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Irritable Bowel and Inflammation

As many as 1.4 million people in the United States suffer from inflammatory bowel diseases (IBD); these include Crohn’s, IBS and colitis. In these conditions, people experience severe states of inflammation leading to pain and discomfort as well as compromised ability to properly digest and absorb necessary nutrients, leading to deficiencies. People suffering from IBS, Crohn’s disease and colitis find that making specific dietary changes can be very helpful to relieve symptoms and prevent recurrence.

Foods including: caffeine, coffee, decaffeinated coffee, insoluble fiber, alcohol, chocolate, hot spices, carbonated drinks and foods high in fat can trigger IBS symptoms. (NIH, 2003), (Simren, et al, 2001), (Russel, et al, 1998) Additionally, food intolerances such as dairy products or gluten-containing grains may trigger inflammatory episodes.

 


Coffee as an Intestinal Stimulant

Coffee produces a laxative effect in susceptible people through stimulation of rectosigmoid motor activity, as soon as four minutes after drinking. Even modest doses of coffee can have this effect, whether or not the body is ready to dispose of the feces, resulting in loose stools. Studies show that decaffeinated coffee has a similar stimulant effect on the GI tract proving that the laxative effect is not only due to caffeine. (Brown, et al, 1990), (Boekma, et al, 1999) Caffeinated coffee stimulates activity of the musculature of the colon and colonic motility, more so than water and equal to the effect of eating a meal. Decaffeinated coffee also increases motility, although less so than caffeinated coffee. (Rao, et al, 1998)

 

Intestinal Lining Damage

Coffee tends to speed up the process of gastric emptying, which may result in highly acidic stomach contents passing into the small intestine more rapidly than normal. This may lead to injury of the intestinal tissue. (Glatzel and Hackenberg, 1967)



Caffeine, the Stress Response and Irritable Bowel

Caffeine in coffee elevates the stress hormones cortisol, epinephrine (also known as adrenaline) and norepinephrine. (Robertson, et al, 1978) (Lane, et al, 1990) (Lane, 1994) (Kerr, et al, 1993) These hormones mediate the body’s stress response, or state of "high alert," during which heart rate and blood pressure increase and blood and resources are diverted from the immune and digestive systems.

IBS and IBD are sensitive to stress, particularly because neural control of the gastrointestinal tract is affected by stress and emotions. (Dapoigny, et al, 2003), (Simren, et al, 2001), (Mulak, et al, 2004)



Caffeine Interferes with the Calming Neurotransmitter GABA

GABA (Gamma-aminobutyric acid) is a neurotransmitter that is naturally produced in the brain and the gastrointestinal (GI) tract. It plays an important role in mood and stress management and it exerts a calming effect on digestive system.

Caffeine has been found to interfere with binding of GABA to GABA receptors, preventing the neurotransmitter from performing its calming function. (Ribeiro, J.A. and Sebastiao, A.M. 2010), (Utley, 1992)

In cases of IBS, ulcerative colitis, and other lower digestive disorders in which the lower GI tract is already irritated and often hyperactive, the lack of GABA’s calaming effect further exacerbates the problem. In addition to the direct effect on the GI tract, GABA’s role in stress management is also compromised in the presence of caffeine. This is significant becuase psychological stress is known to be a contributing factor in IBS. (Babb, 1984) (Rocca, D. J., et al, 1998)



Magnesium, Healing and Caffeine

Magnesium plays an essential role in more than 300 cellular reactions. When magnesium is low in the bloodstream, it will be pulled from cells to maintain plasma concentration, so magnesium deficiencies are difficult to detect. Adequate magnesium is important for maintaining bowel regularity and magnesium is often used to produce a laxative effect in constipation. For people suffering from colon irritation related to irritable bowel disease, adequate dietary magnesium is essential.

