IBS and Coffee: Can They Co-Exist?

IBS and Coffee - Can They Coexist?

IBS and Coffee - Can They Coexist?

Is it possible for IBS and coffee to coexist? This is a conundrum that comes up quite often in the world of gut health and nutrition, and for good reason!

Given the multiple types of adverse food reactions and the delayed, dose-dependent nature of food sensitivities that often co-occur with IBS, it can feel confusing and overwhelming to try and nail down which foods/beverages are making you feel so crummy all the time.

 (If you’re one of many with IBS who has scoured the internet for “foods to avoid with IBS”, seeing coffee and caffeine on a bunch of those lists can feel pretty disheartening to say the least!)

When you suffer from symptoms of IBS and/or leaky gut, savoring a morning cup of coffee might unfortunately feel more like a privilege than a choice.

But luckily, having IBS and enjoying your morning brew don’t always have to be mutually exclusive!

Read on to learn whether it’s possible for your morning coffee ritual to become compatible with your IBS healing journey.

*Affiliate disclosure: this post contains affiliate links, which means if you make a purchase, I make a commission at no extra cost to you! I only endorse and recommend products and companies that I love and use myself.*

What is IBS?

Irritable bowel syndrome (IBS) is a modern-day, functional digestive health epidemic which plagues ~25 to 45 million people in the U.S., and ~10-15% of people worldwide at this time, according to the International Foundation for Gastrointestinal Disorders (1)

Signs and symptoms of IBS vary greatly from person to person.  IBS is characterized by the ongoing presence of any cluster or combination of the following, when in the absence of another underlying medical condition:

  • Frequent gas
  • Bloating after eating
  • Stomach pain/cramping
  • Constipation – small, incomplete, and/or infrequent bowel movements
  • Diarrhea – loose, light-colored stools
  • Urgency or incontinence with bowel movements
  • Nausea
  • Heartburn
  • Adverse food reactions

What is coffee?

There’s nothing quite like the smooth, pleasure-invoking aromas of freshly ground coffee beans wafting from your kitchen or local café first thing in the morning!  Or sitting quietly, sipping on your coffee beverage, soaking up every moment of the “calm before the storm” as a part of your daily morning ritual.

Coffee is a wildly popular caffeinated herbal beverage which is made from extracting the flavors, essences, and constituents of the beans from a plant called Coffea arabica. It can be enjoyed hot or iced, flavored or plain, sweetened/unsweetened, cut with milk/milk substitute or “black”, regular or decaffeinated.

Regardless of how people choose to enjoy their coffee, most fellow coffee-drinkers could probably agree that drinking coffee isn’t just about “getting caffeinated” or for the taste of those extracted coffee beans! For many, mindfully sipping on a cup of coffee can feel more like a mind-body experience.

But whether we like it or not, coffee is hit-or-miss among IBS sufferers…

Coffee and the gut

While some people feel great after drinking coffee and even rely on coffee to stay “regular”, others could find themselves running to the bathroom or feeling queasy after just a few sips of this popular morning elixir.

So how can you tell if coffee is your friend or foe when you’ve got IBS?

While there isn’t one right answer, there are many different factors to consider that could help you determine how well you respond to coffee, from a digestive health standpoint!

Caffeine, coffee and IBS

A recent 2021 study measured rates of coffee and caffeine consumption among people with IBS, and found a “significant positive association between coffee and caffeine intake and odds of IBS in the whole population”. (2)   

  • While studies have found that caffeine consumption is directly correlated with increased incidence of IBS, it’s always important to listen to your body and observe whether or not caffeine and coffee impact you directly!

Coffee as a bitter herb for digestion

Just like other more traditional versions of digestive bitters such as gentian root or artichoke leaf, coffee is also considered a naturally bitter herb. 

The bitter taste receptors stimulated by drinking coffee (or from taking any kind of digestive bitters) trigger gastric acid receptors in the gut, which help to release digestive juices, preparing the body for the digestion and breakdown of food (3).  This can be for better or worse, depending on whether your IBS is linked with low stomach acid or excess stomach acid.

