Coffee is a supremely popular beverage, but some people with irritable bowel syndrome have mixed feelings about it. An estimated 25% of IBS sufferers feel that drinking a cup of coffee angers their digestive system.
So should you ditch coffee then? Well, not so fast… let’s see what’s going on with IBS and coffee and figure out what we can do about it.
Is coffee low FODMAP?
Coffee lovers rejoice! The good news is that black coffee (and espresso) does not contain FODMAPs (1), so technically you could drink it freely on the low FODMAP diet. That may not be a good idea though, since quite a few IBS sufferers feel coffee contributes to their gut symptoms (more about this later).
There’s one exception to the no-FODMAPs-in-coffee rule: instant coffee with chicory root.
While typical instant coffee products are 100% coffee, some contain chicory root which is high in fructans. It’s best to steer clear of these chicory-root-containing instant coffees during the elimination and reintroduction phases of the low FODMAP diet when you’re trying to minimize your FODMAP intake.
Remember to always check ingredient lists for sneaky high FODMAPs in processed foods.
FODMAPs in coffee only become an issue when you start adding milk, milk alternatives, sugars and other FODMAP-containing flavourings.
FODMAPs in your coffee additions
The FODMAP content in any food is dependent on the serving size. There are often low FODMAP serving sizes of high FODMAP foods. Therefore, you can use a high FODMAP addition in your coffee as long as you do so in a small portion that corresponds to a low FODMAP serving size.
The list below is current as of February 2023. Always check the Monash University FODMAP app for the most up to date info.
Low FODMAP milks
- Lactose-free milk (250ml)
- Almond milk (250ml)
- Soy milk made from soy protein (not made from soybeans) (250ml)
- Macadamia milk (250ml)
- Quinoa milk (250ml)
- Rice milk (3/4 cup)
- Coconut milk (UHT) unsweetened (3/4 cup)
Low FODMAP sugars
- White sugar, brown sugar (granulated, cane, raw, organic, etc)
- Maple syrup
- Coconut sugar 1 tsp (moderate FODMAP at 2 tsp)
Other low FODMAP additions
- Cocoa powder, 2 heaping tsp
- Hot chocolate powder (23%, 60%, 70% cocoa), 2 heaping tsp
- Coffee creamer powder, 2 tsp
- Matcha powder (1 tsp)
Low FODMAP alcohol
- Brandy (1 shot)
- Whisky (1 shot)
I love to Irish up my A2 milk lattes with Baileys, but sadly, Bailey’s hasn’t been tested for FODMAPs. A quick look at the ingredients list tells me it’s probably not high FODMAP at the 1-2 Tbsp portion I like to use. Phew!
High FODMAP milks & their low FODMAP portions
- Cow’s milk (1 Tbsp is low FODMAP)
- Soy milk made from soy beans (2 Tbsp is low FODMAP)
- Oat milk (1/2 cup is low FODMAP)
- Coconut milk, light, canned (1/4 cup is low FODMAP)
High FODMAP sugars & their low FODMAP portions
- Honey (1 tsp is low FODMAP)
- Agave syrup (1 tsp is low FODMAP)
High FODMAP alcohol
- Rum (there is no low FODMAP serving size)
Should you ditch coffee if you have IBS? Some things to consider
Ultimately, you have to listen to your body on this one, but there are a few things to consider…
IBS flare and coffee
IBS flare-ups are the worst. So if you’re in the midst of a flare, it might be wise to temporarily press pause on the coffee consumption until your gut has settled – especially if you’re having a diarrhea flare.
Coffee and bowel movements
While coffee does not affect the motility of the stomach or small intestine, it can trigger colonic motor activity. This activity in the large intestine consists of contractions (kneading your stool to help absorb water) and propulsive waves (moving your stool forward). When those waves are strong enough, it’s time to drop the kids off at the pool.
Not everyone needs to answer nature’s call following a cuppa though. About 30% of people feel they need to defecate after drinking coffee, some as soon as 4 minutes afterwards. Interestingly, the existing literature suggests that both regular and decaffeinated coffee can produce this effect, though it’s likely stronger with regular coffee.
Falling into this 30% club is a curse for folks with diarrhea-predominant IBS but a blessing for those with constipation who’d do almost anything for a bowel movement.
In fact, drinking coffee is sometimes recommended for people with constipation-predominant IBS, though there’s no evidence that this is an effective intervention for IBS-C.
When I asked a friend with functional constipation how her coffee trial went, she said “honestly, it hasn’t helped at all.” She’s likely not a member of the 30% club.
Since coffee stimulates gut motility, and because people with IBS have greater gut sensitivity (ie. visceral hypersensitivity), it’s entirely possible that these movements account for the abdominal pain and flatulence some people with IBS report.
