Updated: Jan 12
Whenever we get to the 'tell me about your diet' part of a new patient appointment there is always a hesitation before a patient says how much caffeine they drink.
Probably more than sugar, fat, salt or gluten - caffeine seems to be the indulgence we have the most trouble parting ways with.
Fortunately for most, there is no reason to banish caffeine completely. As with most things, when ingested in moderation most people handle caffeine just fine.
Those with digestive symptoms are in a slightly different situation.
There are specific cases when caffeine can be causing or contributing to a condition like Crohn's Disease, Irritable Bowel Syndrome (IBS) or acid reflux.
Caffeine and Overall Health
On the whole, caffeine (consumed in coffee) has shown significant, long term associations with longevity, even for those who are slow metabolizers of caffeine . The benefits continue up until 5 cups of coffee per day .
Tea, and green tea in particular, has remarkable health benefits and has been shown to reduce your chances of diabetes, stroke, abdominal fat, high blood pressure, high cholesterol and overall mortality .
Soda, on the other hand, is so full of dyes, preservatives, added sugar and other cancer causing ingredients that it does not offer any health benefits. In fact, just one can of soda a day  increases your risk of dying.
Help Or Hurt Acid Reflux?
Both coffee and tea have been known to cause acid reflux in some, and not be a problem for others.
Here is what the latest science says about both.
The consumption of coffee can increase the secretion of gastric acid . Most assume that this is why coffee can give them acid reflux but the whole picture is a little more complicated.
Low stomach acid is the most common cause of acid reflux. In fact, taking acid-suppressing tablets can actually impair your digestion (and contribute to acid reflux) as gastric acid is a very necessary component of your digestion.
If the acidity in your coffee is a trigger for your acid reflux then 'cold brew' processed coffee or low acid coffee variations have been known to allow acid sensitive patients to still enjoy their coffee without the punishing burn afterwards.
If low acid coffee still causes you symptoms then water-processed decaffeinated coffee may offer relief.
If these variations still cause symptoms, you could do a trial period without coffee.
Coffee is one of the most important things to taper off of slowly, as withdrawal symptoms can be severe and frequently involve gastrointestinal symptoms as well as anxiety and irritability.
Tea has been known to cause heartburn in some and suppress it in others. Often, patients can handle tea just fine when coffee causes them symptoms.
A meta-analysis looking at the relationship between tea and acid reflux found that tea did not cause acid reflux (except in populations in east Asia) .
Your reaction, however, may be based on something other than caffeine so always listen to your body.
If tea causes you to have symptoms then try decaffeinated, a different variety, or think about cutting it out altogether.
Read more about The Root Cause of Heartburn
As A Remedy For Constipation
The chemical makeup of coffee encourages regularity - it stimulates the production of stomach acid, which kick starts your digestive system.
Chronic dehydration is one of the most common reasons for constipation - and coffee is a diuretic.
Many find that coffee is the only way they can stay regular.
If this is the case for you, make sure you are not chronically dehydrated.
Before your cup of coffee in the morning, drink a large glass of water with some lemon in it. It will be act as a gentle liver cleanse and counteract any dehydration caused by your coffee.
If your constipation does not go away in a few days, or is recurrent then additional testing is needed to rule out conditions like small intestinal bacterial overgrowth (SIBO) or food poisoning.
Read more about Digestive Problems
Irritable Bowel Disease (IBD)
Crohn's Disease & Ulcerative Colitis
This Swiss study  confirms what I have found to be the case with my own patients.
Although upwards of 90% of patients with IBD report negative reactions when they drink coffee - most do not cut it out of their diet completely.
IBD patients can have the experience of drinking no coffee, eating a strict symptom-avoidance diet and be feeling great and then get hit with a relapse out of nowhere.
In these cases, secondary factors like infections and microbial imbalances are at work and should be addressed.
Don't abandon your diet as a potential tool for symptom management - just be sure you are employing all of the necessary tests so that your efforts are not in vain.
In the meantime, the advise I give to my IBD patients regarding caffeine is the same for my other patients - if you react adversely to something, cut it out (at least temporarily) and find out why you reacted - there is always a reason behind a relapse.
Read more about my approach to Crohn's and Ulcerative Colitis
Coffee And Irritable Bowel Syndrome (IBS)
Scientific studies are notoriously cautious in their conclusions, however most of them correlate caffeine consumption with IBS symptoms .
Most doctors who treat those with IBS will agree that that there is an obvious and strong correlation with what a patient eats and the severity of their IBS.
Patients sometimes experiment with drinking cold brew or low acid coffees but in cases of idiopathic (without known cause) IBS it is best for an in-depth investigation into symptoms to be performed right away.
The same IBS symptoms can implicate low stomach acid, a food allergy, IBS, microbial infection as a result of food poisoning or Crohn's disease. Finding the cause of these symptoms should be your doctor's first priority.
Read more about Irritable Bowel Syndrome (IBS)
Toxins In Coffee
If you a regular coffee drinker, particularly one that has occasional stomach upset, be sure you are drinking fresh, organic coffee.
Fresh coffee is not just a matter of taste preference, when coffee gets old or is not stored properly it can grow mold. Buy beans as soon as possible from the packaged date and grind them as close to drinking it as you can.
If you drink decaf coffee make sure it is 'water processed,' a process used to decaffeinate the coffee that relies on water instead of chemicals. Single origin coffee is preferable over blends.
Coffee that is prepackaged or in 'pods' has been found to contain heavy metals and phthalate contamination .
You can buy organic, single source coffee that is batch tested for contaminants through your local health store or online.
Your gastrointestinal tract is very efficient at absorbing what you eat, that includes any accompanying toxins that are in your drinks.
Toxins like heavy metals found in your coffee or tea can contribute to or cause severe gastrointestinal symptoms as well as other chronic illnesses.
Read more about Toxicity
Toxins In Tea
The tea plant naturally pulls toxins from the ground causing tea leaves to accumulate heavy metals, these heavy metals can cause symptoms and disease .
The amount and type of heavy metals measured in teas varies depending on the environment and country in which they are grown .
If you have heavy metal toxicity then be sure that your tea is sourced so that you are not adding to your health problems.
On a side note, you can save money and know what you are drinking by buying whole leaf tea in bulk. Teabags and especially tea drinks are marked up considerably and could have ingredients that you didn't sign up for (like preservatives).
When Caffeine Is A Problem - And When Its Not
If drinking high quality coffee or tea does not cause you symptoms, your digestion is normal and you do not amend your daily cup with a bunch of sugar - then you are most likely contributing to your overall health.
If something new is happening in your body that causes symptoms like stomach pain, bloating, headaches, or anxiety - excess caffeine may be holding you back from healing.
Also, certain people have a genetic defect that can make caffeine increase their estrogen levels. Excess estrogen in the body can cause a wide range of digestive, autoimmune and hormone-related symptoms.
Functional Medicine Can Help You
Rather than adhering to a strict elimination diet in the hopes of suppressing symptoms, go after the cause.
Employ key functional medicine tests (like a comprehensive stool analysis for gastrointestinal symptoms) to get to the root of symptoms and to determine the steps forward.
If you would like to speak to me to ask questions about functional medicine, chronic illness or how I can help you, please schedule a Free 15 Minute Consultation or call or text my office at 913-728-5291.
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