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 Effects of Caffeine and Coffee on Heartburn, Acid Reflux, Ulcers and GERD: Effects of Caffeine and Coffee on Heartburn, Acid Reflux, Ulcers and GERD - Reviewed by Meri Rafetto, RD, Theresa Grumet, RD, and Gerri French, RD, MS, CDE  
 
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More than 95 million Americans suffer from digestive problems of the upper GI tract including acid reflux or acid indigestion (heartburn), GERD (gastroesophageal reflux disease) and ulcers. Hyperacidity in the stomach and upper digestive tract can be painful and debilitating, but dietary adjustments can significantly affect disorders in the upper GI tract. Some of the foods associated with aggravating these conditions include acidic substances such as coffee, citrus fruits and tomatoes, as well as dietary fat, spicy food, onions, chocolate and caffeine.

Not everyone affected by these foods is diagnosed with a chronic disease; more than 60 million Americans experience episodes of acid indigestion as often as once each month and some studies suggest that as many as 15 million experience episodes of acid indigestion daily. Many people self-medicate with antacids when they could adjust their diet including reducing coffee and caffeine consumption in order to find relief. These conditions are serious: at least 10 million people are hospitalized each year for gastrointestinal disorders and the annual total of health care costs associated with these exceeds $40 billion. 1

Heartburn, Acid Reflux & GERD
Heartburn, or pain behind the breastbone, is a condition in which there is reflux of acid from the stomach into the sensitive esophagus, often caused by a relaxation or weakening of the lower esophageal sphincter, the ring of muscle between the esophagus and the stomach. Foods, including dietary fat, chocolate, mints, coffee, onions, citrus fruit, and tomatoes, have been associated with increased incidence of acid reflux in susceptible persons.2

When symptoms are recurrent or esophageal tissue is damaged, GERD develops. GERD affects 5-7% of the global population.3, 4 When untreated, it can cause complications such as chest pain, bleeding, esophageal stricture (narrowing or obstruction of the esophagus) or Barrett�s esophagus (a pre-malignant condition). Symptoms that indicate damage to the esophagus has occurred include: pain, dysphagia (difficulty swallowing), bleeding and choking. Some risk factors of these more serious conditions are alcohol use, pregnancy, weight gain and coffee consumption.5

Ulcers
Ulcers are another common problem, afflicting approximately 20 million Americans, according to the American College of Gastroenterology. Ulcers can occur in the stomach or duodenum, and are regions where the lining has been destroyed by stomach acids or digestive juices. Even small areas of damage can cause intense pain. The presence of the bacteria Helicobacter pylori is also implicated as a predisposing factor in ulcer development, but not everyone infected with H. pylori develops ulcers. It is unknown why this is the case, although a strong immune system provides protection against the bacteria�s ability to colonize damaged areas of the stomach lining. Increased levels of cortisol and other stress hormones stimulated by caffeine consumption and coffee drinking suppress the activity of the immune system and raise stress levels which are associated with ulcer formation. Other predisposing factors include: being male, family history, prolonged stress, skipping meals, cigarette smoking and coffee ingestion6.

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