  • People with weak digestion and low stomach acid are more likely to benefit from digestive bitters, which may also leave them more prone to benefiting from drinking coffee.
  • Those who are prone to problems caused by excess stomach acid are more likely to feel sick from drinking coffee.

Is coffee acidic?

Depending on whether acidic foods play a role in your IBS flares or not, the type of coffee you choose to drink could potentially make-or-break your day.

The caffeine in coffee makes it naturally very acidic, which can potentially trigger or worsen symptoms such as heartburn or nausea in people with IBS.

  • Switching to decaf may be enough to make the difference and could be well worth the compromise so you don’t have to “feel the burn”. 😉 

Is decaf coffee acidic?

Decaffeinated coffee is less acidic than regular coffee, so that could be an alternative way for you to still enjoy the taste of coffee, minus the nausea or reflux.

Does coffee cause heartburn?

Heartburn is said to be one of the most common reported side effects from drinking coffee, according to Scandinavian Journal of Gastroenterology (4). However, while coffee appears to be a symptom trigger for those who are prone to heartburn, no studies are available to confirm that drinking coffee is directly correlated with developing heartburn or acid reflux.

More research is needed, but it’s likely there are other constituents in coffee aside from just caffeine which are likely playing a role in heartburn:

  • For example, a study from Alimentary Pharmacology and Therapeutics uncovered that switching from regular to decaffeinated coffee diminished heartburn symptoms substantially in the study participants, while switching from regular to decaffeinated tea and adding caffeine to water didn’t have any substantial impact on heartburn symptoms among participants one way or the other (5).  

The best way to determine whether coffee triggers heartburn symptoms for you is to observe and listen to your body. 

A food-symptom journal and working with a dietitian 1:1 can also go a long way to help you figure it out sooner rather than later!

Does coffee move the bowels?

For those seeking more regularity, a morning cup of coffee could be a great ally.

Regular caffeinated coffee has been shown to stimulate the lower gastrointestinal (GI) tract, specifically in the transverse/descending colon (6)

The verdict according to a clinical trial from the European Journal of Gastroenterology and Hepatology was that regular coffee’s stimulant effects on the colon were similar to that of a meal, 60% greater than the magnitude of water, and 23% greater than the magnitude of decaffeinated coffee (6). Wowzah! That’s a pretty big difference.

But for others with IBS-D wanting to reduce the frequency of their bowel movements while still enjoying the taste of coffee, switching to decaf might go a long way.

Decaf coffee and IBS

Decaffeinated coffee is less acidic than its caffeinated counterpart and may be better tolerated by people who experience nausea, heartburn and/or diarrhea from regular coffee.

While decaf coffee still does stimulate the colon more so than water or a placebo (6), people with diarrhea or IBS-D may find they can tolerate some decaffeinated coffee in moderation in place of regular.

Coffee and nausea

Does coffee cause nausea? While there aren’t any direct studies investigating the relationship between coffee and nausea, it’s highly possible to get nauseous from drinking coffee – just like it’s possible to have an adverse food reaction to virtually any kind of food, herb, or chemical.

Nausea is usually a sign of adverse food reactions, indigestion, and/or imbalanced stomach acid levels in the gut, so given the high acidity levels of caffeinated coffee and its tendency to aggravate symptoms of heartburn, this could explain why some people feel nauseous after drinking coffee.

  • Avoiding having coffee on an empty stomach is one way to help reduce the likelihood of developing nausea from coffee.
  • Cutting your coffee with some milk/milk substitute and a natural sweetener can also sometimes make a difference (keep reading!).

Coffee and leaky gut

IBS is often caused and amplified by conditions such as dysbiosis and leaky gut.  Leaky gut is a functional medicine term used to describe the state of having a damaged or compromised gut lining.

While healing a leaky gut requires a multidimensional approach, you may or may not be able to still enjoy coffee along the way! It depends on lots of factors.

  • In order to determine whether coffee is exacerbating your leaky gut, you’ll want to individually rule out a sensitivity to coffee, as well as sensitivities to chemicals such as caffeine, tyramine, and histamine (which are all naturally present in coffee).
  • You’ll also want to to determine if coffee is directly triggering any IBS symptoms for you or not. (This is best done working alongside a functional dietitian nutritionist!)

