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You Are Here: IC
Network : Fresh Tastes
: May 2002
Coffee Break News
When you think
about it, coffee breaks are not really about coffee. They are much
more about the break-- a time for people to gather, relax, and socialize.
Whether it's a group chatting near the lunchroom coffee maker or
couples lounging at cafe tables around the neighborhood coffeehouse,
drinking coffee with others is a comfortable cultural ritual. We
revitalize the body, renew connections with friends, family, or
co-workers, and refresh the spirit over a soothing cup of java.
But for us, having a sensitive bladder really dampens one's enthusiasm
for coffee doesn't it? Who wants to chat over a cup of frothy cappuccino
if it means enduring hours of pain and dozens of trips to the restroom
later? Intense pain or trips to the bathroom every few minutes for
hours on end can be a deterrent to even the bravest of IC people,
and the most dedicated of coffee lovers.
I remember one
evening a few years back. The weather was crisp and chilly, the coffeehouse
was warm and filled with cheerful people sipping their hot drinks
at intimate little tables. The seductive aroma of coffee just seemed
to drag me in the door. I ordered a huge (and incredibly delicious)
cup of decaf coffee mocha. I slowly savored my drink while sharing
a table with my husband and listening to a local guitarist's music.
It was a wonderful interlude. I figured that because the coffee had
been decaf, maybe I wouldn't get too bad of an IC flare-up later.
Actually, I hoped a miracle would happen and the coffee wouldn't affect
my bladder at all. Fat chance. My lapse of willpower that evening
was followed by an unforgettable week of bed-ridden agony and several
sleepless nights. That trauma was a wake-up call. My bladder was not
going to let me get away with coffee... even decaf coffee. I totally
swore off any kind of coffee for the next couple of years.
Coffee breaks minus the coffee
As I learned quickly (the hard way), those with extremely sensitive
bladders may need to stick with hot water or mint tea, at least until
one finds the right IC treatment or combination of treatments to calm
the bladder somewhat. Meanwhile, it's important to our well-being
that we not miss out on the friendliness and social interaction of
coffee breaks, just because our bladder has a snit when we drink coffee.
IC is isolating enough without allowing our diet to isolate us further.
A packet of
non-acid herb tea (mint, chamomile, or licorice) tucked in the purse
comes in handy when everyone heads for Starbucks. Most coffee places
I've found are happy to let you have a cup of hot water, especially
if you also purchase some little snack. Often coffeehouses have
some biscotti or oatmeal cookies that are fairly safe (curiously,
it seems the more upscale the coffee establishment, the less likely
the treats are to have bladder provoking preservatives). Quite a
few coffee houses these days also carry herb tea for those who don't
wish to have any caffeine at all.
Many employers
also now supply herb teas along side the coffee machine in their
lunch rooms. In an increasingly diverse society, not everyone can
or wants to drink coffee. Mormons don't drink coffee for religious
reasons, and many people of Asian heritage prefer teas to coffee.
If your employer doesn't offer it, try asking for a coffee alternative.
Chances are you won't be the only non-coffee drinker.
Certain herb
teas can be quite acid, especially those containing rose hips. Mint
tea however, usually forgoes the acid ingredients. And it's equally
refreshing as a cold drink served over ice. But you don't have to
settle for plain herb tea that merely doesn't provoke pain. Some
IC people say marshmallow root tea calms their bladders. You can
buy this kind of herb tea in loose form at most health food stores.
For travel or work, search out brands that come in travel-friendly
tea bags. (A small plastic box or pill case can keep a tea bag or
two fresh in purse or pocket.)
Travel
mugs: from beverage disguise to comfort commuting
What to drink at work? A tough question if you can't have coffee
but don't want to advertise the fact you're on a medical diet. Sipping
hot water tends to invite prying questions from the curious, and
sometimes you just don't want to discuss your diet or your bladder
with everyone in the office.
One lady I know uses an insulated travel mug for her herb tea or
honey-tinged hot water at work. It keeps coworkers who aren't close
friends guessing as to what she's drinking, she says. Most just
assume its coffee and she manages to avoid explaining the embarrassing
details of her illness to everyone passing by her cubicle. Another
IC patient buys cheap tea bags, shakes out the tea, and puts in
her own blend of herbs-- including marshmallow root and brown sugar.
Then she staples the bag shut with a mini-stapler she found at an
office supply store (if you don't want a metal staple, close it
with a quick stitch of white cotton thread).
There are a variety of coffee substitutes on the market these days.
Postum is probably the oldest brand and the most well-known. Taste-wise,
I prefer the Roma brand. Almost all are grain-based and totally
caffeine free. Some IC people report excellent results using them,
while others say they trigger as much pain as genuine coffee (possibly
from acidity or less likely, a food allergy to the grain). There's
just no way to predict if coffee substitutes are right for your
bladder, you have to try one and see.
