Should You Drink Coffee if You Have Crohn’s Disease?

If you have Crohn’s disease and love your morning cup of coffee, you may be wondering if your daily brew is helping or hurting your gut. When you have an inflammatory condition like Crohn’s, the answer isn’t always simple.

That’s because coffee can do more than give you that jolt of energy first thing in the morning. It’s acidic, which can be harsh on an empty stomach, and it can also speed up digestion and irritate the gastrointestinal tract. For people with Crohn’s, that can be a recipe for trouble.

Coffee isn’t automatically “bad” for Crohn’s disease, but it can be problematic for some people with the condition.

“Crohn's disease is a spectrum — depending on the location and severity of disease, patients can have different symptoms and reactions to foods,” she says. “The fact is that coffee contains caffeine, which is a stimulant. That means if you are prone to diarrhea, you will have more stools. If you have a stricture, it can cause worse pain and cramping.”

If you have ulcers, drinking coffee is like pouring acid on them, says Kendra Weekley, RD, a registered dietitian at Cleveland Clinic in Ohio, where she focuses on gut health and works with people with Crohn’s disease within the hospital’s inflammatory bowel disease medical home.

Mix in common additives like cream or sugar, and you’ve got more potential triggers. “Now you have coffee stimulating motility, added sugars and dairy stimulating motility, and the existing inflammation working against you,” Weekley says. “That’s a recipe for stomach pain and more loose and urgent stools.”

If your symptoms are well controlled and you don’t notice any issues after drinking it, you may not need to avoid it altogether. But if it makes your gut feel worse, especially right after drinking, that’s a sign to cut back or stop.

The short answer is no. If you’re in the midst of a flare, stay away from coffee and caffeinated drinks, which may exacerbate symptoms, says Rachel Dyckman, RDN, a New York City–based registered dietitian and a professional member of the Crohn’s & Colitis Foundation who specializes in digestive health and IBD, along with other gastrointestinal conditions.

It can also be dehydrating. “If you're already having frequent trips to the bathroom, overdoing it on coffee can contribute to dehydration,” Dyckman says.

Save coffee for when you’re safely in remission, and pay attention to how your body reacts to it, says Supriya Rao, MD, a gastroenterology, internal medicine, obesity medicine, and lifestyle medicine physician and a professor of gastroenterology at Tufts University in Massachusetts, where she treats people with IBD and other digestive health issues.

“If you’re noticing increased urgency, loose stools, abdominal cramping, reflux, or even feeling jittery or anxious, consider cutting back,” says Dr. Rao. “Sometimes patients don’t realize how much their cup of coffee is contributing to their discomfort until they take a break from it.”

If you want to enjoy coffee with Crohn’s disease, there are certain things you can do to avoid triggering symptoms. They include:

• Limit your intake. Stick to no more than one to two small cups per day, says Dr. Kane. “What I counsel my patients is that too much of a good thing is a bad thing and that they should likely limit their coffee intake, especially if they put cream and sugar or whipped cream on top,” she says. Dilute it with water and sip it slowly, Dyckman says.
• Try different types. Dyckman often tells her patients who want to drink coffee to try decaf, half-caf, low-acid, darker roast, and organic blends that have fewer chemicals than other kinds. From there, they keep track of their symptoms in a food journal to see which tends to be gentler on the stomach.
• Skip the dairy, cream, and added sweeteners. Lactose intolerance tends to be more common among those with IBD, Dyckman says, so you may want to opt for a lactose-free milk or dairy-free milk alternatives such as soy, coconut, almond, or oat. Sweeteners can also aggravate GI symptoms. Dyckman recommends using these as a treat and not a daily occurrence. “Sweeteners that contain sugar alcohols are poorly absorbed and can draw water into the intestine, leading to diarrhea,” she says. “And artificial sweeteners such as sucralose may negatively impact the gut microbiome over time.”
• Don’t drink it on an empty stomach. Always drink coffee while eating a meal so the acidity in the beverage doesn't hurt your digestive tract, Weekley says. That could look like drinking coffee in the morning with some toast and eggs at breakfast, or sipping on a latte after having a hearty lunch. “Putting something else in your belly while you’re drinking coffee is going to offset some of those symptoms of heartburn and acid reflux,” she says.
• Have it in a controlled setting. People with Crohn’s know about the unpredictability of the disease when it comes to urgent trips to the bathroom after eating a trigger food. If this is the case with coffee for you, drink it in a controlled setting where you know you’ll have easy access to the bathroom. For example, enjoy it on a work-from-home day instead of a day at the office.

• Coffee can worsen Crohn’s symptoms for some people, especially during a flare, because of its acidity and stimulant effects, which can speed up digestion and motility. This means symptoms, from diarrhea to loose stools and abdominal pain, may worsen.
• Steer clear of caffeinated drinks like coffee during a flare. But once you’re in remission, you may be able to add coffee into your diet in moderation. It’s essential to listen to your body and how you feel.
• Choose low-acid or decaf coffee, skip triggers like added sweeteners and dairy, and drink coffee with food to make it easier on your gut.