Episode 21: Should you drink coffee with IBS?

Curious about why or why not coffee is recommended for IBS? The full answer may surprise you!

This episode covers the different characteristics of coffee and how they can impact digestion. You’ll also get a few tips for modifying coffee versus completely removing it, if that’s something you enjoy in your life.

You can check out the podcast on iTunes here, Spotify here, and on YouTube here! Below is a full transcript of the episode if you prefer to read through it or want notes.

Don’t forget to connect to others in The GUT Community, a Facebook group for those with IBS and digestive disorders to support one another and dive deeper into each episode together.

Welcome back to The Gut Show! This episode is a really fun one because we are talking about coffee. One question that I get asked fairly frequently is, should I be drinking coffee with IBS, and if so, what coffee do I drink?

I love this conversation because I personally love coffee. It's something that I start every single day with, and something I find a lot of joy in because I love, love, love the flavor of coffee! And so whenever I'm thinking about coffee for those with IBS, the last thing I ever want to do is take coffee away without proper reason.

Instead of telling you to drink coffee, or don't drink coffee, or giving you a specific portion of coffee that you have to drink, let's talk about why coffee may or may not trigger certain symptoms, and then how to adjust that and find that perfect portion for you in your body as well as your preferences around coffee.

So about 26 to 40% of those with IBS do say that coffee is a trigger for diarrhea and stomach pain. Typically what we see is the cramping, the pain, and diarrhea associated with coffee in the surveys that are assessing what people think are triggering their symptoms. So why does that happen? There's two major reasons.

The first one is a chemical called chlorogenic acid, which stimulates the gut to function more quickly, increasing gut motility. So this acid can actually speed up the gut and lead to faster motility or movement, which then can lead to diarrhea. So those who are dealing with diarrhea already, this may trigger symptoms to be much worse. If there are spasms or hyper activity of the gut, this may also increase the level of spasms, which can lead to cramping and pain. This chlorogenic acid is actually going to be found in your decaf coffee as well as your regular caffeinated coffee, but it might be lower in iced coffee or like cold brew coffee.

Another reason for symptoms being triggered by coffee is caffeine. So caffeine can lead to abdominal cramps, even for those with IBS-C for constipation predominant. So caffeine can speed the gut up a little bit, typically that speed is going to be due to the acid, but the caffeine and coffee can lead to more cramps and can be a trigger for many people. And so there's those are the two main reasons why coffee may cause problems.

Thankfully, the caffeine is a component that's going to be found in caffeinated coffee, but lower in decaf coffee. Not non existent, it's still there, so if you're drinking a large portion of decaf coffee every day, you are going to have some caffeine, it's just much much lower, which is why it can work for those who are avoiding caffeine.

So when we're thinking about the different things that are involved with coffee itself, it would be silly not to also address the fact that coffee is rarely consumed alone, without something added to it. I personally love my coffee black, that's something that I love, the flavor of coffee. And so for me I'm thinking of acid and caffeine, but if you do not drink your coffee completely plain and you add something to it, that's going to add another layer and another factor that we have to consider when we're looking at coffee in relation to symptoms or triggers.

So the things that can be added to coffee frequently include, you know, creamers and sugars, as well as any other kind of alternative flavorings. So with your creamer or our milk, that would include lactose in most traditional forms. So if you're doing maybe a non dairy, or a dairy alternative or if you're using a lactose free product, you might not be consuming lactose but if you are using a dairy product like half and half or a full dairy cream or even just milk, what that does is that actually gives you more lactose, and most of those with IBS are going to be sensitive to lactose at some degree.

Most people even without IBS are sensitive to lactose because we really, we stop producing that enzyme lactase that breaks down lactose as we age. So that added lactose could also be contributing to symptoms, especially if you are very sensitive to the lactose you are consuming and if you're consuming it in a large portion.

Our dairy alternatives aren't always super safe either. There's a lot of popular dairy alternatives, that can also increase symptoms for many people, and that includes oat milk, and even coconut milk. So oat milk has become more popular because it has a thicker texture and it seems to have more of a cream like consistency and mixes well into coffee and coffee drinks, like lattes and things that you would get at a coffee shop. But the problem is that oat milk can become high in fodmaps, which are our fermentable carbohydrates and tend to be some of our biggest triggers for those of IBS. So simply switching to a dairy alternative, maybe say from a lactose standpoint, but might still contain some of our other fermentable carbohydrates that can also trigger symptoms for some people.

And then the other thing that's usually added is going to be our sugars and our flavor additives. So when we're adding sugar, not everyone is extremely sensitive to sugar. If we're in the presence of maybe sucrase-isomaltase deficiency or something like that, then we might notice there being an issue with sugar, which does overlap with IBS and can be problematic for some.

The real problem is going to be found in excess sugar mixed with that caffeine, so it's a very heightened effect, you might throw off blood sugar balance, which can contribute to symptoms for some people. Sugar as a whole just can be a bit irritating to the gut if it's a lot all at once, especially when you're drinking just sugar, because there's not a lot of fiber or anything to help slow that down as you're digesting it, and so that can lead to some cramps and diarrhea, especially for some people.

The big problem is going to be found in our flavor additives or sugar alternatives. So many of our sugar alternatives are non digestible, which means they resist digestion and move through the GI tract. And those are going to be your sugar alcohols or artificial sweeteners, and those can contribute to diarrhea and cramping for a lot of people too. And so getting the sugar free option or buying you know, the light or skinny, you know, quote unquote, options that are out there, that might reduce the calorie intake or the sugar that you're actually digesting and absorbing, the problem is that those can trigger diarrhea and cramping. So it's really important to consider what we're adding to the coffee, not just the coffee itself.

