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Coffee and the gastro intestinal tract

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.  Approximately 1 in 3 adults in the European Union (>150 million) are affected by GI conditions, such as dyspepsia, Irritable Bowel Syndrome (IBS) or constipation.1

Disorders of the stomach

The stomach is the major digestive organ, secreting acid and enzymes that digest food.  Conditions associated with the stomach include:

    • Dyspepsia (poor digestion, pain, discomfort)
    • Gastro oesophageal reflux disease (GORD)  (return of acid from stomach to oesophagus)
    • Peptic ulcers (lesions in stomach wall causing pain and discomfort)
    • Gastritis (inflammation of the stomach wall)

The scale of the issue

  • The prevalence of dyspepsia is estimated at 20- 30%1
  • GORD affects 10-20% of people in Western countries and has an annual incidence of approximately five per 1000 persons1
  • In European primary care practices an average of 3.4% of consultations were for GORD-related reasons and 24.7% of the patients had been previously diagnosed with acid reflux1

Disorders of the intestines

The intestines comprise the small and large intestine where food is further digested and absorbed, enabling elimination of waste material at the end of the process.

Conditions associated with the small intestine include:

    • Duodenal ulcers
    • Abnormal fluid discharge

Conditions associated with the large intestine include:

    • Abnormal peristaltic movement along the intestinal tract
    • Inflammatory Bowel Disease (IBD) e.g. Crohn’s Disease, ulcerative colitis
    • Irritable Bowel Syndrome (IBS)
    • Colorectal cancer

The scale of the issue.1

Irritable Bowel Disease

    • IBD is found in almost 1-2% of the population with accompanying annual healthcare costs of € 2 billion1
    • New cases of IBD are estimated at 20-30 per 100,000 people per year, or 50,000-100,000 new cases across the European Community1

Irritable Bowel Syndrome

      • The prevalence of IBS is estimated at 10 – 20% of the population in Europe1
      • The economic impact of IBS has been reported to be as high as €1,600 annually per patient, including healthcare and indirect costs1

Coffee Consumption and Gastro Intestinal Tract

  • Studies to date suggest that there is no association between coffee consumption and disorders of the stomach including the risk of dyspepsia2,3,4,5,6,7, gastro oesophageal reflux disease (GORD)8,9,10,11,12,13 peptic ulcers14,15 gastritis or stomach cancer.16 There is no evidence to suggest that coffee worsens symptoms in those who suffer these conditions.
  • Research indicates that coffee consumption does not increase the risk of duodenal ulcers and has no effect on fluid balance in the small intestine.17,18,19,20,21,22
  • Evidence suggests that there is no association between coffee consumption and disorders of the large intestine, such as diarrhoea and colorectal cancer.23,24,25 Additionally, research has found no association between coffee consumption and other intestinal conditions such as diverticulitis or Crohn’s Disease.
  • Research suggests that coffee consumption is not linked to a higher risk of pancreatic cancer26,27 and in fact some studies suggest that coffee consumption may reduce the risk of gallbladder disease29,30 and liver cancer 31,32,33 and may help limit liver disease progression.

References

  1. United European Gastroenterology. (2011) UEG Position Paper on the EU Research Framework Programmes   https://www.ueg.eu/fileadmin/user_upload/documents/Publications/UEG_Position_Paper_Version2.pdf
  2. 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.
  3. 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).
  4. 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.
  5. Haug T.T. et al. (1995) What Are the Real Problems for Patients with Functional Dyspepsia? Scan J Gastroenterol, 30(2):97-100.
  6. 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.
  7. 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.
  8. Nilsson M. et al. (2004) Lifestyle related risk factors in the aetiology of gastroesophageal reflux. Gut, 53:1730-1735.
  9. Dore M.P. et al. (2007) Diet, Lifestyle and Gender in Gastro-Esophageal Reflux Disease. Dig Dis Sci, 53(8):2027-2032.
  10. Zheng Z. et al. (2007) Lifestyle factors and Risks for Symptomatic Gastroeosophageal Reflux in Monozy- gotic Twins.Gastroenterology, 132:87-95.
  11. Kim J. et al. (2013) Association between coffee intake and gastroesophageal reflux disease: a meta-analysis,Diseases of the Esophagus, 27(4):311-317.
  12. Pehl C. et al. (1997) The effect of decaffeination of coffee on gastroesophageal reflux in patients with reflux disease. Alim Pharm Ther, 11:483-486.
  13. 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.
  14. Botelho F. et al. (2006) Coffee and gastric cancer: systematic review and meta-analysis. Cad Saude Publica, 22:889–900.
  15. 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.
  16. Elta G.H. et al. (1990) Comparison of coffee intake and coffee-induced symptoms in patients with duodenal ulcer, non ulcer dyspepsia, and normal controls. Am J Gastroenterol, 85:1339-1342.
  17. Brown S.R. et al. (1990) Effect of coffee on distal colon function. Gut, 31:450-453.
  18. Rao S.S.C. et al. (1998) Is coffee a colonic stimulant.Eur J Gastroenterol Hepatol, 10:113-118.
  19. Sloots C.E.J. et al. (2005) Stimulation of defecation: Effects of coffee use and nicotine on rectal tone and visceral sensitivity.Scan J Gastroenterol, 40:808-813.
  20. Simren M. et al. (2001) Food-Related Gastrointestinal Symptoms in the Irritable Bowel Syndrome. Digestion, 63:108-115.
  21. Pandeya N. et al. (2011) Prevalence and determinants of frequent gastroesophageal reflux symptoms in the Australian community. Diseases of the Esophagus, 25(7):573-83.
  22. 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.
  23. Tavani A. et al. (2004)  Coffee, decaffeinated coffee, tea and cancer of the colon and rectum: a review of epidemiological studies 1990-2003.  Cancer Causes Control,15:743-57.
  24. Giovannucci E. (1998) Meta-analysis of coffee consumption and risk of colorectal cancer.Am J Epidemiol, 147:1043–52.
  25. Galeone C. et al. (2010) Coffee consumption and risk of colorectal cancer: a meta-analysis of case–control studies. Cancer Causes Control, 21:1949-59.
  26. Dong J. et al. (2011) Coffee drinking and pancreatic cancer risk: a meta-analysis, World Journal of Gastroenterology, 17(9):1204-10.
  27. Turati F. et al. (2011) A meta-analysis of coffee consumption and pancreatic cancer, Annals of Oncology,23(2):311-8.
  28. Turati F. et al. (2011) Coffee, decaffeinated coffee, tea, and pancreatic cancer risk: a pooled-analysis of two Italian case-control studies. Eur J Cancer Prevention; 20(4):287–292.
  29. Leitzmann M.F. et al. (1999) A prospective study of coffee consumption and risk of symptomatic gallstone disease in men.JAMA, 281:2106-2112.
  30. Leitzmann M.F. et al. (2002) Coffee intake is associated with lower risk of symptomatic gallstone disease in women.Gastroenterol, 123:1823-1830.
  31. Larsson S.C. et al. (2007) Coffee consumption and liver cancer: a meta-analysis. Gastroenterology, 132:1740-1745.
  32. Bravi F. et al. (2007) Coffee drinking and hepatocellular carcinoma risk: a meta-analysis. Hepatology, 46:430-435.
  33. Yu X. et al. (2011) Coffee consumption and risk of cancers: a meta-analysis of cohort studies. BMC Cancer, 15:11-96.

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