Caffeine & IBD

What is caffeine?

Caffeine is a natural substance that works by stimulating our brain and central nervous system. This helps us to stay alert and reduces tiredness.

What drinks contain caffeine?

The most common caffeine containing drinks are coffee, black tea, green tea, cola, Red Bull and even decaf coffee can still contain small amounts of caffeine.  

The positives of caffeine containing drinks

  • Some caffeine containing drinks contain antioxidants – drinks like coffee, tea and green tea contain antioxidants which have been shown to be beneficial for our health (1). People with IBD often high levels of oxidative stress so antioxidants are important (2).

  • Can give an energy boost - caffeine increases our alertness by blocking a brain chemical (adenosine) that makes us feel tired, while at the same time triggering the release of adrenaline that increases our energy (3). This can be helpful in the short term to give us an energy boost which can be much needed sometimes when many of us with IBD experience fatigue (4).

  • Part of some drinks that taste nice! – caffeine can be found in drinks like tea and coffee which just taste really nice and can be lovely and warming on a cold day!  

The negatives of caffeine containing drinks

  • Coffee can make some of us poo – in some people coffee can stimulate movement of the colon - specifically rectosigmoid motor activity – so the bottom end of the colon, within 4 minutes of drinking it which can make us need a poo! Interestingly the impact seems to happen with decaf coffee too in the people who experience this so the effects can’t be entirely put down to caffeine as a stimulant (5, 6). As many of us with IBD have frequent bowel movements and urgency anyway encouraging pooping is usually something we want to avoid!

  • Caffeine causes a stress response – drinking caffeine containing drinks triggers the release of our stress hormones adrenaline and cortisol (7). This can make us feel alert but too much stress can have an negative impact on our health and on IBD (8).

  • Caffeine can increase feelings of anxiety – because drinking caffeine containing drinks increase our fight or flight hormone adrenaline, this increases our heart rate and can mimic anxiety (9). Anxiety is common in IBD with approximately 40% of patients experiencing it (10) and drinking caffeine containing drinks may add to feelings of anxiety.  

  • Caffeine can have an impact on our sleep – caffeine can stay in our system for over 12 hours so it may have a big impact on our sleep if we are drinking it later in the day. Sleep problems are very common in IBD - almost half of people with Crohn’s and colitis experience sleep disturbance, and this increases to 70-80% during relapses (11). 

Take Home 

General guidelines for the management of IBD tend to recommend avoiding caffeine because it can cause diarrhoea and disrupt sleep. I have found in clinical practice this one is very individual and can also depend where you are in your journey with your Crohn’s or colitis. During flare-ups when diarrhoea is more common avoiding things like caffeine which might make that worse is a good idea. When in remission, some people find it makes them go to the loo more or aggravates things, but others can tolerate caffeine containing drinks OK so its about working out what works for you.

If you do want to include caffeine containing tea and coffee I’d recommend keeping amounts to a minimum and avoiding having them after midday to avoid the negative impact they may have on sleep.

I have written a free e-book to help you find a way forward for your everyday life with Inflammatory Bowel Disease. Whether you are right at the beginning of your journey with IBD or have been living with your condition for years and feel like you have tried almost everything, there are things you can do everyday, beyond the medication you are taking, to help you take back control.

Disclaimer: All content found on the nalmclinic.com website, including: text, video, or other formats have been created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor, consultant or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

We are all wonderfully unique and what works for one person may not work for another so please seek help and advice before changing your diet to work out the right way forward for you.

References

  1. Anton Rietveld, Sheila Wiseman, Antioxidant Effects of Tea: Evidence from Human Clinical Trials, The Journal of Nutrition, Volume 133, Issue 10, October 2003, Pages 3285S–3292S, https://doi.org/10.1093/jn/133.10.3285S

  2. Ewa Dudzińska, Magdalena Gryzinska, Katarzyna Ognik, Paulina Gil-Kulik, Janusz Kocki, "Oxidative Stress and Effect of Treatment on the Oxidation Product Decomposition Processes in IBD", Oxidative Medicine and Cellular Longevity, vol. 2018, Article ID 7918261, 7 pages, 2018. https://doi.org/10.1155/2018/7918261

  3. Ferré S. An update on the mechanisms of the psychostimulant effects of caffeine. J Neurochem. 2008 May;105(4):1067-79. doi: 10.1111/j.1471-4159.2007.05196.x. Epub 2007 Dec 18. PMID: 18088379.

  4. Nocerino, A., Nguyen, A., Agrawal, M., Mone, A., Lakhani, K., & Swaminath, A. (2020). Fatigue in Inflammatory Bowel Diseases: Etiologies and Management. Advances in therapy, 37(1), 97–112. https://doi.org/10.1007/s12325-019-01151-w

  5. Boekema PJ, Samsom M, van Berge Henegouwen GP, Smout AJ. Coffee and gastrointestinal function: facts and fiction. A review. Scand J Gastroenterol Suppl. 1999;230:35-9. doi: 10.1080/003655299750025525. PMID: 10499460.

  6. Brown, S. R., Cann, P. A., & Read, N. W. (1990). Effect of coffee on distal colon function. Gut, 31(4), 450–453. https://doi.org/10.1136/gut.31.4.450

  7. Lovallo, W. R., Whitsett, T. L., al'Absi, M., Sung, B. H., Vincent, A. S., & Wilson, M. F. (2005). Caffeine stimulation of cortisol secretion across the waking hours in relation to caffeine intake levels. Psychosomatic medicine, 67(5), 734–739. https://doi.org/10.1097/01.psy.0000181270.20036.06

  8. Mawdsley, J. E., & Rampton, D. S. (2005). Psychological stress in IBD: new insights into pathogenic and therapeutic implications. Gut, 54(10), 1481–1491. https://doi.org/10.1136/gut.2005.064261

  9. Winston, A., Hardwick, E., & Jaberi, N. (2005). Neuropsychiatric effects of caffeine. Advances in Psychiatric Treatment, 11(6), 432-439. doi:10.1192/apt.11.6.432

  10. Bannaga, A. S., & Selinger, C. P. (2015). Inflammatory bowel disease and anxiety: links, risks, and challenges faced. Clinical and experimental gastroenterology, 8, 111–117. https://doi.org/10.2147/CEG.S57982

  11. Marinelli, C., Savarino, E.V., Marsilio, I. et al. Sleep disturbance in Inflammatory Bowel Disease: prevalence and risk factors – A cross-sectional study. Sci Rep 10, 507 (2020). https://doi.org/10.1038/s41598-020-57460-6

Clemmie Macpherson