Caffeine is a stimulant and is known to affect gut motility, meaning, it may make you run to the bathroom, even if you have a healthy digestive system. For some people with IBS, caffeine may trigger symptoms: research has shown that 26-40% of IBS sufferers identify coffee as a cause of symptoms. And about a third of those who re-introduce it after improving their symptoms with an elimination diet experience a recurrence of symptoms, mostly diarrhea. On the other hand, IBS sufferers with chronic constipation may take advantage of the effect of caffeine on colonic motility and experience some benefit in their symptoms.
Due to the lack of clinical data (that is, the data we have is observational or anecdotal and cannot establish cause-and-effect), Monash University has not given specific recommendations on the use of caffeine for people with IBS. Rather, they recommend each person work with a dietitian to determine whether their symptoms may be related to caffeine intake.
Setting the caffeine issue aside, we also need to consider the FODMAP content of coffee, teas (caffeinated or herbal) and other hot beverages (mostly from oligo-saccharides). Here is a quick guide:
- When drinking coffee, prefer espresso and instant coffee, as they are low in FODMAPs. The FODMAP status of American style brewed, drip coffee is less certain and may develop some FODMAPs during the brewing process. Stay away from most coffee substitutes as they usually contain chicory or inulin (high in FODMAPs).
- Choose green or white tea, and lightly steeped black tea. Steeping the tea for a shorter amount of time (less than 2 minutes) will make the tea less concentrated in FODMAPs, which are soluble in water.
- Yerba-mate has not been tested, so it’s best to stay away from it. After you have moved on to your personalized low FODMAP diet, you may test small amounts and see how you react.
- Among herbal teas, choose mint, ginger, lemon or rooibos. Make sure to avoid teas that have chicory root fillers and high-FODMAP teas like chamomile, oolong, dandelion, and fennel.
- Make your own hot chocolate with 2-3 teaspoons unsweetened cocoa, 12 ounces lactose-free or almond milk and ¾ teaspoon of cornstarch. Add a splash of vanilla and sweeten to taste with sugar (but no more than 1 tablespoon). Avoid the pre-mixed cocoa mixes as they are made with dry milk (a source of lactose).
Finally, whatever tea (or coffee) you may choose, be careful about what you put in it. Avoid milk or coffee creamers and opt for lactose-free milk, almond milk or small amounts of half-and-half (virtually lactose-free). If you like to sweeten your beverage, choose regular sugar, 100% maple syrup, or stevia, and stay away from honey and agave.