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Effects of Caffeine and Coffee
On Heartburn, Acid Reflux, Ulcers & GERD
More than 95 million Americans suffer from
digestive problems of the upper GI tract including acid reflux or acid
indigestion (heartburn), GERD (gastroesophageal reflux disease) and
ulcers.
Hyperacidity in the stomach and upper digestive tract can be
painful and debilitating, but dietary adjustments can significantly
affect disorders in the upper GI tract.
Some of the foods associated
with aggravating these conditions include acidic substances such as
coffee, citrus fruits and tomatoes, as well as dietary fat, spicy food,
onions, chocolate and caffeine.
Not everyone affected by these foods is diagnosed with a chronic
disease; more than 60 million Americans experience episodes of acid
indigestion as often as once each month and some studies suggest that
as many as 15 million experience episodes of acid indigestion daily.
Many people self-medicate with antacids when they could adjust their
diet including reducing coffee and caffeine consumption in order to
find relief. These conditions are serious: at least 10 million people
are hospitalized each year for gastrointestinal disorders and the
annual total of health care costs associated with these exceeds $40
billion. 1
Heartburn, Acid Reflux & GERD
Heartburn, or pain behind the breastbone, is
a condition in which there is reflux of acid from the stomach into the
sensitive esophagus, often caused by a relaxation or weakening of the
lower esophageal sphincter, the ring of muscle between the esophagus
and the stomach. Foods, including dietary fat, chocolate, mints,
coffee, onions, citrus fruit, and tomatoes, have been associated with
increased incidence of acid reflux in susceptible persons.2
When symptoms are recurrent or esophageal tissue is damaged, GERD develops. GERD affects 5-7% of the global population.3, 4
When untreated, it can cause complications such as chest pain,
bleeding, esophageal stricture (narrowing or obstruction of the
esophagus) or Barrett’s esophagus (a pre-malignant condition). Symptoms
that indicate damage to the esophagus has occurred include: pain,
dysphagia (difficulty swallowing), bleeding and choking. Some risk
factors of these more serious conditions are alcohol use, pregnancy,
weight gain and coffee consumption.5
Ulcers
Ulcers are another common problem, afflicting
approximately 20 million Americans, according to the American College
of Gastroenterology. Ulcers can occur in the stomach or duodenum, and
are regions where the lining has been destroyed by stomach acids or
digestive juices. Even small areas of damage can cause intense pain.
The presence of the bacteria Helicobacter pylori is also implicated as
a predisposing factor in ulcer development, but not everyone infected
with H. pylori develops ulcers. It is unknown why this is the case,
although a strong immune system provides protection against the
bacteria’s ability to colonize damaged areas of the stomach lining.
Increased levels of cortisol and other stress hormones stimulated by
caffeine consumption and coffee drinking suppress the activity of the
immune system and raise stress levels which are associated with ulcer
formation. Other predisposing factors include: being male, family
history, prolonged stress, skipping meals, cigarette smoking and coffee
ingestion6.
Of all the dietary habits that people find difficult to change, coffee
drinking is one of the most challenging because it is so entrenched in
cultural habits and caffeine addiction.7 Withdrawal symptoms can involve painful headaches, nausea, vomiting, and loose stools.8
People whose health problems would be ameliorated if they gave up
coffee can improve their chance for successfully quitting coffee if
they have both a satisfying alternative and a method to slowly decrease
their caffeine intake to reduce withdrawal symptoms.
The following characteristics of coffee have an adverse effect on the upper GI tract:
- Coffee Decreases Pressure in the Lower Esophageal Sphincter
- Coffee has been shown to decrease pressure in the lower esophageal
sphincter, contributing to gastroesophageal reflux. This suggests that
coffee can either cause or exacerbate heartburn in susceptible
individuals.9, 10, 11
- The type of coffee bean roasting method used does not reduce the
tendency of coffee to produce gastroesophageal reflux. Sensitive
individuals, even when consuming coffee produced through different
roasting processes, while fasting or after a meal, experienced
heartburn, regurgitation and dyspepsia.12
- Coffee consumption has been associated with greater incidence of heartburn than drinking other fluids such as water.13
- Both caffeinated and decaffeinated coffee exacerbate
gastroesophaeal reflux, and coffee creates more reflux than caffeine
added to water, suggesting that other components of coffee contribute
to its aggravating effect.14
- The Acidity of Coffee Irritates the Stomach
- Coffee is highly acidic and it can stimulate the hypersecretion of
gastric acids. Decaffeinated coffee has been shown to increase acidity
to a greater degree than either regular coffee or caffeine alone.15 Both caffeine and coffee stimulate gastric acid secretion and decaffeinated coffee raises serum gastrin levels.16, 17
A study comparing the ability of decaffeinated coffee with that of a
high protein meal to increase gastric acid secretion and gastrin levels
found that decaffeinated coffee was a more powerful stimulant of acid
secretion and gastrin release than the high protein.18
- Coffee tends to speed up the process of gastric emptying, which may
result in highly acidic stomach contents passing into the small
intestine more rapidly than normal. This may lead to injury of the
intestinal tissue.19
- There is a clear relationship between reduction of stomach acid and heartburn relief.20
- Coffee Is a Risk Factor Associated with Ulcer Susceptibility
- Coffee is linked to ulcer susceptibility. Both caffeinated and
decaffeinated coffees have an acid-stimulating effect, and therefore it
is recommended that people with ulcers restrict not only caffeinated
but also decaffeinated coffee intake.21
- Coffee Elevates Stress Hormones
- Caffeine in coffee elevates the stress hormones cortisol, epinephrine (also known as adrenaline) and norepinephrine.22, 23, 24, 25
These hormones are responsible for increased heart rate, increased
blood pressure, and a sense of "emergency alert". Blood is diverted
from the digestive system which can cause indigestion. The circulation
of oxygen to the brain and extremities is decreased and the immune
system is suppressed.
