For many people, enjoying a fresh cup of coffee first thing in the morning is a non-negotiable way to start the day.
But the idea that taking a sip without eating could
damage the gut
- or contribute to other problems like bloating, acne, hair loss, anxiety, thyroid problems or painful periods, as some have said on social media - has garnered so much popularity as disbelief.
According to Kim Barrett, professor of Membrane Physiology and Biology at the University of California Davis School of Medicine and a member of the board of directors of the American Gastroenterological Association, researchers have been studying the benefits and harms of consumption since the 1970s. of coffee, especially in relation to the intestine.
Fortunately, the stomach can
handle all sorts of irritants
, including coffee.
"The stomach has many ways of protecting itself," Barrett explained.
For example, it secretes a thick layer of mucus that creates a
powerful shield
between the stomach lining and what is swallowed.
That shield also protects the stomach from its own natural acidic environment, needed to break down food, he added.
It would be necessary to consume a very aggressive substance "so that
the defenses of the stomach are broken
, because it is constantly in a very adverse and harmful environment," he said.
"This is how the stomach does its job."
Coffee is not likely to cause objective damage to the stomach.
Photo Shutterstock.
How does coffee affect the intestine?
It is well known that irritants such as alcohol, tobacco smoke and nonsteroidal anti-inflammatory drugs - such as ibuprofen or naproxen - disrupt the stomach's natural defense mechanisms and damage its lining, said Byron Cryer, chief of internal medicine at the Medical Center. from Baylor University in Dallas.
His research lab specializes in understanding how different medications and other chemicals can
damage the stomach
and small intestine.
While certain irritants can make the stomach more vulnerable to acid formation and ulcers, multiple large-scale studies have concluded that this is not the case with coffee.
A 2013 study of more than 8,000 people living in Japan, for example, found no
significant association
between coffee consumption and the formation of stomach or intestinal ulcers — even among those who drank three or more cups per day. .
"Coffee, even in concentrated form, is not likely to cause objective lesions in the stomach," Cryer said.
"And much less in the
typical doses
of the usual drinks."
However, coffee does have effects on the intestine: it can speed up the colon and induce defecation, and coffee increases acid production in the stomach.
Outside the intestine, it is well known that the caffeine in coffee increases heart rate and blood pressure.
And if taken too close to bedtime,
it can disrupt sleep
.
But these changes are temporary, according to Cryer.
Adding a splash of milk or cream can help lower the acidity.
Photo Shutterstock.
Does increased stomach acid cause any problems?
Drinking coffee on an empty stomach is unlikely to cause any damage to this organ, but could theoretically cause heartburn, Barrett said.
We know that coffee kickstarts the production of stomach acid, but if you have food in your stomach or if you drink your coffee with milk or cream, that will help create
a shield
that partially neutralizes that acid.
So drinking coffee, especially if it's black, without food can lower
stomach
pH more than it would if you had it with milk or a meal, Barrett said.
Although a slightly lower pH is not a problem for the stomach lining, it might be a problem for the lining of the esophagus, as it is much more vulnerable to acid damage.
Additionally, some studies have shown that coffee can relax and open the sphincter that connects the esophagus to the stomach, which could hypothetically allow stomach acid to more easily
splash up the esophagus
and cause unpleasant heartburn symptoms.
But even in this case, the data is contradictory.
A 2014 review of 15 studies conducted in Europe, Asia, and the United States found no relationship between coffee consumption and heartburn symptoms, while a 2020 study using data from more than 48,000 nurses found, to the contrary. found an increased risk of heartburn symptoms among coffee drinkers.
To understand how coffee might affect the esophagus, scientists are also studying a condition called Barrett's esophagus, which occurs when the esophagus is damaged by chronic exposure to stomach acid, as occurs in people with long-term acid reflux problems. .
In this case, the cells that line the esophagus change into
tougher cells
, similar to those in the stomach, to protect themselves from the acid.
These changes can increase the risk of esophageal cancer, especially if you have a family history of this disease or if you smoke.
But it's reassuring that a 2016 study of US veterans didn't find a similar relationship with coffee consumption.
The authors concluded that for Barrett's esophagus, avoiding coffee would probably not be helpful.
Then what should I do?
In practice, as a gastroenterologist, I often tell my patients to take note of their symptoms.
If you consistently notice a
burning pain
in your chest or a sour taste in your mouth after drinking coffee, you may want to cut back or consider taking an antacid.
Adding a
splash of milk or cream
or a small bite of food with your morning cup can also help.
But if you don't notice any symptoms, you're probably someone who doesn't experience significant reflux after coffee and can continue to drink it with ease.
Cryer usually drinks lattes or cappuccinos: steamed milk reduces bitterness, he said.
And overall, he added, drinking coffee has many health benefits, including its relationship to longevity, a lower risk of cardiovascular disease, and protection against many cancers, including liver, prostate, breast, and colorectal cancers.
"There's a lot more evidence for the benefits of coffee than there are for its harms," Cryer said, something worth keeping in mind as you scroll through social media stories about the beverage's harms.
*
Trisha Pasricha is a gastroenterologist at Massachusetts General Hospital.
©The New York Times
Translation: Elisa Carnelli
***
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