Can you still drink coffee if you have IBS?

The average American coffee drinker downs three cups of coffee a day. That’s not as many as Finland’s four, but it’s still a testament to the beverage’s enduring popularity. What else, after all, is as delicious and as good at getting you started as a morning cup of joe? 

And yet many people with irritable bowel syndrome (IBS) feel they have to skip their favorite go-to drink. Is it really true that IBS and caffeine don’t mix?

Five reasons coffee might be a concern if you have IBS 

For those with IBS, caffeine is often accused of being able to trigger symptoms. Although drinking three to five cups of coffee a day is linked with a lowered risk of many chronic conditions, the caffeine in that coffee doesn’t always pair well with IBS. It may, in fact, encourage diarrhea for people who already have IBS or trigger worse symptoms in general.

Why is that?

Coffee can lead to more stomach acid

Coffee increases production of a hormone called gastrin, which stimulates the acid-producing cells in the stomach to pump out more gastric acid. This is linked to indigestion, heartburn and acid reflux. Both caffeinated and decaffeinated coffee stimulate the release of gastrin, though caffeinated coffee does so to a higher degree.

Caffeine makes your gut act more active

Coffee (and other caffeinated drinks) are famously good at giving you a quick energy boost. Unfortunately, it gives gut enzymes a boost too, so to speak. After drinking coffee, for example, you may notice flare-ups, more abdominal pain along with more intestinal activity (motility) and “restlessness.” 

That’s partly because caffeine intake prompts your small intestine to produce another hormone, cholecystokinin, which can jump-start your digestive system. Food may speed more quickly through the large intestine, and the nerves that interact with your gut may be more sensitive and responsive. Coffee also directly stimulates the colon, which may leave you feeling uncomfortable and as if you need to “go” more often. 

Caffeine can make your stress response feel worse

IBS and stress can be tightly linked. People with IBS often feel higher levels of stress than those without IBS. In turn, stress can exacerbate IBS symptoms like bloating, leading to spirals of pain sensitivity, irritation, possible anxiety or depression, and yet more stress. Add caffeine into the mix, and you may notice your heart rate increasing, which may make you feel more nervous or anxious. 

Coffee contains gut-challenging salicylates

Some researchers are looking into possible connections between worsening IBS symptoms and salicylates, substances some plants contain as defensive chemicals. Some people are quite sensitive to salicylates, and may thus have trouble with coffee. Certain fruits and vegetables contain salicylates, as do aspirin and toothpaste. 

Caffeine may be challenging for those with IBS-D

Since they’re already struggling with loose bowel movements and diarrhea, people with IBS-D may be the most likely IBS patients to feel the effect of coffee and caffeine. For those with IBS-D, caffeine may bring on more gastrointestinal symptoms like unrest, pain and diarrhea. 

How to tell if you can drink coffee (or other caffeinated drinks)

It’s tough to attribute particularly good or bad IBS days to certain foods or beverages. That’s why dietitians often recommend the high FODMAP elimination process to see if high FODMAP foods may be worsening your IBS symptoms. 

Coffee isn’t usually classified as high FODMAP, and so it’s usually considered acceptable for people with IBS. That doesn’t apply across the board, however, as some types of coffee tend to be more gut-friendly than others. Adding milk, sugar, or artificial sweeteners to your coffee can complicate your IBS. And though you may notice caffeine’s effects kicking in within 15 minutes, it may take your body up to ten hours to clear caffeine from your system.

If you suspect coffee may not be ideal for you, you can follow an elimination process to see if cutting coffee out makes you feel any better. Before you start, plan out how you’ll handle coffee elimination. If, like many other Americans, you drink multiple cups of coffee or espresso a day, you may have caffeine dependency. This isn’t the same as addiction, by the way. Rather, it means that your body has gotten used to caffeine and may experience some side effects if you cut off caffeine abruptly. 

If you go “no caffeine” cold turkey, you may get severe headaches, for example. You may also have stomach pain and feel fatigued, weak, or exhausted. So instead of cutting caffeine off suddenly, you may prefer to taper off it over the course of two weeks or so. Within three to six weeks, you should have an idea of whether decreasing your coffee intake may help. 

How to cut back on caffeine or avoid it (if you need to)

Caffeine can show in more things than you might expect. If you need to taper off it or avoid it altogether, certain strategies may work a little better than others: 

Don’t decrease in haste

• Some sources say to cut caffeine out completely. Do this suddenly, however, and you may notice signs of dependency such as withdrawal headaches, stomach upsets, aching muscles, or general tiredness. To avoid this, taper off coffee or caffeine gradually, starting with fewer cups per day and diluting the caffeinated beverages you do drink
• Caffeine too close to bedtime (or caffeine at all if you’re sensitive to it) can make it hard to fall asleep and may also give you a sped-up heartbeat and sense of anxiety or restlessness. Try to get your caffeine early, then, and if you notice unpleasant side-effects, try to drink a little less of it

Watch out for caffeine in sneaky places

• Many medications, including pain relievers, contain caffeine, either to enhance the other ingredients’ actions or to possibly make you feel more alert. Read your medication labels closely to make sure you’re not accidentally getting more caffeine than you calculated
• Caffeine can also show up in certain supplements, such as green tea extract, so keep an eye on that, too
• Chocolate is another potential source of caffeine
• Of course, energy drinks and soda can hold caffeine, so keep that in mind

Enjoy the drinks you can have

• Unless you’re extremely sensitive to caffeine, you can probably enjoy decaffeinated coffee. It has many of the same benefits as normal coffee without affecting your IBS symptoms as severely. You can substitute part of your regular cup of coffee with decaf coffee over two or three weeks until you get used to it
• The world of coffee substitutes offers quite a few options to explore, too
• With time and patience, you may come to like other beverages

Caffeine isn’t only a villain. It has certain positive benefits, too.

Benefits of caffeine and coffee

• When drunk in moderation, caffeine may help you feel like going when you need to if you have IBS-C or even just occasional bouts of constipation
• Caffeine prompts your brain to release dopamine, which can help you feel more alert
• Three to four cups of coffee a day is linked with living longer, with having a lower chance of developing cardiovascular disease, and with being less likely to get Parkinson’s or type 2 diabetes
• Coffee may also help prevent Alzheimer’s, may help your liver, and may decrease the likelihood of certain cancers, among other things 

What does Salvo Health think about coffee?

At Salvo Health, our digital healthcare platform and virtual clinic provides you with continuous text-based support and care for your chronic condition. Imagine being able to text a certified physician or health coach to avoid flare-ups or manage your pain. Alongside text-based communication, members receive a customized care plan that can take account of how their symptoms can be managed, with or without coffee. 

Get immediate access to a coordinated Salvo Health care team, including a certified specialist and board-certified health coach when you join Salvo Health today.