- The purpose of the body's "fight or flight" response initiated by
the release of cortisol, epinephrine and norepinephrine is to provide
the body with a temporary energy boost for intense physical activity.
With today's sedentary lifestyle, the continual state of increased
stress resulting from caffeine consumption may affect symptoms of
heartburn and GERD. Although the relationship between stress and
symptoms of gastroesophageal reflux is still unclear, evidence suggests
that anxiety, along with exhaustion resulting from sustained stress,
are both associated with exacerbation of heartburn and esophageal
reflux.29
- Coffee Supresses Immune System Function
- Immune system suppression caused by chronic increased levels of
stress hormones induced by caffeine intake can create a situation in
which the bacteria Helicobacter pylori can thrive in the stomach.
Infection by H. pylori is implicated in ulcers.
- Caffeine Interferes with GABA Metabolism
- GABA (Gamma-aminobutyric acid) is a neurotransmitter that is
naturally produced in the brain and nervous system as well as the GI
tract. It plays an important role in mood and stress management and it
exerts a calming effect on the GI tract.
- Caffeine has been found to interfere with binding of GABA to GABA receptors, preventing it from performing its calming function.26
Studies suggest that stimulation of GABA receptors may be beneficial
for people with reflux arising from low lower oesophageal sphincter
pressure.27, 28 In addition to its direct effect on the GI
tract, GABA’s role in stress management is also compromised in the
presence of caffeine. This is significant as psychological stress has
been shown to be an exacerbating factor in heartburn and ulcers.29
Recommendation:
Individuals who suffer from or are
susceptible to problems with the upper gastrointestinal tract, would do
well to avoid coffee as it has been demonstrated to be a contributing
factor associated with increased incidence of gastritis, ulcers, acid
reflux and GERD. Dietary changes that include weaning off of coffee and
all other sources of caffeine can help relieve symptoms of these
disorders.30 Nutrition professionals can support
gastrointestinal patients by guiding them through the process of
substituting a non-caffeinated, alkaline herbal coffee that brews and
tastes just like coffee.
Kicking the Caffeine Habit:
The social prevalence of coffee drinking and
the addictive side effects of caffeine can cause problems with patient
compliance. Caffeine-free herbal coffee marketed under the brand name
of Teeccino® helps coffee drinkers replace their regular or
decaf coffee with a satisfying alternative. Coffee drinkers need a
dark, full-bodied, robust brew to help satisfy their coffee craving.
Teeccino satisfies the 4 needs coffee drinkers require in a coffee
alternative:
- Teeccino brews just like coffee, allowing coffee drinkers to keep their same brewing ritual.
- It has a delicious, deep roasted flavor that is very coffee-like.
- It wafts an enticing aroma.
- People experience a natural energy boost from nutritious Teeccino.
Teeccino offers the following health benefits to people suffering from upper GI tract disorders:
| Beneficial Features of Teeccino |
Teeccino Ingredients32, 33, 34, 35, 36, 37 |
- Inulin fiber from chicory
- Unlike coffee, Teeccino has nutritional value, including inulin, a
soluble fiber that helps support a healthy population of beneficial
microflora.
- Inulin improves mineral absoprtion.
- Naturally Caffeine-free
- No chemical processing like decaf coffee
- 65 mg of Potassium
- Teeccino is a source of potassium, an electrolyte mineral that is
important in the healthy functioning of stomach acid production.
- Potassium in liquid form is easily absorbed to help relieve muscle, mental and nervous fatigue.