Magnesium is necessary for stable collagen formation in connective and epithelial tissue. (Vaxman, et al, 1996) It is also a crucial mineral for the biochemical processes involved in wound healing, (Utley, 1992) making it vital to healing the irritated lining of the colon in IBS. Coffee consumption decreases magnesium levels in the body. (Johnson, S., 2001)



The Diuretic Effect of Caffeine Affects Regularity

The diuretic effect of caffeine causes excretion of fluid through the kidneys, which can lead to dehydration. Since water is an important part of the digestion and elimination process, dehydration due to excess caffeine may increase constipation related to water balance. (Vaxman, et al, 1996)


References (by alphabetical order)

Boekema, P.J., Samsom, M., van Berge Henegouwen, G.P. and A.J. Smout. 1999. Coffee and gastrointestinal function: facts and fiction. A review. Scandinavian journal of gastroenterology. Supplement. 230:35-9.


Brown S.R., P.A. Cann, and N.W. Read. 1990. Effect of Coffee on Distal Colon Function. Gut, Apr;31(4):450-3.


Dapoigny, M., R.W. Stockbrugger, F. Azpiroz, S. Collins, G. Coremans, S. Muller-Lissner, A. Oberndorff, F. Pace, A. Smout, M. Vatn, and P. Whorwell. 2003. Role of Alimentation on Irritable Bowel Syndrome. Digestion, 67(4):225-33.


Glatzel, H., and Hackenberg, K. 1967. Effects of Caffeine Containing and Decaffeinated Coffee on the Digestive Functions: X-ray Studies of the Secretion and Peristalsis of Stomach, Intestines and Gallbladder, Medizinische Klinik, 62(16):625-28.
 

Johnson, S. 2001. The multifaceted and widespread pathology of magnesium deficiency. Medical Hypothesis. 56(2): 163-70.


Kerr, D., Sherwin, R.S., Pavalkis, F., Fayad, P.B., Sikorski, L., Rife, F., Tamborlane, W.V. and During, M.J. 1993. Effect of caffeine on the recognition of and responses to hypoglycemia in humans. Annals of Internal Medicine. 119(8):799-804.


Lane, J.D. 1994. Neuroendrocine Responses to Caffeine in the Work Environment. Psychosomatic Medicine. 546:267-70.


Lane, J.D., Adcock, R.A., Williams, R.B. and C.M. Kuhn. 1990. Caffeine effects on cardiovascular and neuroendocrine responses to acute psychosocial stress and their relationship to level of habitual caffeine consumption. Psychosomatic Medicine. 52(3):320-36.


Mulak, A. and B. Bonaz. 2004. Irritable bowel syndrome: a model of the brain-gut interactions. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research 10(4):RA55-62.


NIH Publication No. 03-4686, copyright 2003.


Rao, S.S., Welcher, K., Zimmermn, B. and Stumbo 1998. Is coffee a colonic stimulant? European journal of gastroenterology & hepatology. 10(2):113-8.


Robertson, D., Frolich, J.C., Carr, R.K., Watson, J.T., Hollifield, J.W., Shand, D.G. and J.A. Oates. 1978. Effects of caffeine on plasma renin activity, catecholamines and blood pressure. New England Journal of Medicine. 298(4):181-6.


Russel M.G., L.G. Engels, J.W. Muris, C.B. Limonard, A. Volovics, R.J. Brummer, R.W. Stockbrugger. 1998. Modern life in the epidemiology of inflammatory bowel disease: a case-control study with special emphasis on nutritional factors. European Journal of Gastroenterology and Hepatology, Mar;10(3):243-9


Simren, M., A. Mansson, A.M. Langkilde, J. Svedlund, H. Abrahamsson, U. Bengtsson, and E.S. Bjornsson. 2001. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion, 63(2):108-15.


Simren, M., Mansson, A., Langkilde, A.M., Svedlund, J., Abrahamsson, H., Bengtsson, U. and E.S. Bjornsson. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion. 2001;63(2):108-15.


Utley, R. 1992. Nutritional factors associated with wound healing in the elderly. Ostomy Wound Management, 38(3):22, 24, 26-7.


Vaxman, F., Olender, S., Lambert, A., Nisand, G. and Grenier, J.F. 1996. Can the wound healing process be improved by vitamin supplementation? Experimental study on humans. European Surgical Research. 28(4): 306-14.


Vaxman, F., Olender, S., Lambert, A., Nisand, G. and Grenier, J.F. 1996. Can the wound healing process be improved by vitamin supplementation? Experimental study on humans. European Surgical Research. 28(4): 306-14.

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