So with that in mind, let's look at how you can assess how your body is handling coffee and adjustments that you can make then aren't just black and white or drink it or don't drink it.

The first thing is to see where you are currently. If you love coffee, or coffee drinks, started taking inventory of how much are you truly drinking? It's easy to think, oh, I only drink one cup a day. But is that cup of big mug that's you know, 16 ounces? is that cup, a small eight ounce actual cup? What is the actual serving that you're consuming each day? And so it can be helpful to even measure that out using a liquid measuring container, that way you can really see oh, how much am I actually drinking without judgment or without change at first, just noting, where am I currently and what does it looks like?

Assess what you're adding to coffee. So what kind of coffee are you drinking, and what are you typically adding in? And a lot of times we think, okay, just a little bit of this or a little bit of that, maybe measure it out, just see where am I currently, like what have I started with, and then from there, we can start making some adjustments.

So if you know, okay, I'm drinking this much coffee a day, I’m adding these things to it and I'm having a little bit of diarrhea or cramping in the mornings that I would like to try to get ahold of. If you're dealing with constipation in the mornings, the coffee may not be a problem, but if you are dealing with some cramping or like some uneasiness or just discomfort in the gut, then you may still decide to go forward with adjusting your coffee intake.

So the first thing that we want to do is adjust what's added to the coffee. So we want to remove one layer or just one layer at a time versus all of them at once so that you can really identify what the problem actually is versus like taking all the coffee out with the caffeine with acid and with the additives and not know exactly what was triggering the symptoms to begin with.

So adjust what to add to it. If you're using a cream or a milk, maybe going for a lactose free version, if you're doing oat milk maybe try an almond based version for a little while. And if you're adding a lot of sugar, maybe decrease that portion just a little bit. If you're doing a sugar alternative and you switch to actual just sugar, see what what feels good in terms of those modifications.

So do that for a few days and then notice how that makes you feel. Did your symptoms change? Did they improve? Did they get worse? What do you notice? The next thing that you'll want to do is actually decrease the amount of the coffee as a whole. So if you are doing, you know, 16 ounces, maybe bring it down to 12 ounces. If you're doing 12 ounces, maybe eight ounces, if you're doing 24 or 32 ounces, I've seen it, it's been there, slowly decrease that amount as it as a total.

So what you're going to do there is you're decreasing acid and you're decreasing some of the caffeine to see if just a smaller portion works for you. Just like you did with what you added to it, decrease for a few days, continue to decrease if you're still having symptoms and just note how that makes you feel.

If you get down to eight or six ounces and you're still having symptoms, then what we can do is we can actually decrease either the acid or the caffeine. So if you want to decrease the acid, a cold brew option would be would be the way to go. It's not a huge difference, but an eight ounce portion, it could be the difference that that makes it tolerable for you. So try doing a cold brew and see if that works for you.

If that's not what you want, or that doesn't really work, then we can decrease the caffeine itself. So that would be switching from a caffeinated coffee to a decaffeinated coffee. So you have that eight to 12 ounces, whatever portion you landed on, just switch it over to a decaf option for a few days and see how that makes you feel. If you've decreased some of the caffeine and you've tried maybe switching out the acid, then the next step would be to remove it for a few days, maybe a week or so, and then slowly reincorporate the coffee back in in a simple form.

So you might start with a little bit of decaf coffee, then you may start to build up to caffeinated coffee at eight ounces. And then you may start to build up to 12 ounces and see where your tolerability actually lies. So it does take much longer than just saying, hey, take coffee out, or bring it back in or just drink eight ounces. The value of doing it in this way is that you're going to learn so much more about your body, and you're also going to know okay, what really does work for me, and so that you have some sustainability in that.

You may find that a small portion of coffee every day works for you, you may find decaf coffee works for you, you may find that coffee every day doesn't. But going out maybe on the weekend and going to your favorite coffee shop or when you travel having a cup of coffee every now and then can work, and that's going to be the value for you moving forward.

In addition to this, it's important to remember that the IBS puzzle is very complex. Coffee is one single component in the big wheel of things. So if coffee is a problem now, but you haven't also looked at some other parts of diets and lifestyle pieces, then you might be missing something that will help you actually tolerate the coffee better. And we see this time and time again, with food with drinks, even with some activities that we're doing, as you may not tolerate it now because a lot of the puzzle pieces, your foundational pieces aren't in place to support your digestive system, your hormones, your stress management plan, all of those different things to help you tolerate that moving forward.

we provide a resource called the Master Method Foundation's course that will help you implement strategies for better digestion, hormone support, connecting to your body and understanding your symptoms, and an optimal diet for your gut and your digestion, which will help you then be able to tolerate the coffee better, which it can also help you find more success and other strategies that you try, maybe including the low fodmap diet, or even therapy and mental health resources that you're digging into. We are very excited to offer it to you guys, so check that out if that is a resource that you need.

Alright, go grab your favorite cup of coffee and try making some of these changes! If you have any follow up questions or want to share your results of doing it in this way, head on over to The GUT Community on Facebook so that we can connect with you and answer your questions.

Have an amazing rest of your day, wherever you are. Remember, I see you, I hear you, I'm with you and I cheers my coffee cup to you as you move forward. See you in the next episode!