- Alkaline – helps reduce acidity
- As opposed to acidic coffee, Teeccino is alkaline, which
reduces stomach acidity. Current treatments for reflux focus on
reducing acidity.
- Gluten Free
- Gluten does not extract into boiling water. Tests show Teeccino is gluten free although it contains barley.
|
- Carob
- An herb that has long been used for various diarrhea disorders due to its anti-diarrheal properties.
- Barley
- Has a soothing effect on the GI tract and has been used to treat diarrhea, gastritis and inflammatory bowel conditions.
- Chicory root
- Used to treat abdominal cramps, vomiting, and diarrhea.
- Contains inulin fiber which has been shown to improve mineral absorption in experimental models.
- Almond
- Useful for treating gastric complaints and gastritis.
- Figs
- Mucilages and pectin within the fruit provide a soothing effect on
inflamed gastric or intestinal mucosa. A good source of potassium.
- Dates
- In Indian medicine, traditionally used for relief of gastric complaints.
- Contain potassium.
|
The Pain-free Way to Wean off of Coffee
Start by mixing normal coffee 3/4 to 1/4
Teeccino Herbal Coffee. Gradually reduce the percentage of coffee over
a two to three week period until only 100% Teeccino Herbal Coffee is
brewed. Gradual reduction of caffeine is recommended.31 Side
effects such as headaches, fatigue, and brain fogginess can be avoided
as the body gradually adjusts to less reliance on stimulants.
Example: Use the following proportions if you make a 10-cup pot of coffee daily:
| Day |
Regular Coffee |
Teeccino |
| Day 1-3: |
4 tablespoons |
1 tablespoons |
| Day 4-6: |
3 tablespoons |
2 tablespoons |
| Day 7-9: |
2 tablespoons |
3 tablespoons |
| Day 10: |
1 1/2 tablespoons |
3 1/2 tablespoons |
| Day 11: |
1 tablespoon |
4 tablespoons |
| Day 12-13: |
1/2 tablespoon |
4 1/2 tablespoons |
| Day 14: |
none |
5 tablespoons |
References
- American College of Gastroenterology. Copyright 2004.
- Terry P, Lagergren J, Wolk A, Nyren O. 2000. Reflux-inducing dietary factors and risk of adenocarcinoma of the esophagus and gastric cardia. Nutrition and Cancer. 38(2): 186-91.
- International Foundation for Functional Gastrointestinal Disorders. Copyright 2004.
- Richter JE, Katz PO, Waring JP. Gastroesophageal Reflux Disease. IFFGD, 2000.
- Wang, J.H., Luo, J.Y., Dong, L., Gong, J. and Tong, M. 2004. Epidemiology of gastroesophageal reflux disease: a general population-based study in Xi'an of Northwest China. World Journal of Gastroenterology. 10(11):1647-51.
- Abu Farsakh, N.A. 2002.Risk factors for duodenal ulcer disease. Saudi Medical Journal. 23(2):168-72.
- Braun, S. Buzz: The Science and Lore of Alcohol and Caffeine. Copyright 1996.
- Strain, E.C., G.K. Mumford, K. Silverman, and R.R. Griffiths. 1994. Caffeine dependence syndrome. Journal of the American Medical Association, 272:1043-1048.
- Thomas, F.B., Steinbaugh, J.T., Fromkes, J.J., Mekhjian, H.S., and Caldwell, J.H. 1980. Inhibitory effect of coffee on lower esophageal sphincter pressure. Gastroenterology, Dec; 79(6): 1262-6.
- Boekema, P.J., Samsom, M., van Berge Henegouwen, G.P. and Smout, A.J. 1999. Coffee and Gastrointestinal function: facts and fiction. A Review. Scandinavian Journal of Gastroenterology Supplement. 230: 35-9.
- Cohen, S. 1980. Pathogenesis of coffee-induced gastrointestinal symptoms. New England Journal of Medicine. 303(3):122-4.
- DiBaise, JK. 2003. A randomized, double-blind comparison of two
different coffee-roasting processes on development of heartburn and
dyspepsia in coffee-sensitive individuals.Digestive Diseases and Sciences. 48(4):652-6.
- Feldman, M. and Barnett, C. 1995. Relationships between the acidity and osmolality of Popular Beverages and reported Postprandial Heartburn. Gastroenterology. 108(1): 125-31.
- Wendl, B., Pfeiffer, A., Pehl, C., Schmidt, T. and Kaess, H. 1994. Effect of decaffeination of coffee or tea on gastro-oesophageal reflux. Alimentary pharmacology & therapeutics. 8(3):283-7.
- Cohen, S. and Booth, G.H. Jr. 1975. Gastric acid secretion and lower-esophageal-sphincter pressure in response to coffee and caffeine. New England Journal of Medicine. 293(18):897-9.
