Anyone familiar with heartburn knows the term "trigger foods." They're the food and drink that aggravate heartburn, and although heartburn can come from a variety of different types of foods, chances are you know which are your own trigger foods-the ones you have a hard time keeping down.

For many people, coffee, because of its high caffeine content, makes the list. Since the 1970s, research has maintained that coffee can act as a trigger food, worsening heartburn, which is the main symptom of GERD. Indeed, as a lifestyle change to manage acid reflux organizations like the National Heartburn Alliance and the National Institute of Diabetes and Digestive and Kidney Diseases suggest cutting back on coffee and caffeine. 

But some recent evidence has suggested otherwise. In 2006 researchers at the Stanford University School of Medicine published a study in which they sought to determine if lifestyle measures were effective in patients with GERD.[1] They started by reviewing every article between 1975 and 2004 that focused on heartburn, GERD, and lifestyle changes, like alcohol, weight loss, obesity, and caffeine and coffee. Then they identified 100 relevant surveys and 16 relevant clinical trials. Then they crunched numbers.

The conclusions they drew were interesting. They determined that weight loss and elevating the bed head were effective lifestyle interventions for GERD, but that there was "no evidence supporting an improvement in GERD measures after cessation of tobacco, alcohol, or other dietary interventions." In other words, smoking, drinking, and changing your diet did not improve GERD.

Even more interesting was the attention paid to 14 studies that examined the effect of coffee consumption on sphincter pressure and acidity in the esophagus.[2] None of these studies showed any sort of change resulting from consuming less coffee. This means that if you have GERD and you drink coffee, stopping drinking coffee will not necessarily eliminate your GERD.

But what if every morning that you drink coffee you find yourself reaching for an antacid before lunchtime? Doesn't this clearly indicate that coffee is keeping your GERD going strong?

Not necessarily. It could be that you're ingesting another trigger food around the same time, or that a component of your lifestyle is triggering the heartburn. This leads to what one of the study's author's says makes the "most sense" in treating heartburn: taking medication. Medication will decrease the amount of acid going into the esophagus, and it may just allow you to keep on drinking coffee.

[1] Kaltenbach, Tonya, MD, et al. "Are Lifestyle Measures Effective in Patients With Gastroesophageal Reflux Disease?" Archives of Internal Medicine. May, 2006.