How Coffee Affects Digestion and Gut Health

If you suffer from digestive disorders, you will want to learn how coffee & decaf may be aggravating your condition. Read below for an overview of the reasons why eliminating coffee from your diet may improve your symptoms.

Coffee increases incidence of GERD (gastro-esophageal reflux disease) & heartburn

Heartburn (pain beneath the breastbone), acid reflux and gastroesophageal reflux disease (GERD) occur when there is a regurgitation of acid or acid mixed with food from the stomach into the unprotected lining of the esophagus.

In chronic GERD, the sensitive tissues of the esophagus are frequently damaged, and people experience pain, dysphagia (difficulty swallowing), bleeding, and even choking. General symptoms of acid reflux, heartburn or GERD include chest pain, bleeding, esophageal stricture (narrowing or obstruction of the esophagus) or the pre-malignant Barrett’s esophagus.

Both decaffeinated and regular coffee are highly acidic and can increase the secretion of stomach acids.1 Decaffeinated coffee has been shown to increase acidity to a greater degree than either regular coffee or caffeine alone.2

Coffee has also been shown to decrease pressure in the lower esophageal sphincter (the ring of muscle between the esophagus and the stomach), suggesting that coffee can either cause or exacerbate reflux and heartburn in susceptible individuals.3 Both caffeinated and decaffeinated coffee aggravate reflux more than caffeine added to water, suggesting that components in coffee other than simply caffeine contribute to reflux.4 By kicking the caffeine habit, you can help decrease the painful symptoms of reflux disease and heartburn.

Contrary to popular belief, the type of roasting process used, the time of day coffee is consumed and whether or not it is combined with other foods does not affect the incidence of heartburn in susceptible persons.5

Coffee may aggravate ulcers

Ulcers are regions where the stomach lining has been destroyed by stomach acids or digestive fluids and enzymes. These can occur in the stomach or duodenum, the first part of the small intestine. When these sensitive areas of the body come into contact with digestive enzymes and acids, even small areas of damage can cause intense pain.

Doctors recommend that people with ulcers restrict not only caffeinated but also decaffeinated coffee intake to decrease pain associated with stomach ulcers.6 Coffee stimulates acid in the stomach and tends to speed up the process of stomach emptying, which may result in highly acidic stomach contents passing into the small intestine more rapidly than normal. This increases the risk of injury to the sensitive intestinal wall, heightening susceptibility for duodenal ulcers.7

The presence of the bacteria Helicobacter pylori in the stomach is a predisposing factor in ulcer development, but not everyone infected with H. pylori develops ulcers. A strong immune system may provide protection against the bacteria’s ability to colonize damaged areas of the stomach lining. Chronically increased levels of stress hormones, such as the glucocorticoids, (which happens under stress or as a result of frequent caffeine or coffee intake) can suppress the immune system.

Chronic glucocorticoid elevation also interferes with the reactions of antigen-specific cell-mediated immune responses to the presence of bacteria, viruses, fungi, some tumors and other invading organisms.8 Glucocorticoids can also cause cell death of a variety of lymphocytes, or white blood cells.9 This can create a situation in which the bacteria H. pylori can thrive in the stomach.

According to the American College of Gastroenterology, ulcers affect approximately 20 million Americans. Predisposing factors to ulcer formation include prolonged stress, skipping meals, being male, family history, cigarette smoking, coffee ingestion and presence of the bacteria Heliobacter pylori combined with a sensitive immune system.10

Coffee increases stress

The caffeine in coffee has been shown to increase the body’s production of stress hormones. These hormones, such as cortisol, are responsible for increased heart rate, increased blood pressure, and anxiety. Stress can worsen the symptoms of GERD, heartburn and inflammatory bowel conditions.

Chronic levels of increased stress hormones have also been shown to contribute to the overgrowth of the stomach bacteria H. pylori. Take better control of these conditions by getting off the coffee and stress roller coaster!

Caffeine interferes with your ability to feel good

GABA (Gamma-amino butyric acid) is a neurotransmitter naturally produced in the brain, nervous system, and the heart – it’s our “feel good” brain messenger that has an important role in mood and stress management. It is also shown to have a calming effect on the GI Tract, contributing to smooth functioning of the gastrointestinal musculature. Drinking caffeine may inhibit GABA’s ability to perform this calming function because caffeine interferes with the binding of GABA to GABA receptors11, as well as the activity of GABA-activated currents in nerve cell membranes.12

Caffeine also interferes with GABA’s role in stress management, which may worsen digestive health since chronic psychological stress is known to contribute to conditions such as acid reflux, GERD, irritable bowel syndrome, heartburn, esophageal reflux, and the development of ulcers. Don’t let coffee interfere with your natural calming mechanisms. Take steps to improve your stress by reducing your caffeine intake.

Works Cited

Citations

  1. Coffey, et al 1986
  2. Cohen and Booth 1975; Feldman, et al 1981
  3. Thomas, et al 1980; Boekema, et al 1999; Cohen 1980
  4. Wendl, et al 1994
  5. DiBaise 2003
  6. Marotta and Floch 1991
  7. Glatzel and Hackenberg 1967
  8. Dhabhar and McEwen 1997
  9. Wyllie 1980; Blewitt, et al 1983; Cidlowski, et al 1996
  10. Abu Farsakh 2002
  11. Roca, et al 1998; Ribeiro, J.A and Sebastiao, A.M. 2010; Cantu, et al 2003; Koek, et al 2003
  12. Li, et al 2004

References

Abu Farsakh, N.A. 2002. Risk factors for duodenal ulcer disease. Saudi Medical Journal 23(2): 168-72.

