GI Mythbuster

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Introduction

The gastro intestinal (GI) tract provides the means for the body to digest and absorb nutrients contained in food and drink and comprises the mouth, stomach, small intestine and large intestine. The digestive process is also dependent upon other organs including the pancreas, gallbladder and liver.

Digestion involves the enzymatic breakdown and absorption of nutrients and fluid ensuring that the body is nourished with an adequate supply of nutrients for health.  A healthy GI tract promotes healthy digestion.  Damage, disease or infection in any part of the GI tract can limit the effectiveness of digestive processes and may have an impact on the nutritional status of the individual.

Research on the impact of drinking coffee on the various functions of the digestive tract suggests that coffee consumption has no significant adverse effects on the functioning of the GI tract in healthy individuals.

However, there are a number of common misconceptions regarding the role that coffee consumption plays in the GI tract.  Some of these misconceptions are addressed below, highlighting the latest scientific research in each of the areas discussed.

MYTH: Drinking coffee stimulates gastric acid secretion and can aggravate stomach pains and heartburn (acid reflux).
FACT: There is no evidence to suggest that drinking coffee causes stomach problems such as gastritis (irritated stomach lining).  Individuals with gastritis often self-regulate their diet according to their own sensitivities and some may choose to limit their coffee consumption.1 There is also no clear evidence to suggest that consuming coffee worsens the symptoms of acid reflux, or that stopping drinking coffee reduces the symptoms. In fact, it is suggested that common causes of acid reflux are the consumption of spicy or fatty food and overeating.2,3,4,5

MYTH: Coffee consumption increases the risk of the developing ulcers in both the stomach and intestine.
FACT: Coffee consumption is not associated with an increased occurrence of stomach ulcers.  Recent research has focused on understanding the role of the bacterium Helicobacter pylori (H. pylori) in the development of peptic ulcers.  Research on duodenal ulcers also suggests that drinking coffee is not associated with their development.6,7

MYTH:  Coffee should be avoided by those who suffer from IBS, gastritis, Crohn’s Disease, colitis and ulcers.
FACT: Coffee can be enjoyed by those who suffer such disorders as there is no indication that it influences disorders such as IBS, gastritis, Crohn’s Disease, colitis and ulcers.

MYTH:  Coffee stimulates gastric emptying and in turn causes diarrhoea.
FACT: Most food and drink stimulates movement in the large intestine, as part of the routine digestive process.  One study comparing the effect of regular and decaffeinated coffee on intestinal motility suggested that the effect of caffeinated coffee was as substantial as a full meal, but stronger than water and decaffeinated coffee.8

MYTH:  Coffee is a diuretic, which leads to dehydration and loss of minerals amd other nutrients. 
FACT: Although there is some indication of a mild, short-term diuretic effect of caffeine, it is not strong enough to counter-balance the benefits of fluid intake from coffee drinking. Recent research suggests coffee does not lead to dehydration and contributes to daily fluid intake. The advice to avoid coffee because it causes dehydration is not supported by scientific evidence.9,10

MYTH:  Coffee increases the risk of developing cancer of the stomach, colon, liver, pancreatic or bowel.
FACT: Overall, the scientific evidence suggests there is no link between moderate coffee consumption and an increased risk of developing cancer at these sites.11,12

MYTH:  Coffee consumption increases the risk of developing gallstones and exacerbates the problem of those already suffering from gallstones.
FACT: Research suggests that drinking coffee may help to reduce the risk of developing gallbladder disease (or symptomatic gallstones) by up to 45% in men and up to 28% in women.  Caffeine in coffee can cause contraction of the gallbladder and whilst it may prevent small stones forming in the gallbladder, those with pre-existing gallstones may experience pain caused by such contractions.13,14

MYTH:  Coffee is a cause of dyspepsia (discomfort in the stomach).
FACT: Research in the Netherlands suggests that whilst 38% of people thought that coffee was a cause of dyspepsia, no association between drinking coffee and this condition have been found.   Recent work has investigated a role for the bacterium, H. pylori, in dyspepsia.15,16,17,18,19

“Approximately 1 in 3 adults in the European Union (more than 150 million) are affected by digestive health problems such as dyspepsia, IBS or constipation. Many of my patients with digestive complaints ask me if their coffee consumption is the issue and if they should cut coffee out of their diet. It is true that some individuals who suffer GI problems may choose to avoid certain foods or drinks to manage their symptoms, and this may include coffee. However, the research available shows that there is no evidence to suggest a link between coffee consumption and gastric health problems.”