For disguising what one's drinking, or simply to enjoy a hot soothing
drink on the commute home, a wide variety of insulated travel mugs
are on the market (with an equally wide variety of prices). Recently,
the Wall Street Journal's Jonathan Welsh compared several brands from
online catalogs such as amazon.com, cooking.com, kitchenetc.com, brookstone.com,
and coffeecakes.com. The mugs were judged on how well they held heat
for several hours and how well they prevented leaks and spills, among
other things. The top-rated mug turned out to be the "Drive Time"
model made by Trudeau and available for $24.95 (plus shipping) through
CoffeeCakes.com. According to Mr. Welsh, it kept his piping hot beverage
fairly warm. After three hours it was still a respectable 125 degrees
F. The container was also virtually spill-proof when properly closed.
Another interesting use for a warm and (hopefully) spill-proof travel
mug... warming the bladder area in the car. I'll let your imagination
figure out how that might work.
No pain, no gain
Every so often it pays to risk a symptom flare-up to test your limits.
Things can change, especially if you've recently switched IC medications,
or even if you've been on one regimen a long time. Bravery pays off
as long as you don't overdo it or do it too often. I find I can "cheat"
and get away with things like a little bit of fruit juice if I've
strictly kept to my diet for several weeks straight. If I get lazy
or greedy though and start cheating on the diet regularly, then my
bladder seems to become increasingly sensitized. Foods I could get
away with on an occasional basis, become difficult to endure.
Help with coffee
By and large,
most people with IC have a problem with coffee, even decaf. It's
the one food item doctors regularly remember to tell their IC patients
to avoid. No doubt that's because coffee is one of the worst bladder
irritants for all people, regardless of their health. Caffeine stimulates
the nerves. It stimulates the bladder muscle (thus the spasms) and
is a diuretic (which means it basically dehydrates you, concentrating
any irritants in the urine).
Caffeine is
the great equalizer-- it makes everyone, IC people and healthy individuals
alike, use the bathroom more. Caffeine interferes with sleep, especially
the restorative level, REM sleep), and worsens sleep apnea. It provokes
GERD (gastroesophageal reflux), stomach ulcers, and IBS (irritable
bowel syndrome). This is in addition to the myriad acids in coffee--
which not only provoke IC bladders and give many older people sour
stomachs, but also give coffee some of its characteristic flavor.
In the last
few years we've seen a number of acid neutralizing substances come
to market. At least one of these has even been scientifically tested
on IC patients. The most popular and heavily advertised acid neutralizer
in the IC patient community is
Prelief. Prelief (active ingredient, calcium glycerophosphate)
adequately neutralizes food acids for many people with IC and comes
in convenient pills one can carry in a pocket. Like most things
IC people try, not everyone finds the Prelief product helpful. It's
definitely worth trying, though. If it helps, then you'll also need
to experiment a bit to find out how much you need to take to offset
the acid effects of various foods on your bladder (its not always
the amount needed to totally neutralize the acids).
Another acid neutralizing product specifically created for coffee,
is Coffee Tamer. It comes in packets containing just enough powder
to neutralize the acidity of a typical cup of coffee. It's tasteless,
dissolves well when stirred, and doesn't appreciably affect the
coffee's flavor. You can order it online too. Check out the product
at www.tamer.com. It's similar to Tums in that the active ingredient
is calcium carbonate (chalk). The company has several products to
reduce food acidity and some (but not all) IC patients have found
these helpful too. The company also now sells low-acid coffee beans
on their web site. The Tamer company also notes that potassium is
added to their coffee beans. There is some debate as to whether
or not potassium in foods can cause flare-ups in IC pain for people
who test "positive" with the bladder-instilled potassium
test. Without going into the arguments on either side, suffice to
say that the best test is how your bladder feels when you eat high-potassium
foods like bananas. One note about their web site: The page on diseases
contains some extremely outdated information (for instance, fibromyalgia
is not as they say, an inflammation of muscles. Several years ago
"fibrositis" was renamed fibromyalgia in order to more
clearly characterize the condition as non-inflammatory.)
You can always
try the old time tested stand-bys too: Tums or a half-teaspoon of
baking soda in a glass of water (use the soda only if your physician
advises). These two have some drawbacks though, including constipation
if you take too many Tums, or diarrhea from too much baking soda.
One added benefit of using Prelief or other calcium-based acid reducers
over baking soda is that you get some extra calcium to help stave
off osteoporosis.
New reduced-acid coffees
Over the last ten
years, the U.S. coffee market has undergone a revolution. As the population
becomes increasingly sophisticated in their coffee consumption, vendors
have been carving out marketing niches, catering to say, certain age
groups, or specific personal needs.
No where was
this more abundantly clear than at the recent annual convention
of the Specialty Coffee Association of America (SCAA) in Anaheim,
California this last May. Retailers these days are very attentive
to the baby boomers who, as they age, are increasingly likely to
get "sour stomach" from drinking coffee.
Sour stomach
(known as dyspepsia, to doctors) is thought to be brought on by
certain coffee acids. Although no one is sure why, older people
do seem more prone to the problem. And although scientific trials
are lacking, the word among coffee experts is that removing one
kind of acids-- chlorogenic acids-- may help some people cope with
coffee. That thought has inspired at least one manufacturer to actively
remove the chlorogenic acid from their coffee specifically to help
people who can't tolerate the acids in coffee.