Blewitt, R.W., Abbott, A.C., and Bird, C.C. 1983. Mode of cell death induced in human lymphoid cells by high and low doses of glucocorticoid. British Journal of Cancer 47(4): 477-86.

Boekema, P.J., Samsom, M., van Berge Henegouwen, G.P. and Smout, A.J. 1999. Coffee and Gastrointestinal function: facts and fiction. A Review. Scandinavian Journal of Gastroenterology Supplement 230: 35-9.

Borger HW, Schafmayer A, Arnold R, Becker HD, Creutzfeldt W. 1976. The influence of coffee and caffeine on gastrin and acid secretion in man. Deutsche Medizinische Wochenschrift 101(12): 455-7.

Cidlowski, J.A., King, K.L., Evans-Storms, R.B., Montague, J.W., Bortner, C.D., and Hughes, F.M. Jr. 1996. The biochemistry and molecular biology of glucocorticoid-induced apoptosis in the immune system. Recent Progress in Hormone Research 51: 457-90, 490-1.

Coffey, R.J., Go, V.L., Zinsmeister, A.R. and DiMagno, E.P. 1986. The acute effects of coffee and caffeine on human interdigestive exocrine pancreatic secretion. Pancreas 1(1): 55-61.

Cohen, S. 1980. Pathogenesis of coffee-induced gastrointestinal symptoms. New England Journal of Medicine 303(3): 122-4.

Cohen, S. and Booth, G.H. Jr. 1975. Gastric acid secretion and lower-esophageal-sphincter pressure in response to coffee and caffeine. New England Journal of Medicine 293(18): 897-9.

Dhabhar, F.S., and McEwen, B.S. 1997. Acute stress enhances while chronic stress suppresses cell-mediated immunity in vivo: a potential role for leukocyte trafficking. Brain, Behavior, and Immunity 11(4): 286-306.

DiBaise, JK. 2003. A randomized, double-blind comparison of two different coffee-roasting processes on development of heartburn and dyspepsia in coffee-sensitive individuals. Digestive Diseases and Sciences 48(4): 652-6.

Feldman EJ, Isenberg JI, Grossman MI. 1981. Gastric acid and gastrin response to decaffeinated coffee and a peptone meal. JAMA 246(3): 248-50.

Feldman, M. and Barnett, C. 1995. Relationships between the acidity and osmolality of Popular Beverages and reported Postprandial Heartburn. Gastroenterology 108(1): 125-31.

H. Glatzel and K. Hackenberg, 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. April 21, 1967; 62(16): 625-28.

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.

Li, S., An, J., Sun, C.K., Li, Z.W. 2004. Inhibitory effect of caffeine on GABA-activated current in acutely isolated ganglion neurons. Sheng Li Xue Bao. June 25. 56(3): 384-8.

Marotta, R.B. and Floch, M.H. 1991. Diet and nutrition in ulcer disease. The Medical Clinics of North America 75(4): 967-79.

Naliboff BD, Mayer M, Fass R, Fitzgerald LZ, Chang L, Bolus R, Mayer EA. 2004.The effect of life stress on symptoms of heartburn. Psychosomatic Medicine 66(3): 426-34.

Ribeiro, J.A. and Sebastiao, A.M. 2010. Caffeine and adenosine. Journal of Alzheimer’s Disease 20 Suppl 1: S3-15.

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.

Roca, D.J., G.D. Schiller, and D.H. Farb. May 1988. Chronic Caffeine or Theophylline Exposure Reduces Gamma-aminobutyric Acid/Benzodiazepine Receptor Site Interactions. Molecular Pharmacology 33(5): 481-85.

Shi, D. Nikodijevic, O., Jacobson, K.A., Daly, J.W. June 1993. Chronic caffeine alters the density of adenosine, adrenergic, cholinergic, GABA, and serotonin receptors and calcium channels in mouse brain. Cell Mol Neurobiol 13(3): 247-61.

Terry P, Lagergren J, Wolk A, Nyren O. 2000. Reflux-inducing dietary factors and risk of adenocarcinoma of the esophagus and gastric cardia. Nutrition and Cancer 38(2): 186-91.

Thomas, F.B., Steinbaugh, J.T., Fromkes, J.J., Mekhjian, H.S., and Caldwell, J.H. Dec 1980. Inhibitory effect of coffee on lower esophageal sphincter pressure. Gastroenterology 79(6): 1262-6.

Wendl, B., Pfeiffer, A., Pehl, C., Schmidt, T. and Kaess, H. 1994. Effect of decaffeination of coffee or tea on gastro-oesophageal reflux. Alimentary pharmacology & therapeutics 8(3): 283-7.

Wyllie, A.H. 1980. Glucocorticoid-induced thymocyte apoptosis is associated with endogenous endonuclease activation. Nature 284(5756): 555-6.