duration of the withdrawal symptoms vary. 

Overall, stopping drinking can trigger withdrawal symptoms that last for about a week, and a few cases persist for more than a week.

The alcohol withdrawal timeline is:

  • 6 to 12 hours after the last drink. Withdrawal symptoms begin within 6 hours after stopping drinking. They start with common symptoms like a headache, insomnia, anxiety, and stomach upset. 
  • By 24 hours, the symptoms transition from mild to severe, depending on the duration and severity of alcohol abuse. Signs such as tremors, hallucinations appear. 
  • 24 to 72 hours, severe withdrawal symptoms appear and can last up to two weeks if you are a chronic drinker. The severe symptoms usually entail psychiatric issues such as paranoia, disinhibition, and delirium tremens. 

Some symptoms can last for months, such as sleep disturbances, changes in mood, fatigue, and diarrhoea. 

Not everyone who goes through withdrawal experiences diarrhoea. Some people only experience mild symptoms, and some don't experience any issues at all. Several factors affect the likelihood of experiencing diarrhoea.  

They are: 

  • Level of alcohol consumption.The amount of drink that one takes before alcohol detox determines whether you'll get diarrhoea and other withdrawal symptoms. NIAA (National Institute on Alcohol Abuse and Alcoholism) states that women should take no more than 3 drinks a day, or 7 drinks per week. The recommended amount for men is no more than 4 drinks per day or 14 drinks per week. Drinking beyond the recommended limits increases your chances of getting diarrhoea plus other withdrawal symptoms. 
  • Nature of consumption.Binge drinking is one of the main triggers of alcohol-related diarrhoea. This is one of the most popular drinking habits among young people. The issue with binge drinking is that it is likely to lead to severe alcohol withdrawal symptoms. Going for alcohol detox after binge drinking is likely to lead to diarrhoea. 
  • Diet.Most people struggling with addiction also have nutrient deficiencies. Chronic alcoholics are also likely to exhibit malnutrition. Those who have a balanced diet and eat healthy meals are likely not to go through diarrhoea. But people with unhealthy diets and those who have low fibre in their bodies are at risk of diarrhoea when they enter detox. 
  • Bowel diseases.People with bowel diseases such as Crohn's disease, Celiac disease, and Irritable bowel syndrome are also at risk of diarrhoea during withdrawal. 

Those who are mild to moderate drinkers will experience the symptoms tapering off in 48 hours.

But as mentioned earlier, the symptoms of alcohol withdrawal are different for each individual. Heavy drinkers may see diarrhoea persist for days. 

Some studies show that people with irregular sleep patterns, for instance, those who go for night shifts, are likely to experience diarrhoea during withdrawal. 

This is because the person's physical state is already vulnerable. After all, they are not getting enough rest [4]. 

Why do you get diarrhoea when you stop drinking? 

You get diarrhoea because of the toxic effects of alcohol use in the body. 36% of hangover cases have diarrhoea as a symptom [2].

In contrast, chronic alcoholics may have diarrhoea that persists for days or weeks after abstinence. The cause of this symptom is because when you stop drinking, you go through withdrawal. 

Alcohol withdrawal syndrome occurs in people struggling with alcohol dependence or alcohol addiction. The term alcohol dependence encompasses alcohol addiction and alcoholism.

Alcohol detox refers to the natural process that the body undergoes to eliminate waste products from alcohol. 

The alcohol detox begins when you stop drinking. Several hours after your last drink, your body may start showing signs of alcohol withdrawal. These signs can range from mild, moderate to severe.

Common signs include headaches, gastrointestinal disturbances, insomnia, tremors, heart palpitations, and diarrhoea.

Those with a chronic drinking problem are likely to experience a severe case of diarrhoea plus other life-threatening symptoms called delirium tremens. 

Diarrhoea is a common symptom in substance abuse cases. When you stop taking the drugs or alcohol, the body begins removing the toxic wastes (the detox) and repairing itself.

The brain goes into shock as it seeks to regain the equilibrium that was there before the alcoholism. 

Alcohol withdrawal diagnosed with other drugs will increase the severity of the withdrawal diarrhoea. For instance, people who mix drinking with opioids will experience severe withdrawal. 

It takes time for the body to return to normal. Therefore, diarrhoea can persist throughout the alcohol detox process. This may be about one or two weeks. 

