Caffeine is a known gut-irritant. But does that mean people with IBS and other chronic gut health issues should avoid caffeine?

The scientific literature is inconclusive, (thankfully!). 

There are numerous studies that link moderate coffee consumption with a reduced risk of cardiovascular disease, diabetes and a range of colon, uterine and liver cancers. One of the more recent studies of the impact of caffeine on the microbiome analysed colonic mucosa biopsies taken from 34 participants undergoing a routine colonoscopy (Gurwara et al, 2019). They analysed the samples and used a standardised food questionnaire to determine daily caffeine consumption. The researchers concluded that high caffeine consumption was associated with greater bacterial diversity, more anti-inflammatory bacteria, and lower levels of potentially harmful bacteria. Round 1 for caffeine!

On the other hand, there are equally compelling studies linking coffee consumption to health problems such as esophageal cancer and high blood pressure, along with adverse side-effects including anxiety, agitation, insomnia and restlessness. Uh-oh!

Many IBS patients report that caffeine can trigger symptoms, likely due to its impact on colonic motility. Brown et al (1990) studied the impact of coffee on gut motility in healthy subjects compared to a group that consumed hot water alone. They found that drinking coffee can stimulate a motor response in healthy subjects. This might not be such a bad thing in constipation predominant IBS patients!

There are a number of reasons for such mixed research outcomes. The studies themselves face many methodological challenges. Caffeine comes in so many varieties and often combined with sugars, sweeteners and/or milks. Also challenging is that individuals metabolise caffeine at different rates and the effects on individuals vary too (read more here). 

The very best person to determine if there’s a link between your caffeine intake and your IBS symptoms is YOU. 

Over 30 years, I’ve learned that reducing my daily caffeine intake to 2-3 cups of black tea with lactose free milk is optimal. This isn’t a fixed rule, as I often have to vary my intake depending on my water consumption, symptoms, sleep and stress.

The most valuable habit I’ve embraced is turning each and every cup of loveliness into a ritual. I now avoid all lukewarm bags of disappointment (tea bags) and only drink high-quality loose leaf tea.

The perfect brew begins with copious amounts of boiling water and a pre-warmed teapot and cup. Takeaway is rarely an option. I have a teapot for every occasion from work conferences to camping. The process isn’t hurried or rushed. The perfect cuppa takes time to brew. 

If you choose to reduce your caffeine intake as part of your IBS management, try ritualising the experience to maximise the enjoyment from each and every cup.