Coffee is one of the most popular beverages in the world, and for many adults, an enjoyable part of their daily routine. But coffee has a reputation for causing abdominal discomfort, since it is presumed to aggravate gastrointestinal disorders including ulcers, acid reflux and irritable bowel syndrome. However, most people can consume moderate amounts of coffee without ill effects.
If you suffer from acid reflux, also known as heartburn, coffee may cause upper abdominal discomfort if it aggravates your symptoms. The caffeine in coffee is known to relax the sphincter muscle which connects the stomach to the esophagus. When the sphincter relaxes too much, the acidic stomach contents are more likely to travel up into the esophagus -- causing pain and irritation. This explains the commonly-held belief that coffee should be avoided in people with acid reflux. However, research doesn't support a blanket restriction on coffee. A June 2013 article in "PLoS One" compared 993 people with gastrointestinal reflux disease (GERD), a severe form of acid reflux, to almost 6000 GERD-free study participants, and found no association between coffee intake and injury to the esophagus lining. However, if you find that your symptoms worsen after you consume coffee, it's wise to avoid this beverage.
Coffee has also been linked to aggravating ulcer pain, which can be felt in the upper or middle abdominal area. An ulcer is a sore in the lining of the stomach or small intestines. Since coffee stimulates gastric acid secretion, this beverage has a reputation for aggravating ulcer pain and increasing the risk of ulcer development. It's now known that most ulcers are not caused by coffee or certain foods, but by the H. pylori bacteria or anti-inflammatory drugs such as aspirin or ibuprofen. The article in "PLoS One" compared coffee intake in 75 people with stomach or intestinal ulcers to the coffee intake in almost 8000 ulcer-free study participants, and found no link between coffee consumption and ulcers. However, it's best to assess your own tolerance. Since coffee is an acidic drink which can stimulate stomach acid secretion, drinking coffee has the potential to aggravate the pain or discomfort caused by an ulcer.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a disorder characterized by abdominal pain, diarrhea, bloating and constipation. Coffee has traditionally been considered a trigger food that should be avoided in IBS. While there is limited research on coffee and IBS, this beverage is reputed to have a laxative effect -- and laxatives can cause gas, bloating or abdominal discomfort. Warm beverages such as coffee, particularly when consumed in the morning, stimulate peristalsis, which is the wave-like movement of the intestines. Many people rely on coffee's laxative effect to help stimulate a bowel movement. In general, however, the mild laxative effect of coffee should not cause lower abdominal pain.
Intolerance or Allergy
If you have abdominal pain after drinking coffee, you may need to consider your coffee's additives. Lactose intolerance is a common reason for abdominal pain, gas and bloating, so the milk or cream in your coffee could be the culprit. Milk or soy allergy could also cause pain, and these substances are found in most creamers. If you think you have an allergy or intolerance to any foods, talk to your doctor and find alternatives.
According to an October 2014 review published in "European Journal of Gastroenterology and Hepatology," coffee in moderation is acceptable and may even have health benefits. While individual tolerance may vary, the authors of this review defined moderate as a daily intake of 24 to 32 ounces, or 3 to 4 cups. However, if coffee causes abdominal discomfort or other unwanted symptoms, try avoiding it to assess the benefits. Also avoid or limit coffee if recommended by your doctor. Excess coffee has been linked to headaches, anxiety, nausea, high blood pressure and restlessness.
Reviewed and revised by Kay Peck, MPH, RD