Diarrhoea plus other problems may take longer depending on the severity of the alcohol dependence. 

The recovery process can be fatal, mainly if you have been drinking alcohol for a long time. A severe case of diarrhoea can be overwhelming for your body as it is already nutrient deficient.

As such, it is important to consult a healthcare professional to offer you medications that will help you safely manage the substance abuse treatment.  

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How to relieve diarrhoea during alcohol withdrawal?

One of the first things you can do to relieve diarrhoea during alcohol withdrawal is to seek ongoing addiction treatment.

People who try to quit cold turkey are likely to experience severe withdrawal symptoms because the body goes into shock. The cold turkey approach also puts you at risk of possible complications that could be fatal. 

You can get professional medical advice at a rehab facility or from your GP on how you can safely detox. When you detox safely, you lower your chances of getting severe diarrhoea plus other unbearable withdrawal issues. 

Addiction treatment offers you medication that will help you manage the withdrawal process. It is important to note that some withdrawal medications, such as benzodiazepines, can cause diarrhoea when you stop using them. 

Aside from proper treatment, hydration helps relieve diarrhoea. You need to keep hydrating regularly during the detoxification process.

You should drink lots of water plus electrolyte drinks to help your body with the detox process. 

Anti-diarrhoea medicines

Over-the-counter medications such as Kaopectate, Imodium, Clonidine, Pepto-Bismol can help relieve diarrhoea. 

  • Imodium(Loperamide):This medication helps treat diarrhea by slowing down the gastrointestinal system. You can get Imodium over-the-counter. The side effect of this medication is that it causes dehydration. It's advisable to seek medical care before self-medicating on Imodium, especially if you are a chronic drinker. 
  • Kaopectate: This medication treats diarrhea, nausea, heartburn, gas, indigestion, or stomach upset. It works by slowing down the bacteria that may cause diarrhea. 
  • Clonidine:This medication is designed to treat diarrhea. However, it can be used as a last resort if other medications fail. 
  • Pepto-Bismol:This medication works by increasing the amount of fluid absorbed by the intestines. 

Foods can help relieve diarrhoea in alcohol withdrawal

A healthy diet will help relieve diarrhoea. During detox, you should take up a healthy, balanced diet. Foods such as:

  • Yogurt: The cultures in yogurt help manage the severity and duration of diarrhoea. You should go for yogurt that has no sugars or artificial sweeteners. 
  • Soups: Soups that are high in sodium help relieve diarrhoea. The body goes through dehydration during the detox process. When you take soups with sodium, you help the body retain more fluids, thus lowering the risk of diarrhoea. 
  • Taper off the drinking:Lower your drinking or stop altogether until diarrhoea stops. Seek medical assistance if you are a chronic drinker to avoid complications.  
  • Take easily digestible foods, e.g., soda crackers, eggs, rice, toast, applesauce, chicken, bananas. The issue with bananas is that if you are experiencing vomiting or nausea, this food is likely to worsen the symptom. 
  • Spicy foods, particularly foods with cayenne pepper, help ease the withdrawal symptoms. 

You can contact a detox centre for more advise on ways to relieve the diarrhoea plus other medical issues. 

Conclusion 

Alcohol interferes with the performance of the digestive and nervous system. This disruption leads to withdrawal diarrhoea plus other discomforting symptoms.

But you don't have to go through this process alone. There are extensive rehab programs with various ongoing treatment options that you can choose depending on your needs. 

The national institute on alcohol abuse highly recommends seeking medical attention if you are experiencing withdrawal symptoms such as diarrhoea [5].

When you go to the hospital, the care practitioner will diagnose you for alcohol withdrawal. They will check your vital signs like your breathing rate and high blood pressure.

They will also check your medical history to determine other co-occurring conditions that may exacerbate the symptoms. 

It is advisable for those struggling with chronic alcohol or drug use to detox at a rehab or medical facility.

This is because the withdrawal process can be life-threatening, and you'll need medical supervision to prevent the symptoms from becoming fatal. 

Addiction medicine, a proper diet, and hydration will lower the duration and severity of diarrhoea, amongst other manifestations. 

Speak to a care practitioner today to discover the best addiction treatment process for you. 

Abbeycare Pricing Bot

Last Updated: November 8, 2021

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.