EFFECT OF DIFFERENT COFFEES ON ESOPHAGEAL ACID CONTACT TIME AND SYMPTOMS IN COFFEE-SENSITIVE SUBJECTS

The purpose of this study was to correlate the effects of different co ffees on esophageal acid contact, heartburn, and regurgitation in pati ents with coffee-sensitivity. Twenty volunteers with coffee-sensitivit y were studied in a double-blind, 3 period, crossover study examining the effect of three regular (caffeinated) coffees (a coffee from the U SA-''A''; a ''treated'' coffee from Europe-''B''; and an ''untreated'' coffee from Europe-''C'') before and after a high-fat test meal. The median acid contact times for coffees A, B, and C were 6.5%, 9%, and 1 0.5%, respectively (A vs. C, p = 0.005). Significantly fewer patients reported any symptoms with coffee A compared with coffee C (p < 0.05). Symptoms were usually more frequent and severe after the test meal. T here was a trend toward fewer and less severe symptoms with the treate d coffee (B) compared with its untreated counterpart (C). Our conclusi ons are as follows: (a) Different coffees induce variations in gastroe sophageal reflux in coffee-sensitive individuals. (b) Coffee can be tr eated in a manner which decreases heartburn symptoms by 75% while decr easing acid contact by only 14%. (c) Gastroesophageal reflux and sympt oms of coffee sensitivity increase with the concomitant ingestion of f ood. (d) Symptoms of dyspepsia appear to be influenced by variations i n both the coffee itself and characteristics of susceptible individual s. (e) Although gastroesophageal reflux is important in the genesis of coffee-sensitivity, there must be other factors which act in concert with reflux to produce symptoms of coffee-sensitivity.