Understanding Why Coffee Can Cause Heartburn (and other Acid Reflux Symptoms)
A long-time patient of mine, someone I’ve seen on and off for three years, never got her reflux completely under control. However, one day she came in with a confession: “I think I’ve known all along that coffee was a trigger food for me, but I just didn’t want to give it up. Now that I have, my reflux is gone.” Sure enough, when I examined her, she looked terrific.
If you have any of the symptoms of reflux, you should try to identify if you have trigger foods. It’s important to note that reflux isn’t just heartburn or indigestion, but breathing issues, postnasal drip, sinus issues, too much mucus, coughing, chronic throat clearing, morning hoarseness, difficulty swallowing, etc.
The hardest part of treating reflux is that everyone is different, and trigger foods vary wildly. However, the most common trigger foods are chocolate, alcohol, onions, fried foods, and soft drinks. Coffee actually is not a problem for most people when consumed in moderation. But if you’re getting a sour taste in your mouth after drinking coffee or a sour feeling in your stomach, especially if you’re following all the basic lifestyle steps, then it’s time to figure out what kind of reaction you’re having to your coffee.
Debunking the “Coffee is Acidic” Myth
It’s a common misconception that coffee is acidic, so it causes acid reflux.
However, coffee is relatively low on the pH scale (usually ~5.0). Soda is FAR more acidic than coffee. So is orange juice. And wine.
It’s actually something else that makes coffee be a reflux trigger, for those who get a reflux response.
The 2 Types of Sensitivities to Coffee
For most people, a cup of coffee or two in the morning does not cause reflux.
- For some people, any amount of coffee is a reflux trigger food (and for them it does not matter whether it has caffeine or not). I’ve seen this in about 15% of refluxers, and it’s a sensitivity to something in the coffee bean itself.
- For anyone, if you drink a pot of coffee before noon, you’re going to have reflux. Caffeine makes the lower esophageal sphincter, the valve between the esophagus and stomach, relax / go loose. Because of this, too much caffeine will usually cause reflux.
Most people have a cup or two of coffee, usually in the morning. If that’s you, switch to decaf. If you’re still having a reflux response, then you know it’s not the caffeine, and you’re likely in that 15% that’s sensitive to the coffee bean itself.
Coffee Replacement to Consider
If you want a kick in the morning, black tea is a better choice than coffee for refluxers, just remember to have a cup or two, not more.
Any kind of black tea is a better choice than coffee, but my patients have really enjoyed lapsang souchong, which is a mouthful to say, but it smells smokey and tastes sweet, and you can finally buy it online!
First, See If You Likely Have Reflux
The Koufman Reflux Symptom Index (RSI) is a proven tool to determine if you likely have acid reflux. Note that heartburn / indigestion is just one symptom in the index (which only 20% of refluxers experience).
If you have an RSI score of 15 or greater, you have a 90% chance of having reflux, even if you have never had heartburn or indigestion. This is called silent reflux, and it's very common.
Please understand that it’s important to take steps if you have reflux to manage it through lifestyle changes (explained later). If you let reflux run rampant, you’re setting yourself up for sleep apnea, COPD, chronic respiratory conditions, and a far higher risk of esophageal cancer.
Where to Get More Information
If you've read at least one of my books and you're following my guidance and you still need help, you can book a consultation with me.
P.S. - Why Doesn’t My Doctor Know About This?
I get asked this all the time: “Why doesn’t my doctor know about this?!”
My primary research on acid reflux and chronic cough has been available for decades. Dropping Acid has been a best-seller for a decade. And I was on TV and quoted in mainstream media for many years. But the medical community remains virtually unaware that LPR (laryngopharyngeal reflux), today often called silent reflux or respiratory reflux (all terms I coined), is a major cause of respiratory issues and chronic cough. In addition, neurogenic cough seems almost never properly diagnosed.
Thousands of my patients have been on a merry-go-round of specialists… a GI doctor, an ENT, an allergist, an asthma specialist. They’ve had tens of thousands of dollars of tests, prescriptions for medications that never could have helped them, and their respiratory issues never improved.
The problem in the U.S. is over-specialization. Most Americans mistakenly believe that they must see specialists for almost every medical problem. What people don’t know is that specialists determine what services insurance will pay the most for, and they can choose to deliver those expensive services… even for patients who don’t need them! The idea of dividing the body up into small, non-overlapping, anatomic areas makes no sense. The respiratory and digestive systems are intimately connected, and specialists do not seem to know that.
Imagine building a house by allowing each workman to do his own thing. The plumber would put a sink in every room. The electrician would install chandeliers on every ceiling. The carpenter would panel every room in luxurious wood. That’s how America’s medical specialist system works.
The evolution of my personal medical practice as an expert in acid reflux that affects the throat and airway (LPR, silent reflux, respiratory reflux - all terms that I coined) helped me see that silent respiratory reflux was ubiquitous. That means it’s all over the place, and it’s likely in almost half of Americans. REFLUX is the single most common cause of “allergies,” “asthma,” “sinus disease,” true sleep apnea, and chronic cough.
Please read up and advocate for yourself, finding solutions that may be elusive through traditional care channels.