To Drink Coffee or Not to Drink Coffee with IBS?


Coffee is one of the three most popular beverages in the world, next to water and tea. One of the top reasons people drink coffee is for it’s caffeine, and it is also a very social drink. No wonder why so many people with IBS are curious on how this beloved beverage impacts their digestion!


Even though coffee is a low FODMAP food, it is important to be aware of how it impacts our digestion. Studies have shown that up to 26-40% of people with IBS complain of coffee as a trigger (1,2).


CAFFEINE’S IMPACT ON DIGESTION:


The colon is part of the large intestine, which is the final part of the digestive tract. The job of the colon is to reabsorb fluid and process waste products from the body and prepare it for elimination. The colon mixes and kneads the contents within the digestive through various types of contractions.


Some studies have shown that when coffee is consumed it stimulates the colonic motor activity (3). Some studies have shown that the motor activity had increased within 4 minutes of consuming coffee (regular and decaffeinated) and lasting up to 30 minutes afterwards, and is comparable to eating a meal (3,,4).


So what does this mean if you have IBS?

For individuals with IBS- Diarrhea predominant, drinking coffee can be problematic since the motility of the colon is already moving faster than normal. Coffee will likely increase the urgency to defecate.


Also, several people with IBS suffer from anxiety. Having caffeine from sources such as coffee enhances the "fight or flight" response that can exacerbate anxiety, which can create a more spasmodic response in the colon.


For those with IBS-Constipation predominant, drinking coffee can be helpful to stimulate their motility to have a bowel movement. So, having a cup or two in the morning can help you have a bowel movement.


Too Much of a Good Thing.

Even if you have IBS-Constipation, there could be too much of a good thing. Too much caffeine can still cause cramping even in normal digestive tracts.


If you love your coffee, and want to see if you have a threshold you can tolerate. Than try:

  • Eliminating coffee for 2 or more weeks, until digestion normalizes.

  • Then gradually add coffee back in small portions day by day to see how much you can tolerate.

  • Also, avoid any other items that could be irritating your digestion such as: sugar free syrups, flavored coffees, or milk if lactose intolerant.

If you can keep coffee in your diet, keep caffeine to less than 400 mg per day. (<200mg/day if pregnant). All caffeine sources contribute to this daily amount, such as:


Brewed Coffee, 8 oz = 96 mg

Brewed Decaf Coffee, 8 oz = 2 mg

Espresso Coffee, 1 oz = 64 oz

Brewed Black tea, 8 oz = 47 mg

Brewed Green Tea, 8 oz = 28 mg

Energy Shot, 1 oz = 215 mg


If you are someone who does not tolerate coffee, yet enjoys something warm to drink. Try sipping on a cup of ginger or peppermint tea.



References:

1.Simren, M., et al., Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion, 2001. 63(2): p. 108-15.

2.Monsbakken, K.W., P.O. Vandvik, and P.G. Farup, Perceived food intolerance in subjects with irritable bowel syndrome-- etiology, prevalence and consequences. Eur J Clin Nutr, 2006. 60(5): p. 667-72.

3. Boekema, P, et al. Coffee and Gastrointestinal Function: Facts and fiction. A Review. Scand J Gastroenterol Suppl, 1999. 230:35-9.

4. Brown, S, Et al. Effect of coffee on distal colon function. Gut. 1990 Apr; 31(4): 450–453.

4. Rao, S. Et al. Is Coffee a Colonic Stimulant? Eur J Gastroenterol Hepatol. 1998 Feb;10(2):113-8.

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