Coffee advice from the
experts
The good news for
IC people is that more and more coffee suppliers are meeting the desires
of an aging population, offering decaf versions of naturally low-acid
coffees. These coffees often boast of world-class taste too. Several
roasters and retailers remarked that consumers seem to favor their
more naturally low-acid beans. Bear in mind when I say "acid"
I'm thinking of the pH value. But the word "acid" when used
by coffee sellers, refers to the taste of the coffee, not the chemical
pH of the coffee. The pH (a scientific measure of acidity) frequently
corresponds with the taste, but not always, according
to the coffee experts at Fresh Cup (a specialty-beverage industry
magazine). However in general, coffees from Indonesia are low in pH
as well as low-acid in taste, due to their peculiar growing conditions.
Some low-acid Indonesian coffees to look for are: Sumatra, Sulawesi,
Estate Java, Sumatra Boengie, Papua New Guinea, and Sumatra-Mandheling.
If you are looking for coffee with a low chemical acidity (pH), check
out the ones described by retailers as "soft" or "sweet".
"Mellow" denotes a low to moderate acidity. Retailers will
often describe acid tasting coffees as "crisp", "vibrant",
or "sharp" and many of these are in fact chemically very
acidic as well. At all costs avoid the canned coffees you find in
supermarkets. They are the absolute worst in terms of caffeine content
and acidity (pH). Most of these coffees are made from inferior robusta
beans (as opposed to the gourmet coffees which are made exclusively
from milder arabica beans). Starbucks coffees are another brand that
many IC people report problems with
(even when other gourmet-type coffees don't bother them).
According to the knowledgeable folks at the SCAA, espresso made with
decaffeinated low-acid beans would probably be less acid AND the less
caffeinated than drip or percolated coffee. That's because the espresso
brewing method leaches less caffeine into the coffee. The longer the
coffee is in contact with hot water, the more caffeine is leached
out, and espresso allows it to be in contact with hot water for only
a very short time.
The best IC coffee method
Another idea is
to use a "coffee extract" method, which creates a cold concentrate
that one then dilutes for drinking. (One such extract method is described
in my cookbook, A Taste
of the Good Life- a Cookbook for an Interstitial Cystitis Diet).
You can buy equipment specifically designed for making coffee this
way from the Toddy Company... or make your own. Whether you buy their
equipment (under $30.00) or make your own version, be sure to read
the FAQ page ont heir web site. It contains some useful information
about making coffee this way. The main benefit of this method is that
you can use ground low acid beans that are already decaf to reduce
both the caffeine and acid further.
Again, this works on the principle that the hotter the brewing water,
the more caffeine is leached out of the bean and into the liquid.
Check out their web site at toddyproducts.com.
Most coffee vendors still don't offer low-acid beans in a decaf version.
But here are a few sources that do:
COFFEE LEGENDS,
Little Rock, Arkansas
Offers a unique decaf coffee that has been further processed to
remove much of the chlorogenic acids as well. You can order some
online or find it in stores. The brand targets people who get indigestion
from drinking coffee. It's sold as "Johan Wulff's Considerate
Coffee", and has begun to appear in some supermarkets on the
West Coast. www.theconsideratecoffee.com
OLD CITY
COFFEE, Philadelphia, Pennsylvania
Located in the Reading Terminal Market in downtown Philadelphia
(an excellent place to find IC-safe lunch fare among the gazillion
vendors of all kinds of foods), this company offers a low-acid Sumatra.
It is decaffeinated via the Swiss Water Process (SWP). On two separate
occasions I found parking to be both difficult to find, and expensive.
If all you want is coffee, the best bet is to order the coffee through
their web site, oldcitycoffee.com. The page with decaf coffees is:
oldcitycoffee.com/shop/decaf.
THE GOURMET
CUP, Abbotsford, British Columbia
This is a chain of stores with locations in Canada listed on their
web site. Low acid Sumatra in a decaf version is available via mail
order too. Unfortunately they don't specify how the coffee is decaffeinated.
Contact them at thegourmetcup.com
BALTIMORE
COFFEE AND TEA CO., Baltimore, Maryland
Custom roasters and importers, they offer a delicious Swiss Water
Process decaf Sumatra Mandheling. You can order online or via phone
at 800-823-1408. They also sell more than 120 varieties of coffee
at their store in Timonium (9 W. Aylesbury Rd.). Check out their
web site at baltcoffee.com.
PEETS COFFEE
AND TEA, Emeryville, California
Headquartered in California, they have coffeehouses throughout that
state as well as stores in Chicago, Seattle, Portland Oregon, and
the Boston area. They have an excellent decaf Sumatra which is especially
good for making espresso. Long a favorite of upscale coffee consumers
on the West Coast, it's little known that they also donate 20,000
pounds of their coffee annually to charities. You can order via
phone at 800-999-2132 or via their web site at peets.com.
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