#4: The skinny on your tall.
#4: The skinny on your tall.
Q: On the issue of acid reflux, what is it about coffee that causes it? Is it the acid, the caffeine, or both? I'm wondering if I'm okay with this low acid coffee I found just to wake me up in the morning? What would Aaron say?
-Lisa M.
A: Well let's start with the basic question of "Does coffee contribute to acid reflux?" There is some research which shows that for people who already have symptoms of acid reflux (or GERD), there is an increase, but only if the coffee is consumed between meals. No increase was shown in people who didn't have reflux to begin with. And even for the people who already had reflux, the coffee made no difference when it was consumed during a meal. So the answer to that one is yes, but not under all conditions.
Regarding the acidity versus the caffeine, there is some general disagreement as to which is kicking up the gastrointestinal fuss.
We know from years of medical research that caffeine can irritate the stomach, stress the adrenal system, cause coronary vasospasms, contribute to hypertension, insomnia, and anxiety disorders, and increase hydrochloric acid production leading to ulcers. As an added bonus it's addictive and has some pretty unpleasant withdrawal symptoms. For at least these reasons if for none other, it's a good idea to limit intake regardless of the reflux connection. Is decaf so bad? (This red flag goes for caffeine-contaning tea as well.)
If it's the acidity of the coffee that turns out to be the culprit, one might consider turning to darker roasts. The darker the roast, the lower the level of acid. For instance, an Espresso or French roast will be lower in acidity than an American or Viennese roast. Additionally, cold brewing your coffee is another way to reduce acidity (assuming that the acidity even relates to reflux).
Beyond acidity and caffeine lies a third category of reflux treachery: coffee add-ins. There's typically a lot more in our coffee than just the coffee. The milk and sugar (and the many variations, e.g. foams, whips, flavor syrups, sweeteners) are certainly contributors to reflux. Evidence suggests that poorly digested "excess" carbohydrates may be a major cause of the now-all-too-common reflux. Consider also the adult propensity for intolerance of dairy products and you have a good understanding of why coffee upgrades can be major contributors to the digestive tract uproar.
Short of drinking only water (not a bad idea!!!), the best solution is a process of deduction; i.e., for a while, cool it with whatever you think is bugging your stomach. See if it simmers down after a bit (typically the more severe the reaction, the longer the cool-down time), and then if you want to, reintroduce the potential irritant to see if you get a flare-up. If so, you've got pretty reasonable evidence that you should avoid that substance.
In some cases, a prolonged vacation from the irritant can allow the body to regain an equilibrium that can withstand the occasional indulgence. In a few cases, people report that after a long break they can go back to their old ways and not have a recurrence at all. In these cases, however, it's far more likely that the person previously had other stresses in his or her life that, when combined with the food irritant, became more than the body could handle. In some people, certain allergies only occur when an acute "life stress" is present. Oodles of people getting married, changing jobs, or dealing with another major life change will suddenly exhibit never-before-seen allergies. When these allergies are food-related, they can play a major role in triggering a host of GI horrors (hence the stress-reflux connection).
So the redux for reflux is: know your triggers, and then don't pull 'em! If cutting out coffee isn't yielding enough improvement, work with your gastroenterologist to figure out what the real problem is. In the mean time, it's not a bad idea to play it safe and leave out coffee (and the other common triggers like spicy foods, sugar, dairy, fried foods, and peppermint) while you continue the deductive experimentation with your diet. And do yourself the biggest favor by making sure that stress awareness and stress management are part of your reflux remix.
Happy experimenting! (With your diet.)
-Aaron Hagan, voice technician extraordinaire














