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Is Alcohol or Drug Abuse Taking a Toll on Your Digestion?

Support your recovery by improving gut health.

Carolyn Ross/Shutterstock
Source: Carolyn Ross/Shutterstock

The main focus when you or a loved one has a drug or alcohol addiction is getting them off their drug of choice. Once this has been accomplished, however, it is important to realize that addiction affects your whole body. To get completely well, you need to take an integrative approach that considers you as a whole person.

Of course, it’s important to get treatment that focuses on managing cravings and strengthening your ability to choose not to use the substance. For many people, medications (such as Suboxone, methadone, or Naltrexone) are a key part of this. But full recovery goes beyond this kind of treatment to look at how substance use has affected your whole body and how supporting your body’s healing can boost your recovery.

In a recent blog post, I talked about how substance abuse can lead to nutritional deficiencies. Here, I’ll focus on a related topic: gut health.

Your digestive system is the gateway through which nutrients enter your body. Anything that harms the health of your digestive system can affect the way your body gets its nourishment. For instance, alcohol causes inflammation in the gut, making it difficult for your body to absorb nutrients. But the problem is more complex than that.

If you’re like many people, your spiral of increasing drug or alcohol use may have started as an attempt to manage symptoms of depression or anxiety. Of course, heavy use of alcohol or drugs doesn’t solve these problems; in fact, over time, it only makes them worse.

You may be surprised to learn that mood problems have as much to do with the gut as they do with the brain. The gastrointestinal tract has over 100 million neurons (nerve cells), making it the second-largest collection of neural or nerve tissue in the body (after the brain). Problems with the so-called gut-brain may be involved in both mental health issues and addiction.

Your digestive tract is home to a huge population of microorganisms that help you digest your food and absorb nutrients. Normally, there is a balance of a number of different “gut bugs.” But if the proportions become imbalanced, you may end up with an excess of inflammatory molecules called cytokines that can have a significant effect on brain function, leading to depression, anxiety, and cognitive problems. Some people with depression after they began having stomach problems.

One of the jobs of your digestive tract is to identify substances that may be toxic to the body. The gut wall provides a barrier to keep harmful substances out of the bloodstream. Cortisol, the hormone our bodies produce under stress—including the difficult life circumstances that arise from addiction—can make the walls of the intestine overly permeable, allowing toxins and pathogens into the bloodstream. These toxins can lead to inflammation not just in the gut but also in the brain and can affect mood, sensitivity to stress—both of which can increase your risk for relapse.

Aside from problems with gut permeability and nutrient absorption, alcohol and drugs simply put a strain on your digestive system. Gastrointestinal troubles like poor digestion and constipation are common in people with substance use disorders.

Many of these problems will improve after you’ve been abstinent for a while, but you can feel better sooner by taking charge of your digestive health right now. Here’s how:

Take a probiotic supplement. These can help reduce digestive symptoms such as constipation, gas, and bloating. Probiotics have also been shown to put back the good bacteria in the gut and improve damage to the liver caused by alcohol. Eating probiotic foods (such as yogurt, kimchi, or sauerkraut) can improve brain function. Probiotic bacteria also produce anti-inflammatory cytokines that fight inflammation and that can have a positive impact on mood.

Manage constipation with magnesium. Constipation is common among people who use opiates such as prescription pain pills. To keep your bowels regular, take 400 to 800 mg of magnesium oxide every night at bedtime. I recommend using this every day, not only when constipation occurs.

Take anti-inflammatory supplements. To reduce inflammation in the gut, take vitamins C and E. You may find it helpful to add N-acetyl cysteine, green or black tea, and the spice curcumin.

Try a plant-based digestive enzyme. Digestive enzymes help break down carbohydrates, fat, and protein. A digestive enzyme supplement can help relieve symptoms of poor digestion.

When you struggle with addiction, so many things are out of your control. Caring for your body by improving your digestive health is a simple way to be compassionate with yourself and support your healing as a whole person.

More from Carolyn C. Ross M.D., M.P.H.
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