I rarely drink to excess these days because when I do, bad things happen. On one memorable-yet-unrememberable occasion in 2013, I took shameless advantage of an open bar at a birthday party. Some nine hours later, I woke up with a raging headache, a sprained ankle, a voicemail from a woman I’d apparently given my number to outside of a Dunkin’ Donuts at two in the morning, and no recollection of how I’d gotten home. I must have been in some disarray—the complete stranger was calling to make sure that I was alive.
When I called a friend to tell him what had happened, he told me that I’d called him at 2 AM and laughed hysterically for 25 minutes straight. He asked if I had thrown up as it seemed natural that puking would be a part of the story. To the best of my knowledge, I had not. This was backed up by the lack of splatter marks on my shoes.
Then, while were trying to piece together the few fragments of information I’d gathered, I fully shit the bed. I’d expelled about a half-cup of rusty water before my sphincter snapped shut, and I could shuffle/hobble to the bathroom to finish what I‘d sharted. A return to standard GI functionality was a long and challenging day away.
This incident was just one of dozens of sessions of heavy drinking that made venturing farther than ten paces from a toilet a dangerous proposition. In the public imagination, diarrhea doesn’t seem so closely linked to a night of boozing it up as vomiting is, but for me, it’s how a wild night invariably ends. So I made a point of finding out why.
The first thing to know is that alcohol is one of the very few things that the stomach can readily absorb, says Arthur Beyder, a gastroenterologist at the Mayo Clinic and a spokesperson for the American Gastroenterological Association. “That’s why it’s good to have food in your stomach if you’re going to be consuming alcohol,” he says. That food is going to slow down the rate at which alcohol is absorbed through the stomach wall and gets into the bloodstream.
By having a full stomach, Beyder says, you’re slowing down the rate at which you get messed up and lessening the likelihood of making a mess. That’s because drunk people tend to carry on drinking, and more alcohol is setting the scene for a potentially explosive situation. This is at least partially because of booze’s inflammatory effect on the lining of the GI tract—an unhappy state of affairs that starts in the stomach.
“Even after one binge episode, people may develop some inflammation or ulceration of the gut epithelium,” Beyder tells me, referring to the tissue that lines organs and blood vessels throughout the body. Alcohol can stimulate the production of more stomach acids, which can lead to the disruption of the digestive tract’s thin barrier, and can stimulate diarrhea. Though the colon is closer to the exit point, there’s less disruption to the epithelium there because the alcohol has been absorbed by the stomach and then the small intestine by the time it gets there, Beyder says. By then, however, the entire GI system—including your colon—is working in concert to get out what ails it.
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This expedited process culminates with the muscles in the colon contracting more frequently, expediting your stool’s delivery window from ten minutes after you drink your morning cup of coffee to like, right fucking now. The muscles in this organ move in an orderly, coordinated squeeze to push your stool out—these squeezes are called peristaltic waves and also happen in the esophagus, stomach, and small intestines, explains Niket Sonpal, New York City-based gastroenterologist and professor of medicine at Touro College. But it’s the accelerating peristaltic waves in the colon that will boldly alert you to the fact that you definitely should have stopped hours before you did.
But here’s where shit really hits the fan: The large intestine's main gig is to absorb the liquid from your waste before pushing it out in the usual, cigar-shaped format or what GI experts refer to as a Type 3 or Type 4 on the Bristol Stool Chart. Increasing the tempo of peristalsis abridges the colon’s opportunity to absorb liquid, which means that the situation can quickly turn both wet and wild and stop you from living your best life, Sonpal tells me.
Case in point: I once turned down a clearly stated invitation to come back to a woman’s place for sex because I’d foolishly tried to match her drink for drink and was mere minutes away from creating a monochrome Jackson Pollack in her presence. So clear and present was the danger, in fact, that I couldn’t even spare the time to make up a less embarrassing excuse to leave. I said a curt goodbye and minced out of the bar and toward home at double speed.
The most obvious way to prevent a sophisticated evening from becoming a shit show is—quelle surprise—to reduce the volume and decrease the pace of your drinking. But given that even the most resolute among us can be talked into a nightcap or three once the alcohol starts fucking with the part of the brain that separates good from bad ideas, that’s not always an option.
A more realistic solution is to eat before you start drinking, thereby minimizing the direct contact the alcohol has with the stomach wall. In addition to eating first, you can try to minimize the severity of alcohol-induced diarrhea by taking a soluble fiber supplement like Citrucel or Benefiber before you start drinking, Sonpal suggests. “Soluble fiber supplements absorb water in the bowel and hold onto it well,” he says, adding that this should help ensure your stools are more formed than they otherwise would be after having a few drinks.
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