– Dr. Patricia MacNair, Trust Practitioner, Royal Surrey County Hospital, UK.

References

  1. Aldoori W.H. et al. (1997) A Prospective Study of Alcohol, Smoking, Caffeine, and the Risk of Duodenal Ulcer in Men. Epidemiology, 4(8):420-424.
  2. Bolin T.D. et al. (2000) Esophagogastroduodenal Diseases and Pathophysiology, Heartburn: Community perceptions. J Gastroenterol Hepatol, 15:35-39.
  3. Kaltenbach T. et al. (2006) Review: sparse evidence supports lifestyle modifications for reducing symptoms of gastroesophageal reflux disease. Arch Intern Med, 166:965-971.
  4. Kim J. et al. (2013) Association between coffee intake and gastroesophageal reflux disease: a meta-analysis, Diseases of the Esophagus, 27(4):311-317.
  5. Boekema P.J. et al. (1999b) Effect of coffee on gastroesophageal reflux in patients with reflux disease and healthy controls. Eur J Gastroenterol Hepatol, 11: 1271-1276.
  6. Rosenstock S. et al. (2003) Risk factors for peptic ulcer disease: a population based prospective cohort study comprising 2,416 Danish adults. Gut, 52: 186-193.
  7. Rao S.S.C. et al. (1998) Is coffee a colonic stimulant. Eur J Gastroenterol Hepatol, 10: 113-118.
  8. Maughan R.J. et al. (2003). Caffeine ingestion and fluid balance: a review. Hum Nutr Dietet 16, 411-42
  9. Killer S. C. et al. (2014) No Evidence of Dehydration with Moderate Daily Coffee Intake: A Counterbalanced Cross-Over Study in a Free-Living Population. PLoS ONE, 9(1): e84154.
  10. Yu X. et al (2011). Coffee consumption and risk of cancers: a meta-analysis of cohort studies. BMC Cancer, 11:96.
53.
  11. Nkondjock A. (2009) Coffee consumption and the risk of cancer: an overview. Cancer Letters, 277:121-5.
  12. Leitzmann M.F. et al. (1999) A prospective study of coffee consumption and risk of symptomatic gallstone disease in men. JAMA, 281:2106-2112.
  13. Leitzmann M.F. et al. (2002) Coffee intake is associated with lower risk of symptomatic gallstone disease in women. Gastroenterol, 123, 1823-1830.
  14. Boekema P.J. et al. (2001) Functional bowel symptoms in a general Dutch population and associations with common stimulants. Neth J Med, 59(1): 23-30.
  15. Boekema P.J. et al. (1999a) Chapter 4: Prevalence of functional bowel symptoms in a general Dutch population and associations with use of alcohol, coffee and smoking. Coffee and upper gastrointestinal motor and sensory functions, Zeist (the Netherlands).
  16. Haug T.T. et al. (1995) What Are the Real Problems for Patients with Functional Dyspepsia? Scan J Gastroenterol, 30(2):97-100.
  17. Nandurkar S. et al. (1998) Dyspepsia in the community is linked to smoking and aspirin use but not to Helicobacter pylori infection. Arch Intern Med, 158(13):1427-1433.
  18. Moayyedi P. et al. (2000) The Proportion of Upper Gastrointestinal Symptoms in the community Associated With Helicobacter pylori, Lifestyle Factors, and Nonsteroidal Anti-inflammatory Drugs. Am J Gastroenterol, 95(6):1448-1455.
  19. Shimamoto T. et al. (2013) No association of coffee consumption with gastric ulcer, duodenal ulcer, reflux esophagitis, and non-erosive reflux disease: a cross-sectional study of 8,013 healthy subjects in Japan, PLoS One,  8(6):e65996

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