Does Coffee Cause Ulcerative Colitis Flare-ups?

Contains compounds that affect the gut and may affect UC

A cup of coffee contains caffeine, beneficial antioxidant plant compounds known as polyphenols, and acids like chlorogenic acid.

According to research, the drink may increase stomach acid, lead to heartburn, stimulate defecation, and affect the gut microbiome — the colony of microorganisms that reside in your gut.

Still, a lot remains unknown about coffee’s effect on UC.

Summary

Coffee contains many active compounds, including caffeine and antioxidants, that may influence the drink’s effects on your body and UC.

Does drinking coffee cause UC? 

Emerging research indicates that drinking coffee isn’t associated with an increased risk of developing UC. In fact, it may even lower your risk.

However, the exact reason behind coffee’s possible UC benefits is not fully understood.

Coffee may have anti-inflammatory properties, and research suggests that an anti-inflammatory diet could help reduce the risk of UC. Plus, coffee is rich in antioxidant polyphenols, which may have similar effects.

Coffee has also been found to positively affect the gut microbiome because it has prebiotic properties. In other words, coffee feeds the good bacteria in your gut and lowers harmful specifics of microbes, thereby supporting a healthy microbiome in the large intestine.

Summary

Research suggests that drinking coffee isn’t a risk factor for UC. It may even protect you from developing the condition.

Does coffee trigger UC flare-ups? 

While some people attribute their UC symptoms to certain foods, only a few high quality studies have assessed how your diet may affect the condition. Additionally, no studies have yet focused on UC and coffee consumption.

Instead of relying on studies, people with UC often identify which foods and drinks trigger their intestinal problems through trial and error — either on their own or with the help of a healthcare professional like a registered dietitian.

Caffeine and UC symptoms

Even though there is a lack of research on caffeine and UC symptoms, the Crohn’s & Colitis Foundation lists coffee and other caffeinated drinks like soda as potential UC flare triggers.

Coffee can cause contractions within your digestive tract and speed up the elimination of its contents. In fact, one in three people report that drinking coffee increases the desire to defecate as soon as 4 minutes after consumption.

This effect was once attributed to coffee’s natural caffeine content. However, both decaffeinated and caffeinated coffee have been shown to stimulate bowel movements, so the effect is likely due to other chemical compounds like polyphenols or acids.

Because diarrhea is a common symptom of UC, anything that increases bowel movements may be undesirable. So, whether or not caffeine is at fault, coffee may be best avoided if you have UC and find that it worsens your symptoms.

Summary

There is little data on coffee’s role on UC. While it may trigger symptoms in some people, others may tolerate it. Thus, the best way to identify if coffee affects you is to work with a healthcare professional.

How to reduce coffee’s side effects if you have UC

While many people with IBD drink coffee, some do avoid it and attribute some of their intestinal symptoms to the drink.

In a 2021 survey of 208 people in UC remission, 37% believed diet can initiate symptoms, and 24% reported avoiding coffee.

In other words, it appears that some, but not all, people living with UC avoid coffee as they believe it may affect their symptoms. Still, many people with the condition drink coffee with no perceived negative effects.

Although not ideal, the main approach to IBD symptom management is generally trial and error. This is also the case when learning what you can eat and drink.

The Crohn’s & Colitis Foundation recommends using a food diary to figure out which foods may be your triggers.

Depending on what your triggers are, consider these tips to see if they improve your tolerance to coffee.

Try a smaller serving size

Maybe you’re unable to tolerate larger servings of coffee, but sticking to smaller portions can be possible.

If you keep a food diary, also record how much of the food or beverage you consume. You might find your sweet spot at one cup of coffee per day versus three.

Keep in mind that 1 cup of coffee is defined as 8 ounces (236.6 mL) and that the smallest size offered at many coffee shops can be more than this.

Limit excess added sugars and sugar alcohols

Sugary foods are also on the list of potential trigger foods from the Crohn’s & Colitis Foundation.

Lattes, frappuccinos, and macchiatos from cafes can be loaded with upward of 20 grams of sugar. At-home coffee creamers are typically lower in sugar, with around 5 grams per serving.

Meanwhile, sugar alcohols like sorbitol and mannitol may be added to sugar-free coffee creamers. Sugar alcohols are also listed as potential UC triggers and may induce diarrhea in some people.

Try opting for unsweetened coffee to see if this triggers any UC symptoms. If you like and tolerate milk, milk alternatives, or cream in your drink, choose unsweetened versions of these add-ons.

Choose a dairy-free alternative

Research has found that many people with IBD avoid dairy due to adverse symptoms resulting from dairy consumption. If you’re unsure whether the coffee or dairy may aggravate your symptoms, try to trial and error them separately.

There are many plant-based milk and creamer options available — including soy, almond, oat, and coconut — that you can add to your coffee instead.

Avoid sources of carrageenan

Carrageenan is a food additive derived from seaweed. It’s used to thicken and preserve many foods, including some coffee creamers.

In a small 2017 study, 12 people with UC were told to avoid all sources of carrageenan in the diet. Half received a placebo, while the other half received carrageenan. Participants were interviewed every 2 weeks and followed for a year or until relapse.

No participants receiving the placebo experienced a relapse, whereas three receiving the carrageenan supplement did.

It’s important to note that this is just a small, preliminary study, and it only showed marginal differences in UC outcomes. Ultimately, more research is needed to learn more — especially since carrageenan is not commonly consumed in supplement form.

Summary

Keeping a diary of the types and quantities of foods and drinks you consume can help identify potential triggers of your symptoms.

Alternative beverages to enjoy with UC

Staying hydrated with water is always important, but especially so if you’re experiencing a UC flare and losing a lot of liquid through frequent, runny stools.

In addition, consider adding electrolyte tablets to water or drinking electrolyte drinks during a severe flare. It’s important to replenish lost electrolytes to stay hydrated and keep your body’s nervous system and muscles working optimally.

Tea, including green tea, may also be a good drink option for those with UC. Tea is rich in antioxidants that may have anti-inflammatory properties and could help reduce symptoms of a flare-up.

However, keep in mind that green, black, and oolong tea all have caffeine. Some herbal varieties can also have a laxative effect on some people. If you react negatively to drinking it, it’s likely best to avoid it.

Summary

Try to stay hydrated with water or tea, if you can tolerate it. This is especially important during a flare-up to counteract water losses from diarrhea or runny stools.

The bottom line

A lot is still unknown about the role of diet in UC.

This can be frustrating since it means that there’s no clear-cut answer for which foods may cause a UC flare in those with UC.

Currently, coffee is flagged by professionals as a drink you may need to avoid during a flare. Further, it’s speculated that it may trigger unwanted gut symptoms in some people. Yet, to date, little research exists to support or refute this.

Managing UC requires an individualized approach. Lean on your gastroenterologist or seek out a registered dietitian specializing in digestive conditions for additional support and guidance.

If you do find that coffee triggers or worsens your UC symptoms, there are many coffee alternatives to enjoy instead.