- Coffee and IBD
- How does coffee impact IBD symptoms?
- Does coffee cause IBD?
- Alternatives to coffee for people with IBD
- Our tips and recommendations
Coffee and IBD
Everyone loves a good cup of joe—but sometimes, for people suffering from IBD, this can lead to trouble.
Irritable Bowel Disease is characterized by a group of recurring symptoms, such as gut inflammation, abdominal pain or cramping, bloating, abnormal bowel movements, and fatigue.
Due to the nature of the disease, IBD patients need to be cautious about the types of food they eat and avoid potential trigger foods. Trigger foods contain compounds that, while causing no harm indirectly, activate IBD symptoms. Coffee is a common trigger drink for some people with IBD.
What is coffee and how does it work?
Coffee contains caffeine, a stimulant agent best known for combating drowsiness. An average cup of instant coffee contains 60mg of caffeine, whereas a freshly brewed cup contains anywhere between 80-120mg.
Caffeine impacts several metabolic pathways in the body. Through binding to an adenosine receptor, it prevents sleepiness and promotes wakefulness. Likewise, it can also inhibit glucose receptors in cells, leading to high glucose levels in the blood and consequent stronger insulin releases (in fact, there is evidence that caffeine consumption can reduce the risk of type 2 diabetes!) Caffeine also triggers the release of the stress hormone cortisol, responsible for the “fight or flight” response affecting appetite and digestion.
How does coffee impact IBD symptoms?
Caffeine impacts many of the metabolic processes in the body, especially those related to digestion. It can reduce digestion, increase the speed of bowel movements, and cause constipation and inflammation. Despite all of this, research remains controversial about whether caffeine is good or bad for IBD patients. Some studies suggest that caffeine’s inhibition of adenosine leads to the activation of a pro-metabolic factor protein kinase A, leading to a reduction of inflammatory protein production and release. However, a meta-study performed in Japan in 2023 comparing research over a 20-year period found that more recent studies begin to show a correlation between caffeine consumption and symptom-intensive IBD. In any case, the mechanisms by which caffeinated coffee triggers IBD symptoms are clear:
Release of cortisol
Cortisol is a stress hormone released by the adrenal glands. Caffeine stimulates the release of cortisol, which increases alertness, increases muscular reactivity, causes inflammation, and suppresses appetite. However, these same metabolic pathways also decrease the rate of digestion, which can lead to unnecessary stress on the sensitive GI tract of IBD patients.
Causes diarrhea
Caffeine accelerates muscle reactivity. While this can be great for increasing alertness and improving performance, many IBD patients struggle with speedy bowel movements, leading to diarrhea. Through accelerating already quick bowel movements, patients may see an increase in the severity of their symptoms and pain due to muscular strain.
Causes dehydration
Caffeine acts as a diuretic, which means it can cause dehydration. While this does not directly affect IBD, a lack of fluids can lead to harder stools and constipation.
Decrease in cell growth and regeneration
Cells are constantly regenerating in our body, at a rate controlled by metabolism, which ensures that we get the nutrients we need to produce and support healthy cells. Caffeine may slow down cellular regeneration, impacting the repair of the inflamed intestinal tract. This can extend the duration between inflammation and cellular repair, especially if sleep is disrupted due to caffeine.
Does coffee cause IBD?
While the research community is still unsure whether there is a causal connection between the development of IBD and caffeine consumption, there is evidence that caffeine consumption triggers the appearance of IBD symptoms. This is because caffeinated coffee only stimulates already existing natural pathways without depositing toxins or harmful materials into the body. The problem, like any other physiological occurrence, is a matter of balance. Too much of anything is bad for you, and for IBD patients, who typically have gut sensitivity, caffeinated coffee can lead to the development of symptoms such as abdominal pain, abnormal bowel movements, and inflammation.
Alternatives to coffee
Coffee drinkers can be loath to remove the drink from their diet, and the truth is many IBD patients drink coffee without issue. However, if someone does experience issues with caffeine consumption, there are effective alternatives to coffee containing less caffeine with similar nutritional benefits.
While career coffee drinkers often think less of it, instant coffee contains less caffeine (60 mg as opposed to 80-120 mg of freshly brewed coffee) per cup. For those with only mild side effects, trying instant coffee might be a quick way to reduce symptoms without giving up on the stimulatory effects in the morning.
Tea, especially green tea, is often used as a substitute for coffee, since it contains energy-boosting materials, similar antioxidant properties, and remediates the social activity of drinking coffee. However, green tea often contains caffeine as well; therefore, IBD patients struggling with the symptoms caused by caffeine consumption should limit this alternative as well.
Decaffeinated coffee is often thought to provide the same benefits as coffee in terms of nutritional value and contains much less caffeine per cup (2-10mg per cup). With the reduced caffeine load, but all the same ingredients, this could be a great alternative for IBD patients struggling with caffeine consumption but still craving that morning coffee.
Our tips and recommendations:
Less is more
The National Institute of Health reports that consumption should not exceed 400mg of caffeine per day. However, IBD patients should consume much less than this! Drinking too much coffee, especially for IBD patients, can lead to tremors, anxiety, tachycardia, and other undesirable symptoms. Drinking coffee in moderation, both in frequency and quantity, can reduce unwanted side effects from your IBD.
Drink slowly
Did you know that people who drink coffee slowly experience more benefits and fewer side effects? It’s true! Through gradual consumption of coffee over a 15-30 minute period, there is more time for the body to ready itself to receive the nutrients and antioxidants in the coffee. Another reason to drink slowly is to reduce the amount of caffeine that encounters the GI tract in one instant, regulating the gradual release of cortisol instead of instigating a massive wave of stress hormones released to the body resulting in a physiological response.
Don’t drink coffee at night
This seems like a no-brainer since coffee wakes you up, but drinking coffee at night can lead to insomnia. Sleep is important for proper digestion and reducing stress hormone release in the body. This is especially important for people with IBD, who may suffer from IBD-related fatigue.
Drink coffee with food
Caffeine consumption with food can help reduce the impact of caffeine on the GI tract since digestion and caffeine absorption occur simultaneously. Some studies suggest caffeine can even be used for IBD patients as a dietary aid, but this is individual to the type of IBD and the person’s symptoms. Either way, having something in your stomach while drinking coffee can lead to less nausea and anxiety.
Summer Pitocchelli-Schwartzman