That being said, healthy coffee drinkers in a recent study didn’t report negative gastrointestinal symptoms with coffee consumption. Of course, people who experience GI distress with coffee are less likely to be regular coffee drinkers so the study may have accidentally selected for people who never would have claimed GI issues in the first place.
Coffee and reflux
Acid reflux is a common co-morbidity of IBS, meaning lots of people with IBS also suffer from reflux (ie heartburn) and its associated stomach pain. If you’re one of these people, it’s possible coffee is contributing to your digestive woes. But it’s also possible that it’s not.
Although coffee (specifically caffeine) is commonly touted as a trigger for reflux, the research supporting this is not high quality and the results are inconsistent.
The literature suggests that coffee is a trigger for some but not for others and that bodily responses to coffee are highly individual. Such responses may be dependent on numerous other factors like coffee bean roasting, caffeine content, and other components in coffee like salicylates and polyphenols.
This means we can’t make blanket statements like “everyone should cut out coffee if they have reflux”. Ultimately, it’s best to listen to your body and make the best decision based on what it tells you.
How can you listen to your body in the most helpful way? By embarking on a mini elimination diet (aka self experiment):
- Keep your diet stable for 2 weeks – eat foods that you normally eat and tolerate.
- Meanwhile, record your coffee intake, symptoms and symptom severity for 1-2 weeks.
- Cut out all coffee (including decaf) for 1-2 weeks and record your symptoms.
- If you notice an improvement in symptoms during the elimination weeks, try adding coffee back into your diet for 1-2 weeks while recording symptoms.
- Did your symptoms get worse when you reintroduced coffee? If so, you might be sensitive to coffee and it may be worthwhile to cut it out, or at least limit it to a manageable level.
- If you want to try decaf, then wait til symptoms settle and then introduce decaf coffee and make note of your symptoms.
Does how you make your coffee affect your symptoms?
Cold brew coffee vs. hot brew? French press vs. traditional drip? Dark vs. light roasts?
Will changing the way you prepare your coffee influence your IBS symptoms? There’s no evidence to suggest it will.
Most of the research on coffee making methods and gut symptoms focuses on heartburn, which isn’t the focus of this post so I won’t explore it here. Suffice to say, the research in this area is complex, confusing and the results are inconsistent.
If you wish to try a different method of coffee prep to see if it improves your abdominal cramps, bloat, gas and bowels then go for it (see my self-experiment tips above) – there’s likely no harm.
What about trendy coffees like mushroom coffee and bulletproof coffee?
Bulletproof coffee: yay or nay?
Nay all the way, baby.
A typical recipe for bulletproof coffee is as follows:
- 1 tsp – 2 Tbsp medium-chain triglyceride oil (ie. fat)
- 1 – 2 Tbsp butter (ie. more fat)
- 1 cup coffee
Personally, I wouldn’t touch bulletproof coffee with a 10 foot pole. I much prefer my fats in my whole foods and of the unsaturated variety. Also, I like my heart.
Fat has been shown to trigger abdominal pain in people with IBS, so drinking 1/4 cup fat with a bit of coffee added sounds like a recipe for a grumpy gut to me.
If you want to try bulletproof coffee, have it with a side of angioplasty and keep the peppermint oil handy.
Mushroom coffee – does it have FODMAPs?
Mushroom coffee isn’t a cup of joe with mushrooms floating on the top, which I’ll admit is what I envisioned the first time I heard of it. Yuck.
It’s coffee brewed from coffee grounds mixed with mushroom extracts (by-products of dried and processed mushrooms).
Many kinds of mushrooms are high in the FODMAP mannitol, a member of the polyol family, so it begs the question – does mushroom coffee contain FODMAPs and can it trigger IBS symptoms?
I couldn’t find much info on this so I zeroed in on food labels*. Since FODMAPs are fermentable carbohydrates and fibres, I was checking the carbohydrate line in the nutrition facts table.
Given the small numbers I saw (0-1 gram carb), and given that mushrooms contain carbs other than polyols, I’m willing to wager that these mushroom extract coffees are not high in FODMAPs.
*(Brands I checked PureShrooms, La Rebpublic, Four Sigmatic, The Youth Effect, VitaCup)
How to enjoy coffee if you have IBS
Again, responses to coffee are pretty individual so you have to listen to your body. But here are some general health tips around IBS and coffee:
- keep your portion small (eg. order small or medium rather than large at your fav coffee shops);
- no more than 3 cups of coffee per day (750mL total);
- use low FODMAP additions (or low FODMAP portion sizes of high FODMAP additions)
- use modest amounts of sugar;
- make your early/mid-afternoon coffee your last caffeinated coffee of the day so it doesn’t interfere with your sleep;
- enjoy coffee with food rather than on an empty stomach.
How does IBS affect your coffee intake? Let me know in the comments below 🙂
xoAndrea Senchuk, RD, MHSc