Is Coffee Good for Bile Reflux? Understanding the Risks

November 15, 2025 •

4 min read

According to a 2019 study, high intake of coffee, tea, and soda was linked to an increased risk of gastroesophageal reflux symptoms. This effect is particularly relevant when considering whether coffee is good for bile reflux, as many of the same mechanisms that trigger acid reflux also affect bile reflux.

Quick Summary

Coffee can aggravate bile reflux by relaxing the lower esophageal sphincter, increasing stomach acid, and being naturally acidic. Exploring dietary changes and alternatives is often recommended to manage symptoms.

Key Points

Coffee and Bile Reflux Don't Mix: Due to caffeine and high acidity, coffee can worsen bile reflux by relaxing the lower esophageal sphincter (LES).
Caffeine is a Key Culprit: Caffeine relaxes the LES and can stimulate increased gastric acid secretion, aggravating reflux symptoms.
Decaf is Not a Perfect Fix: While less aggravating, decaffeinated coffee can still trigger symptoms for sensitive individuals due to its natural acidity and non-caffeine compounds.
Brew Method Matters: Cold brew coffee and dark roasts are generally less acidic, offering a potentially gentler option for some reflux sufferers.
Explore Gentle Alternatives: Herbal teas like ginger or chamomile, chicory coffee, and plant-based milks are excellent reflux-friendly substitutes.
Dietary Adjustments are Crucial: Managing bile reflux involves avoiding high-fat, acidic foods and opting for small, frequent meals with a focus on high-fiber foods.

The Connection Between Coffee and Bile Reflux

While most research focuses on coffee's effect on acid reflux (GERD), many of the same physiological responses are relevant for individuals suffering from bile reflux. Bile reflux occurs when bile, a digestive fluid produced in the liver, flows backward into the stomach and, in some cases, the esophagus. This irritation can worsen symptoms and cause significant discomfort. Coffee, especially regular caffeinated coffee, has several properties that can exacerbate this condition.

How Coffee Aggravates Reflux Symptoms

There are three primary mechanisms through which coffee can worsen bile and acid reflux:

Relaxation of the Lower Esophageal Sphincter (LES): Caffeine, a key component in coffee, is known to relax the LES, the muscle valve that separates the esophagus from the stomach. When this muscle loosens, it becomes easier for stomach contents—including both acid and bile—to flow backward into the esophagus. This backward flow is the central event in reflux. Studies have shown that even decaffeinated coffee can have a similar effect on the LES, although caffeine itself is a potent trigger.
Increased Gastric Acid Production: Coffee can stimulate the stomach to produce more acid than usual. Caffeine, a bitter alkaloid, binds to specific bitter receptors in the stomach, which in turn triggers an excessive release of gastrin, a hormone that causes the parietal cells in the stomach to produce more acid. For a digestive system already dealing with irritation from refluxed bile, this can significantly heighten discomfort.
Inherent Acidity: Coffee is naturally acidic, with a pH typically ranging between 4.85 and 5.10. For individuals with a sensitive esophageal lining, the added acidity can be an irritant, compounding the damage already being caused by bile and stomach acid. This is why many people report increased heartburn after consuming coffee, regardless of caffeine content.

Can You Reduce Coffee's Negative Effects?

For some people, completely eliminating coffee is not practical. Fortunately, there are strategies to mitigate its adverse effects, though success varies by individual.

Switch to Low-Acid or Cold Brew: The cold brewing method extracts fewer acidic compounds from the beans, resulting in a coffee that is up to 70% less acidic than hot-brewed coffee. Some roasters also specialize in low-acid beans or dark roasts, as darker roasts generally have lower acidity.
Opt for Decaf: While not a perfect solution, switching to decaffeinated coffee removes the majority of the caffeine, which is a significant factor in LES relaxation. Water-processed decafs are chemical-free alternatives worth considering.
Modify How You Drink: Avoid drinking coffee on an empty stomach, as this can amplify the acidic effects. Pairing it with food can help buffer the stomach acid. Additionally, limiting your intake to one cup per day and avoiding coffee close to bedtime can help minimize nighttime reflux.