Coffee and the microbiome

Dysbiosis, an imbalance of healthy and unhealthy microbes in the gut, is shown to be present in most if not all people with IBS (7).  

A surprising benefit of coffee and the gut microbiome is that coffee has been shown to increase levels of beneficial probiotic strains of Bifidobacterium spp., which help to enhance digestion, protect the integrity of the gut lining, support the immune system, and prevent multiple types of disease (8).

Coffee and FODMAPS

Many people with IBS are encouraged to go on a low FODMAP nutrition protocol to help reduce/prevent IBS flares.

  • FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols”. These are certain types of short-chain carbohydrates and fibers which aren’t well digested in the gut, so they end up getting fermented by microbes in the gut that cause unwanted symptoms like gas and bloating.
  • While the low FODMAP diet is not meant to be a long-term solution for people suffering from IBS, sticking to low FODMAP foods can help to provide some relief for people with IBS from a symptom-management standpoint.

(Download my free gut health nutrition guide to learn why simply cutting out foods is NOT the way to long-term gut repair!)

5 Biggest Diet Mistakes to Avoid When Healing Your Gut

Coffee itself is naturally low FODMAP, but instant coffee has the potential to contain high FODMAP additives such as chicory root, which is a common trigger for gas and bloating among many people with IBS. Not ideal!

Avoiding instant coffee and sticking to traditionally-made coffee is an easy way to maintain low FODMAP compliance – as long as you’re also staying mindful of the sweeteners and milk/milk substitute you are adding or not adding to your morning brew! (Keep reading.)

Sweeteners in coffee

Figuring out how to tolerate coffee from a gut health standpoint is a battle in itself; knowing how to sweeten your coffee for digestive health purposes is a whole other story…

With dozens of different types of sweeteners available on the market and in our favorite café’s, it doesn’t take much to find yourself in a state of “decision fatigue” when it comes to picking out a sweetener for your coffee!

Most types of sweeteners (natural or artificial) are known to alter the gut microbiome one way or the other, so it’s important to be mindful and purposeful about selecting a staple sweetener for your coffee that you can enjoy while also tolerating from a digestive health standpoint.

The sweeteners most likely to amplify dysbiosis among people with IBS include:

  • Table sugar / cane sugar
  • Corn syrup / high fructose corn syrup
  • Sucralose / Splenda
  • Aspartame / Equal
  • Saccharin / Sweet & Low
  • Erythritol
  • Xylitol

GI-friendly sweeteners less likely to amplify dysbiosis among people with IBS:

  • Real maple syrup
  • Coconut palm sugar
  • Monk fruit extract (aka Luo Han Guo, or Siraitia grosvenorii)
  • Stevia leaf extract

What about honey and agave?

  • Honey and agave nectar are considered natural sweeteners, but they’re also very high in fructose (a type of FODMAP) so they’re “hit-or-miss” when it comes to managing IBS.  

The best way to determine which GI-friendly sweetener is the best option for you is to try each of them out, observe, and listen to your body. Working 1:1 with a functional dietitian nutritionist can also help you to save lots of time and frustration!

Milks and dairy substitutes in coffee

Milk, cream, half & half, creamer, oat milk, almond milk, soy milk, coconut milk – oh my!  Trying to decide on a milk or dairy substitute for your morning brew can be just as overwhelming as picking a sweetener when you find yourself in “analysis paralysis”.

While there isn’t one right answer, it’s important to note lots of people with IBS do have a tendency towards lactose intolerance and/or a dairy sensitivity. 

  • The best way to determine this is to work with a functional dietitian nutritionist who can help you through nutritional assessment and functional nutrition testing!

At the same time, sweetened milk substitutes are often loaded with added sugars and fillers which can potentially trigger and amplify dysbiosis.

Adding something to your coffee once in a while really won’t make a difference, but if you’re trying to craft a daily staple brew that works for your body, this stuff matters.

