Abstract
Probably due to caffeine-induced gastric acid secretion, negative effects of coffee upon various upper-gastrointestinal diseases have been precariously accepted, despite the inadequate epidemiological evidence. Our aim is to evaluate the effect of coffee consumption on four major acid-related diseases: gastric ulcer (GU), duodenal ulcer (DU), reflux esophagitis (RE), and non-erosive reflux disease (NERD) based on the large-scale multivariate analysis. Of the 9,517 healthy adults, GU, DU, and RE were diagnosed by endoscopy, and NERD was diagnosed by the symptoms of heartburn and regurgitation without esophageal erosion. Associations between coffee consumption and the four disorders were evaluated, together with age, gender, body mass index (BMI), Helicobacter pylori (HP) infection status, pepsinogen I/II ratio, smoking, and alcohol. We further performed meta-analysis using the random effects model to redefine the relationship between coffee intake and peptic ulcer disease. The eligible 8,013 study subjects comprised of 5,451 coffee drinkers and 2,562 non-coffee drinkers. By univariate analysis, age, BMI, pepsinogen I/II ratio, smoking, and alcohol showed significant associations with coffee consumption. By multiple logistic regression analysis, positively correlated factors with significance were HP infection, current smoking, BMI, and pepsinogen I/II ratio for GU; HP infection, pepsinogen I/II ratio, and current smoking for DU; HP non-infection, male, BMI, pepsinogen I/II ratio, smoking, age, and alcohol for RE; younger age, smoking, and female for NERD. The meta-analyses could detect any association of coffee consumption with neither GU nor DU. In conclusion, there are no significant relationship between coffee consumption and the four major acid-related upper gastrointestinal disorders.
Highlights
Coffee is one of the most widely consumed beverages in the world; in particular, Japan is one of the biggest coffee markets in Asia [1]
peptic ulcer (PU) is comprised of gastric ulcer (GU) and duodenal ulcer (DU), and gastroesophageal reflux disease (GERD) is comprised of reflux esophagitis (RE) and non-erosive reflux disease (NERD); these four are the most frequent upper gastrointestinal disorders considered to be acid-related [3]
Distribution of subjects with these four disorders is represented by venn diagram (Figure 2), in which one glance is enough to grasp the much higher prevalence of GERD (RE and NERD) in comparison with PU (GU and DU)
Summary
Coffee is one of the most widely consumed beverages in the world; in particular, Japan is one of the biggest coffee markets in Asia [1]. Coffee consumption has been reported to be associated with several diseases including peptic ulcer (PU) and gastroesophageal reflux disease (GERD), both of which are very common esophago-gastro-duodenal disorders worldwide [2]. PU is comprised of gastric ulcer (GU) and duodenal ulcer (DU), and GERD is comprised of reflux esophagitis (RE) and non-erosive reflux disease (NERD); these four are the most frequent upper gastrointestinal disorders considered to be acid-related [3]. For GERD, non-epidemiological studies have reported that coffee causes a relaxation of the lower esophageal sphincter [17,18], which could increase the risk of both RE and NERD. Two epidemiological studies implied that coffee consumption might affect the risk of GERD [19,20], but the numbers of studies investigating the relation of coffee with GERD are at present very small. The effects of coffee consumption upon these four upper gastrointestinal disorders are still disputable matters
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