Coffee Alternatives for Bile Reflux Sufferers

If coffee continues to trigger symptoms, several alternatives can provide a warm beverage fix without the reflux risk. Some of the most popular and gentle options include:

Herbal Teas: Chamomile, ginger, and licorice root teas are often recommended for their soothing properties. Ginger, in particular, is a natural anti-inflammatory that aids digestion and promotes gastric emptying.
Chicory Coffee: Made from roasted chicory root, this is a caffeine-free alternative with a nutty, coffee-like flavor. It also contains prebiotic fiber, which can promote healthy gut bacteria.
Plant-Based Milks: Almond or soy milk are often lower in fat than whole cow's milk and can be used to dilute or replace coffee. Almond milk is naturally alkaline, which can help neutralize stomach acid.
Coconut Water: Unsweetened coconut water is a good source of electrolytes that can help maintain pH balance in the body.

Broader Dietary and Lifestyle Changes

Managing bile reflux is not just about avoiding coffee. Many dietary and lifestyle adjustments can help reduce symptoms. The primary goals are to reduce pressure on the LES and minimize irritation.

Do's and Don'ts for Bile Reflux Diet


Focus On	Limit or Avoid
High-fiber foods: Oatmeal, brown rice, whole-grain breads, nuts, legumes.	High-fat foods: Fried foods, fatty meats, full-fat dairy, oily dressings.
Lean proteins: Grilled or baked chicken breast, turkey, fish, and egg whites.	Spicy foods: Onions, garlic, hot sauces, and strong spices.
Non-citrus fruits: Bananas, melons, apples, and pears.	Acidic fruits and vegetables: Tomatoes, citrus fruits like oranges and grapefruit.
Low-fat dairy: Skim milk, low-fat yogurt, and low-fat cheese.	Chocolate: Contains fat and caffeine, both of which can trigger reflux.
Herbal teas: Ginger, chamomile, and licorice.	Carbonated beverages: Sodas and sparkling water create pressure that can worsen reflux.

Conclusion: Finding the Right Balance for Your Health

In conclusion, while beloved by many, coffee is generally not considered beneficial for individuals with bile reflux. The combination of caffeine-induced LES relaxation, increased stomach acid production, and natural acidity makes it a common trigger for worsening symptoms. The specific impact, however, can vary from person to person, and some may tolerate it better than others. Experimenting with modifications like switching to cold brew or decaf, drinking smaller amounts, or pairing it with a meal can help. For many, transitioning to gentle alternatives like herbal teas or chicory is the most effective path to symptom relief. Ultimately, finding the right dietary and lifestyle balance is key to managing bile reflux effectively and comfortably. Consulting a healthcare provider or gastroenterologist can provide personalized guidance for your specific condition.

Clinical Gastroenterology and Hepatology study on beverage intake and GER symptoms.

Frequently Asked Questions

Coffee is bad for bile reflux primarily because its caffeine content relaxes the lower esophageal sphincter (LES), the muscle that prevents stomach contents from flowing up. This allows both stomach acid and bile to move back into the esophagus and cause irritation.

Decaf coffee is generally less likely to cause reflux than regular coffee, but it can still trigger symptoms for some. It still contains some acid and non-caffeine compounds that can stimulate stomach acid production, though it eliminates most of the caffeine.

Excellent alternatives to coffee include herbal teas like ginger, chamomile, or licorice, which can soothe the stomach. Chicory coffee is another caffeine-free option with a coffee-like flavor, and unsweetened coconut water can also help maintain pH balance.

Yes, cold brew coffee is often better for reflux because the cold brewing process extracts fewer acidic compounds from the beans. It can be up to 70% less acidic than hot-brewed coffee, making it a gentler option for the stomach.

Adding milk or cream can help buffer the acidity of coffee, but it may not eliminate the reflux entirely. For some, high-fat dairy can be a trigger, so plant-based milks like almond or soy are often better options.

In addition to coffee, you should limit or avoid high-fat and spicy foods, acidic foods like tomatoes and citrus fruits, chocolate, peppermint, and carbonated beverages. These can all contribute to the relaxation of the LES or increase stomach acid.

Besides diet, lifestyle changes like eating smaller, more frequent meals, staying upright for at least two hours after eating, avoiding eating close to bedtime, and losing excess weight can help manage bile reflux symptoms.