  • Finding a plant milk without added sweeteners or fillers (such as Malk, Rise, Elmhurst, Nutty Life, or even a homemade version like this pecan milk) is an ideal option for IBS!
  • An unsweetened version of your favorite plant milk/dairy substitute is a great second-best option from a gut health standpoint.

Water in coffee: does it matter?

Long story short, the water we use to make our morning brew will make a difference over time. Given that most if not all cases of IBS are linked with dysbiosis (an imbalance of good and bad bacteria in the gut microbiome), using chlorinated tap water to make coffee is not going to help your situation!

Using a great quality water filter such as this Berkey filter* (which is what we use at home) can go a long way to reduce your consumption of chlorine, which have a negative impact on gut microbes and gut health over time (9).

Coffee alternatives

While there’s nothing quite like caffeinated coffee, there are some fabulous herbal alternatives on the market that can help you to get your fix without the flare!

A few non-coffee herbal alternatives to consider trying include:

IBS and coffee: conclusions

While the research shows there is definitely a correlation between coffee consumption and IBS, it’s important to note that not everyone with IBS will need to avoid coffee!

Switching to decaf, choosing a good quality coffee, cutting your coffee with a good quality sweetener and dairy sub, and staying mindful of the quality of water you use to make your daily brew can all go a long way to help you enjoy coffee again without flares.

Considering an herbal alternative to coffee can also help you to have a coffee-like experience without the unwanted IBS symptoms, if you don’t mind going without the caffeine rush in the morning!

While improving your coffee routine can help with managing IBS, it’s also important to make sure you’re working with a holistic treatment team to investigate and address the underlying root causes of your IBS/leaky gut symptoms.

Working 1:1 with a functional dietitian nutritionist is going to be the fastest way for you to crack your code, get answers and find relief from your IBS once and for all.  It’s a much more ideal option than continuing to throw things at the wall to see what sticks.  😉 

Please don’t hesitate to reach out if you’d like to learn more about how we can work together on your holistic gut repair journey!

References:

  1. “Facts about IBS.” About IBS, International Foundation for Gastrointestinal Disorders, Inc., 25 Mar. 2021, https://aboutibs.org/what-is-ibs/facts-about-ibs/.
  2. Koochakpoor, Glareh et al. “Association of Coffee and Caffeine Intake With Irritable Bowel Syndrome in Adults.” Frontiers in nutrition vol. 8 632469. 15 Jun. 2021, doi:10.3389/fnut.2021.632469 
  3. Boekema, P J et al. “Coffee and gastrointestinal function: facts and fiction. A review.” Scandinavian journal of gastroenterology. Supplement vol. 230 (1999): 35-9. doi:10.1080/003655299750025525 
  4. Jaquet, Muriel et al. “Impact of coffee consumption on the gut microbiota: a human volunteer study.” International journal of food microbiology vol. 130,2 (2009): 117-21. doi:10.1016/j.ijfoodmicro.2009.01.011
  5. Wendl, B et al. “Effect of decaffeination of coffee or tea on gastro-oesophageal reflux.” Alimentary pharmacology & therapeutics vol. 8,3 (1994): 283-7. doi:10.1111/j.1365-2036.1994.tb00289.x
  6. Rao, S S et al. “Is coffee a colonic stimulant?.” European journal of gastroenterology & hepatology vol. 10,2 (1998): 113-8. doi:10.1097/00042737-199802000-00003
  7. Wang, Lin et al. “Gut Microbial Dysbiosis in the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies.” Journal of the Academy of Nutrition and Dietetics vol. 120,4 (2020): 565-586. doi:10.1016/j.jand.2019.05.015
  8. Hidalgo-Cantabrana, Claudio et al. “Bifidobacteria and Their Health-Promoting Effects.” Microbiology spectrum vol. 5,3 (2017): 10.1128/microbiolspec.BAD-0010-2016. doi:10.1128/microbiolspec.BAD-0010-2016
  9. Sasada, Tatsunari et al. “Chlorinated Water Modulates the Development of Colorectal Tumors with Chromosomal Instability and Gut Microbiota in Apc-Deficient Mice.” PloS one vol. 10,7 e0132435. 17 Jul. 2015, doi:10.1371/journal.pone.0132435

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