A Gastroenterologist’s Best Advice for Drinking Coffee if You Have IBS

Due to its caffeine content, coffee can cause adverse side effects for people with sensitive stomachs, especially those with irritable bowel syndrome (IBS). “It stimulates the gut to function more quickly, thus increasing gut motility,” says gastroenterologist Niket Sonpal, MD, FACP, DABIM. This is why doctors often don’t recommend coffee for IBS patients, as it can cause diarrhea and stomach pain.

“Coffee stimulates the release of two hormones, gastrin, released in the stomach, and cholecystokinin, released from the small intestine," Kate Scarlata, RDN, LDN, a FODMAP and IBS expert, previously told Well+Good. "Gastrin increases colonic movements and cholecystokinin releases bile and digestive enzymes, initiating the digestive process.”

As a result, Scarlata says, about 30 percent of people note that drinking coffee makes them poop. And now that we have your attention, there are a few things you need to know about coffee for IBS that can influence how the stimulant impacts your GI tract, starting with how what type of IBS you have can impact your tolerance to a cup of joe.

Coffee can be most problematic for people with IBS-D

“In terms of IBS, coffee can be either a friend or a foe,” explains Dr. Sonpal, who says the first thing you should do is consult a doctor to determine: 1. If you truly have IBS and 2. If so, which of the three types you have: IBS-C, IBS-D, or IBS-M. “For those with IBS-D, coffee can be problematic because gut motility is already faster than it should be,” he explains.

No matter what type of IBS you have, Dr. Sonpal suggests you stop drinking it for a period of time to see if quitting coffee improves your symptoms. (Elimination diets typically take three to six weeks for best feedback and results, FYI.)  Then if you do notice an improvement, either continue to stop drinking coffee or introduce it back into your system in small doses so you can figure out how much your body can tolerate, he suggests.

Decaf or light-roast coffee could potentially be better for IBS

“Stronger coffees or those with a lot of caffeine can exacerbate symptoms because the natural chemicals that are in the coffee are in greater quantities; however no studies exist to show this as a 100-percent effect, and we just extrapolate this data from what we know from patients who drink normal coffee,” Dr. Sonpal says.

Given this, decaffeinated coffee or lighter roasts may be worth trying if you have IBS. Just bare in mind: “There is a lot of conflicting data to say which type of bean, roast, and milk (if yes or no) will affect your IBS, but the best advice I can give my patients is that they should be mindful of what they are drinking and should experiment slowly with new types of coffee to see what agrees with them and what doesn't, then take it from there,” says Dr. Sonpal.

Tips for drinking coffee with IBS

Dr. Sonpal says that based on anecdotal evidence he’s collected from his patients, a bit of milk or a plant-based milk substitute or creamer may help ease an IBS reaction. “There are no studies to prove this yet, but patients have told me they notice improvement with adding milk or milk substitutes into their coffee,” he says.

“Others have noticed that quitting the use of sugar substitutes improves their diarrhea, too, so if you have lots of gas and diarrhea, giving up all sugar substitutes is a good idea,” he adds.

The takeaway

In general, doctors don’t recommend coffee for IBS patients because it can exacerbate symptoms including diarrhea and stomach pain due to the fact that the caffeine in coffee speeds up gut motility. But not everyone with IBS will have issues with coffee, so the best way to figure out if you do is to eliminate if from your diet, and then reintroduce it in small doses to see how you feel. And lighter roasts or beans with less caffeine may be easier for people with IBS to consume.

Apart from those coffee-drinking tips and some trial and error, the most pivotal factors is the kind of IBS you have—people with IBS-D tends to have a harder time with coffee because their guts already move faster than average. But the best way to determine what’s right for you is by working with your doctor to decide, and of course, following your gut.

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