- Coffey, R.J., Go, V.L., Zinsmeister, A.R. and DiMagno, E.P. 1986. The acute effects of coffee and caffeine on human interdigestive exocrine pancreatic secretion. Pancreas. 1(1):55-61.
- Borger HW, Schafmayer A, Arnold R, Becker HD, Creutzfeldt W. 1976. The influence of coffee and caffeine on gastrin and acid secretion in man. Deutsche medizinische Wochenschrift. 101(12):455-7.
- Feldman EJ, Isenberg JI, Grossman MI. 1981. Gastric acid and gastrin response to decaffeinated coffee and a peptone meal. JAMA. 246(3):248-50.
- H. Glatzel and K. Hackenberg, Effects of Caffeine Containing and
Decaffeinated Coffee on the Digestive Functions: X-ray Studies of the
Secretion and Peristalsis of Stomach, Intestines and Gallbladder, Medizinische Klinik, April 21, 1967;62(16):625-28.
- Huang, J.Q., Hunt, R.H. 1999. pH, healing rate, and symptom relief in patients with GERD. Yale Journal of Biology and Medicine. 72(2-3): 181-94.
- Marotta, R.B. and Floch, M.H. 1991. Diet and nutrition in ulcer disease. The Medical Clinics of North America. 75(4): 967-79.
- Robertson, D., Frolich, J.C., Carr, R.K., Watson, J.T., Hollifield, J.W., Shand, D.G. and J.A. Oates. 1978. Effects of caffeine on plasma renin activity, catecholamines and blood pressure. New England Journal of Medicine. 298(4):181-6.
- Lane, J.D., Adcock, R.A., Williams, R.B. and C.M. Kuhn. 1990. Caffeine
effects on cardiovascular and neuroendocrine responses to acute
psychosocial stress and their relationship to level of habitual
caffeine consumption. Psychosomatic Medicine. 52(3):320-36.
- Lane, J.D. 1994. Neuroendrocine Responses to Caffeine in the Work Environment. Psychosomatic Medicine. 546:267-70.
- Kerr, D., Sherwin, R.S., Pavalkis, F., Fayad, P.B., Sikorski, L., Rife, F., Tamborlane, W.V. and During, M.J. 1993. Effect of caffeine on the recognition of and responses to hypoglycemia in humans. Annals of Internal Medicine. 119(8):799-804.
- Roca, D.J., G.D. Schiller, and D.H. Farb. 1988. Chronic Caffeine or Theophylline Exposure Reduces Gamma-aminobutyric Acid/Benzodiazepine Receptor Site Interactions. Molecular Pharmacology, May;33(5):481-85.
- Cantu, P., Carmagnola, S., Savojardo, D., Allocca, M. and Penagini, R. 2003. Effect
of non-selective gamma-aminobutyric acid receptor stimulation on motor
function of the lower oesophageal sphincter and gastro-oesophageal
reflux in healthy human subjects. Alimentary pharmacology & therapeutics. 18(7):699-704.
- Koek GH, Sifrim D, Lerut T, Janssens J, Tack J. 2003. Effect of
the GABA(B) agonist baclofen in patients with symptoms and
duodeno-gastro-oesophageal reflux refractory to proton pump inhibitors. Gut. 52(10): 1397-402.
- Naliboff BD, Mayer M, Fass R, Fitzgerald LZ, Chang L, Bolus R, Mayer EA. 2004. The effect of life stress on symptoms of heartburn. Psychosomatic Medicine. 66(3):426-34.
- Roberfroid MB. 1997. Health benefits of non-digestible oligosaccharides. Advances in experimental medicine and biology. 427: 211-9.
- Silverman, K., Evans, S.M., Strain, E.C. and Griffiths, R.R. 1992 Withdrawl Syndrome after the Double-Blind Cessation of Caffeine Consumption. The New England Journal of Medicine. 16(327): 1109-14.
- Cherniske, S. Caffeine Blues: Wake Up to the Hidden Dangers of America’s #1 Drug. Copyright 1998.
- Fetrow, C.W. and J.R. Avila. Professional’s Handbook of Complementary and Alternative Medicines. Second Edition. Copyright 2001.
- Murray, M., and J. Pizzorno. Encyclopedia of Natural Medicine, Revised Second Edition. Copyright 1998.
- Physicians Desk Reference for Herbal Medicines. Second Edition. Copyright 2000.
- Roehl, E. Whole Foods Facts: The Complete Reference Guide. Copyright 1996.
- Biddle, W. 2003. Gastroesophageal reflux disease: current treatment approaches. The Official Journal of the Society of Gastroenterology Nurses and Associates 26(6): 228-36.
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