- Coffee and Ulcerative Colitis
- How does coffee impact ulcerative colitis symptoms
- Can coffee trigger ulcerative colitis?
- What kind of coffee is safe for ulcerative colitis
- Alternatives to coffee for people with ulcerative colitis
- Our tips and recommendations
Coffee and Ulcerative Colitis
Ulcerative colitis is one of two prominent versions of IBD (Irritable Bowel Disease) where patients experience a series of GI symptoms that interfere with day-to-day life. Symptoms range in both severity and recurrence, with some patients experiencing gastrointestinal issues daily to periodically, or in response to certain triggers, like stress or specific foods. One common trigger food for UC patients is coffee.
How does coffee impact ulcerative colitis symptoms?
Coffee contains a stimulant molecule called caffeine, which activates a variety of neurological pathways. In general, caffeine promotes alertness through competitively binding to the adenosine receptor. Normally, when it binds to its receptor, this signals the body to send electrical impulses to the parasympathetic system (responsible for the “rest” response) to calm the body down and make one feel tired. However, because caffeine appears similar in structure to adenosine, it can bind to the adenosine receptor and prevent signals being sent to the body to induce drowsiness.
When the rest response of the body is suppressed, the opposite system, the sympathetic nervous system, is activated. This system is responsible for the “fight or flight” response and induces a heightened sense of alertness. This can create a higher heart rate, increased blood pressure, upregulated release of the stress hormone cortisol, and acceleration of neuromuscular communication. It can also suppress immune response and cause inflammation.
Activation of the sympathetic nervous system is inevitable. However, too much or prolonged activation of this system can lead to issues, especially in patients with UC. Caffeinated coffee can increase both the length of time that the sympathetic system is stimulated for (for example, the half life of caffeine can vary between 5 to 10 hours, based on metabolism and body weight) and intensity of the stimulation. This can trigger ulcerative colitis symptoms or potentially increase already existing ones.
Can coffee trigger ulcerative colitis?
It is worth noting that there are many ulcerative colitis patients that drink coffee with little to no side effects. However, the caffeine in coffee can certainly trigger UC symptoms, or make them worse.
For example, caffeine stimulates the release of the stress hormone cortisol from the adrenal glands above the kidney. Cortisol is a long-lived hormone that increases the stimulation of the sympathetic nervous system. One possible outcome of a high cortisol release is increased activity of smooth muscle lining the small intestine, increasing the speed of bowel movements and leading to diarrhea. An increase in the movement of the gastrointestinal muscles and bowels can also lead to improper digestion and decrease in uptake of nutrients from food, leading to malnutrition and weight loss in patients with UC. Alternatively, this can cause weight gain as well, since the body compensates for the lack of nutrition by increasing the collection of fats, which provide more energy but are harder to digest.
Another possible side-effect for UC patients consuming caffeinated coffee is dehydration. Caffeine, through the stimulation of the release of cortisol, leads to the reuptake of fluids from food, meaning digestive material is harder to break down and pass. This can lead to abdominal pain from muscular strain and constipation.
Caffeine, through stimulating the fight-or-flight reaction, also suppresses immune response, making ulcerative colitis patients who are already susceptible to infection even more vulnerable. Ulcerative colitis patients who experience gut inflammation can expect to see an intensification of their symptoms, due to longer periods between the initial inflammation and cellular repair of these locations in the GI tract.
Though there are certainly benefits to drinking coffee, for patients with ulcerative colitis, the consequences may outweigh any possible gain.
What type of coffee is safe for patients with ulcerative colitis?
As we’ve discussed, coffee is problematic for ulcerative colitis patients because of the caffeine content. However, not all coffee is created equal. Instant coffee, for example, contains less caffeine compared to a freshly brewed cup per 100 mL (one 8 oz cup of coffee.)
Decaffeinated coffee
The general rule is moderation; if coffee causes your symptoms to get worse, drink less and drink less caffeinated coffee. Decaffeinated coffee is especially ideal for this purpose. Containing only 2-10mg of caffeine per cup, decaf provides all the benefits of coffee without the caffeinated content.
Alternatives to coffee for people with ulcerative colitis
For UC patients with especially sensitive GI tracts, there are several alternatives that provide the same nutritional benefits, such as antioxidant material, as coffee without caffeine content. Decaffeinated tea, especially green tea, contains antioxidant and anti-inflammatory materials similar to coffee that can help improve UC symptoms.
The most important aspects of finding alternatives are finding decaffeinated substitutes and being careful of the additives used to flavor them. Certain additives in sugar, cream and syrups can be harmful to the gut lining or even contain caffeine themselves, therefore it is important to be aware of what replaces your coffee.
Our tips and recommendations
Get enough sleep: Typically, people start drinking coffee because they want to feel more alert, but with enough sleep, the body can provide its own energy through natural means. It’s especially important for UC patients to get enough sleep to promote a healthy gut, good digestion, and hormone regulation.
Combine your coffee with a meal: If you are going to drink coffee, the best way to consume caffeine is together with food, which can mitigate the acidity and impact of coffee on the gut.
Drink coffee in the morning: Cortisol levels are highest when you wake up and for the half hour afterwards, and then begin to decline. It is best to drink coffee after this initial spike of morning cortisol, between the hours of 9:30-11:00 am, for a maximal boost of energy.
Summer Pitocchelli-Schwartzman
