Does coffee help those with Irritable Bowel Syndrome? A Greek dietician explains

Mr Eumenis Karafillides, Clinical Dietitian-Nutritionist and Director of the Dietetics Department at Metropolitan General, summarises the latest research data on the relationship between gastrointestinal disorders and favourite beverages.

Irritable Bowel Syndrome, also known as IBS, is a common gastrointestinal disorder that causes the gastrointestinal tract to become hypersensitive and the muscles of the intestine to contract.

The main symptoms of the syndrome are abdominal pain, bloating, cramping, constipation and diarrhoea. IBS is often accompanied by severe flatulence and affects women more often than men, but it does not increase a person's risk of developing colon cancer.

Drinking coffee may help protect against the development of IBS or relieve its symptoms for some people, according to a new meta-analysis published in the journal Nutrients in 2023.

According to the meta-analysis, which included data from 432,022 participants in eight different studies, coffee drinkers appeared to be 16% less likely to develop IBS than people who did not drink coffee.

This is true for people who drink any amount of coffee at regular intervals.

The analysis was based on eight studies that met the investigators' criteria and were selected from an initial pool of 187 studies from the EMBASE, PubMed, and Cochrane Library databases up to 31 March 2023.

The meta-analysis suggested that the contradictory findings of previous studies, that coffee acts in a harmful manner in IBS, may be related to the complexity of coffee. More specifically, coffee contains over a hundred compounds, varying significantly depending on their origin, roasting and preparation methods.

Not all parameters are always considered in all studies.

In addition, the connection between coffee and the syndrome has to do with the bioactive molecules of coffee, as it is a beverage rich in bioactive substances, such as polyphenol diterpenes, trigonelline and melanoidins. These substances have antioxidant, anti-fibrotic, and anti-inflammatory properties and affect gut microflora, bile acids, motility, and intestinal permeability. These properties can potentially have a beneficial impact on IBS.

But why isn't coffee good for everyone's gut health?

Gastroenterologist Dr Babak Firoozi, who was not involved in this research but was asked to comment on the study's results, claimed that of the eight studies included in the meta-analysis, three showed that coffee promotes irritable bowel syndrome (IBS).

He stated that all three studies were cross-sectional, where cross-sectional studies only identify associations and cannot prove a causal relationship between the parameters under consideration.

Firoozi explained that the results of these three studies may not be so surprising, given that coffee can sometimes disrupt digestion and is a powerful laxative due to the bioactive compounds it contains.

Not only caffeine but also other molecules in coffee promote bowel movements through increased intestinal transit. So, coffee in some patients with diarrhoea as the predominant symptom of IBS may not be beneficial and could actually make the symptoms worse.

As for patients with fatty liver disease, at least one cup of coffee every day is recommended, as coffee reduces fibrosis in the liver and helps prevent gallstone formation.

"Overall, current evidence suggests a possible protective effect of coffee on irritable bowel syndrome (IBS). We know that coffee consumption is safe at permissible and defined consumption levels and may benefit gut health, which should be further studied in large prospective cohort studies," concluded Mr Karafillides.

The article first appeared in Ygeia Mou. Translated by Paul Antonopoulos. 

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