Does Coffee Irritate Stomach Ulcers?

If you have a stomach ulcer, you've probably heard it's best to avoid coffee. Although coffee doesn't cause ulcers, drinking this popular beverage might irritate your stomach and worsen ulcer pain. Whether or not you should drink coffee, though, depends on your individual tolerance.

Stomach ulcers, also known as gastric ulcers, are lesions that occur in the gastric mucosa, or the mucous membrane that lines the inner surface of the stomach. Gastric ulcers are a common form of peptic ulcer disease, a term that describes open, sometimes painful sores in the lining of the gastrointestinal tract.

While some ulcers produce no symptoms, the main sign of a gastric ulcer is gnawing, burning or soreness just below the breastbone. Eating may worsen or relieve this ulcer pain.

Stomach ulcers are formed when there is a weakening of the gastric mucosal barrier, a system of physical and chemical defense mechanisms that protect the stomach lining from harsh digestive juices and stomach acid. This compromised mucosal barrier makes the stomach lining more susceptible to erosion or damage.

Historically, stress and diet factors — including coffee intake — were thought to cause gastric ulcers. Coffee doesn't cause these ulcers, though, a belief reaffirmed by a 2013 population study published in the journal Plos One.

It's now known that most ulcers are caused by the Helicobacter pylori bacteria or nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin, ibuprofen or naproxen, because they weaken the stomach lining and make the mucosa more susceptible to damage from gastric juices.

Coffee is known to influence stomach acid production, and this effect isn't simply related to its caffeine content. Other components in coffee, including catechols and N-alkanoyl-5-hydroxytryptamide, stimulate gastric acid secretion, which is why coffee is thought to worsen ulcer symptoms.

But coffee has at least one compound that suppresses stomach acid production — an antioxidant called N‐methylpyridinium, which is formed during the roasting of the beans.

Despite the common advice that people with stomach ulcers avoid coffee, the theory that coffee worsens ulcer pain has not been clearly proven by research. In addition, the available research on coffee's impact on various gastrointestinal complaints may not be entirely applicable to the average, moderate coffee drinker.

For instance, some of these studies investigated symptoms after unusually large amounts of coffee, while some of this research only included people known to be sensitive to coffee, and some studies were based on perceived and not diagnosed side effects.

Differences in bean variety and roasting techniques are also factors that may influence symptoms. For instance, a 2014 study published in Molecular Nutrition and Food Research concluded a dark-roast coffee blend stimulated less stomach acid secretion as compared to a medium-roast market blend.

And a 2017 Austrian study demonstrated that bitter taste receptors in the mouth and stomach were involved in the stimulation of gastric acid production, which suggests different varieties and blends will have varying effects in the stomach. In other words, the relationship between coffee and stomach acid production is complex and needs further study.

So whether or not to avoid coffee is a personal decision, based on coffee's impact on your symptoms. Your coffee habits, including the type and amount you drink and whether or not you drink coffee on an empty stomach, will also play a role in your symptoms.

While clinical practice guidelines for gastric ulcer management don't outline a specific diet plan, a food pattern that emphasizes fruits, vegetables, whole grains and beans may be a helpful starting point.

A high-fiber diet is associated with low levels of stomach acid production, and a diet rich in fruits and vegetables can improve gastric ulcer severity and symptoms through their antioxidant, anti-inflammatory, antimicrobial and cell-protective properties.

Some other dietary changes to consider if you have a stomach ulcer include:

• If your ulcer symptoms get worse when you drink coffee, try drinking smaller amounts or experiment with other beverages, such as decaffeinated coffee or tea.
• Keep a log of your diet and your symptoms. If certain foods or beverages cause irritation or pain, try avoiding them.
• Add some yogurt or fermented milk, such as kefir, to your daily diet, because the healthy bacteria in these foods may improve the effectiveness of H. pylori treatment.
• If you drink alcoholic beverages, seek your doctor's advice on whether or not you should continue. Because alcohol is a gastric irritant, it may aggravate symptoms, and you may find it best to limit or avoid these beverages.

‌Read more:‌ Diet Plan for a Stomach Ulcer

Most ulcers can be treated and will heal, even though this process may take several weeks. If you have a stomach ulcer, your doctor will determine the best course of treatment for you.

Antibiotics will be used to treat the H. pylori infection, and NSAIDs will be stopped if these medications are believed to be the cause of your ulcer. These antibiotics can include:

• Amoxicillin (Amoxil)
• Clarithromycin (Biaxin)
• Metronidazole (Flagyl)
• Tinidazole (Tindamax)
• Tetracycline (Tetracycline HCL)
• Levofloxacin (Levaquin)
  

Medications may also be prescribed to lower the acid in your stomach and to protect the lining of your stomach as it heals. These may include:

• Omeprazole (Prilosec)
• Lansoprazole (Prevacid)
• Rabeprazole (Aciphex)
• Esomeprazole (Nexium)
• Pantoprazole (Protonix)
  

Your doctor will also recommend quitting smoking (if you smoke) to promote healing.

It's important to know when to seek medical attention. If you have severe pain, are unusually weak or dizzy or if you notice any blood in your stool or vomit, see your doctor immediately. Ask your doctor if there are other symptoms that warrant an urgent or routine visit.