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P390. Patient perceptions on the impact of coffee consumption in inflammatory bowel disease: friend or foe?

C. Barthel1,2, S. Wiegand1,3, S. Scharl1, M. Scharl1, P. Frei1,4, M. Fried1, S.R. Vavricka1,5, N. Wiegand1,3, G. Rogler1, L. Biedermann1, 1University Hospital Zurich, Gastroenterology & Hepatology, Zurich, Switzerland, 2Robert-Bosch-Hospital Stuttgart, Division of Gastroenterology and Hepatology, Stuttgart, Germany, 3Klinik St. Anna, Luzern, Division of Gastroenterology and Hepatology, Luzern, Switzerland, 4Seespital Horgen, Gastroenterology & Hepatology, Horgen, Switzerland, 5Hospital Triemli, Gastroenterology & Hepatology, Zurich, Switzerland

Background

The pathogenesis of IBD is based on a complex interplay of etiologic key components, including a growing number of established environmental factors. Regarding the latter, there is an increasing interest in nutritive components, such as dietary fibre or unsaturated fatty acids. While the potential disease-modifying role of coffee has been intensively investigated in a variety of diseases (with the majority of studies indicating a beneficial effect), the data on the potential impact of coffee consumption on the course of IBD is very limited, despite the fact that coffee is one of the most ubiquitously consumed beverages all over the world containing a magnitude of ingredients that potentially harbour a wide spectrum of biological effects. In this study we aimed to determine the patient's perspective on coffee consumption in IBD.

Methods

We conducted a questionnaire among 496 adult patients with Crohn's disease (CD) and ulcerative colitis (UC) in Switzerland, assessing key questions regarding coffee consumption. The results were analysed by means of descriptive statistics including chi square testing.

Results

Among the 442 patients completing all questions 67%, 31% and 2% suffer from CD, UC and IBD unclassified, respectively. In total 72.6% regularly consume coffee (according to attributed impact on on disease symptoms: 96.4%, 91.1% and even 49.1% in those attributing a positive, no impact at all and a negative impact, respectively). The vast majority of coffee drinkers (93%) prefer caffeinated coffee. Within the subgroup of patients consciously refraining from regular coffee intake (121 of 442) 62% are convinced that coffee adversely influences their intestinal symptoms, significantly more in CD than in UC patients (75.8% vs. 44.4%, p = 0.002). In general, 38% of all IBD patients (168 of 442) suppose that coffee actually has an effect on their symptoms of disease, more than half of all patients with CD (53.5%) in contrast to less than a quarter of patients with UC (22%, p < 0.001). Moreover, while 45.2% of CD patients feel that the effect of coffee is detrimental, only 20.2% of UC patients share this impression (p < 0.001).

Conclusion

Two thirds of IBD patients regularly consume coffee. More than twice as many CD patients compared to UC patients attribute any disease-modifying effect to coffee consumption, the majority of these identifying a detrimental effect on their symptoms. Interestingly, this negative perception does not result in a complete abstinence from coffee consumption. These findings call for controlled in vitro and in vivo studies to explore the biochemical and clinical effects of coffee consumption in IBD.