Coffee and IBS: Is Your Morning Routine Triggering Your Symptoms?

Grace Clark-Hibbs

February 25, 2021

Ever wonder why you find yourself running to the bathroom with diarrhea shortly after having your morning cup of Joe?…

Or why all of a sudden it feels like someone is stabbing you in the stomach and twisting the knife?…

Or on the flip side, why the only time you can have a normal bowel movement (BM) is right after drinking a cup of coffee?…

If you can related to any of these situations you have probably found yourself pondering, is coffee bad for IBS? What is it about coffee that triggers IBS symptoms? And why are the symptoms so different for different people?

Hold on tight! This article is going to dive into these questions (and more!) so you can feel confident in your decision to either keep, limit or eliminate coffee from your daily routine.

Let’s start with some background…

Coffee and the Gut

What exactly happens to the gut, or the gastrointestinal (GI) tract, when you drink coffee?

  • Movement is stimulated in the lower portion of the colon (aka the large intestine) and the gallbladder (the organ that releases bile to assist with fat digestion) contracts. (1, 2)
  • Stomach acid secretion increases and the the flap the prevents stomach acid from entering the esophagus (the sphincter) gets weak. (3)
  • The amount of time food spends in the stomach is sped up, which can lead to stomach contents being released into the small intestine too early. (4)

Does this mean coffee triggers IBS symptoms?

In short, sometimes.

These actions can lead to different results depending on the type of IBS a person has. For example, if you have IBS-C (constipation dominant) and you haven’t had a BM in awhile, the stimulation of the lower colon may lead to a positive release.

However, if you have IBS-D (diarrhea dominant), the stimulation may come before the body is ready to dispose of the feces, resulting in loose stools as quickly as four minutes after drinking coffee. (4)

Finally, the increased stomach acid, weakened sphincter, and faster gastric emptying often triggers a “coffee stomach ache” and/or heartburn in people with IBS, regardless of type. (4)

Just an interesting side note, current research has shown that decaffeinated coffee also increases stomach acid production, which suggests that caffeine is not the primary culprit. (4)

Coffee, IBS, and the Low-FODMAP Diet

This leads us to the discussion of whether coffee can be included in a healthy diet if you suffer from IBS. The answer is…it depends.

I know you were hoping for a more black and white response, but I hope you’re starting to see the trend here. The trend is that every person is different and therefore their tolerance of different food and drink is different too.

That being said, it is possible to drink coffee while also following a low-FODMAP diet. All you need to do first is test whether it triggers your specific symptoms.

How to test if coffee triggers IBS symptoms:

  1. Stop drinking it all together for at least 1 week.
  2. Reintroduce a small amount of black coffee back into your routine (~ 1/2 cup or 4 oz).
  3. Slowly increase the amount over the next couple days.
  4. Observe and take note of any changes in your symptoms.

Next, you want to think about the type of coffee you are drinking and what you are adding to it every morning.

During this step, think about the following:

  • Ground vs. Instant:
    • Either should be fine. However, double check the nutrition facts label of the instant coffee to make sure there are no high-FODMAP ingredients added (i.e. cane sugar, milk, chicory, etc.).
  • Milk:
    • Plant-based milks:
      • This includes almond, cashew, macadamia, quinoa, and soy milk made from soy protein. These can all be enjoyed in servings of no more than 8 oz or 236 mL.
    • Other plant based milks can be enjoyed in smaller servings:
      • Including coconut milk (≤ 4 oz or 125 mL or 1 Tbsp coconut milk powder as long as it does not contain inulin – high-FODMAP added to some foods to improve taste), hemp milk (≤ 4 oz), and rice milk (≤ 6 oz or ~200-250 mL).
    • Cow’s milk:
      • Lactose-free is the best option.
      • Very small amounts of standard cow’s milk (~3 tsp or 15 mL) may be possible depending on your tolerance.

Controlling the exact ingredients in your coffee may be easy at home, but what about when you want to meet a friend at a coffee shop or café?

What to do when you’re out and about:

  • Look for a place that offers unsweetened almond milk or lactose-free milk.
  • Try and avoid soy milk when you’re out.
    • Soy milk offered in coffee shops and cafés is often made from whole soy beans because it acts more like standard cow’s milk in drinks such as cappuccinos and lattes. Unfortunately, soy milk made from whole soy beans is high-FODMAP.
  • Be careful of ordering oat milk or coconut milk because these are only low-FODMAP in small servings.
  • Consider ordering a drink without milk, such as an espresso, a macchiato or an Americano.
  • If you can’t live without the creaminess and there is no almond milk or lactose-free milk option, ask for the milk on the side so you can be in control of the amount that’s added.
4 step guide on how to incorporate coffee into a low-FODMAP diet

Lastly, keep in mind serving sizes. The FDA has identified 400 mg of caffeine per day to be a healthy daily limit. (5)

Below is a list of common caffeine containing foods/drinks and the amount of caffeine they contain on average.

8 oz coffee 95-165 mg (90-100mg)

8 oz cold brew 100-150 mg

8 oz decaf coffee 2-5 mg

1 oz espresso 47-64 mg

8 oz black tea 25-48 mg

8 oz green tea 25-29 mg

8 oz soda 24-46 mg

50 g dark chocolate 21 mg

Energy drinks (varies by brand)

Pre-workout supplements (varies by brand)

Final Thoughts

All in all, coffee and IBS symptoms are interconnected, but the extent will vary person to person. Although it is possible to include coffee in a healthful low-FODMAP diet, you need to take the time to evaluate how your body reacts to it.

I recommend taking a couple of weeks to test whether coffee triggers your specific symptoms before jumping all in. If you discover that it doesn’t, be mindful of how you prepare it (i.e. what type of milk you use, whether it’s fresh or instant, etc.) and finally, ENJOY!

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Grace sitting

Hi, I’m Grace! A registered dietitian and gut health expert based in Portland, OR, where I live with my husband and our orange tabby, Tony. As someone who has struggled with my own severe, chronic, and painful bloat and constipation for over 15 years, I understand what it’s like not to get the answers you’re looking for from conventional medical support. So I decided to take matters into my own hands and figure out what was going on for myself using a functional nutrition approach and identifying my root causes. This approach was a game changer for me and now I’m on a mission to share it with every other woman experiencing embarrassing gut issues. You are not alone!

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