Coffee Break News – Fresh Tastes by Bev

By Bev Laumann, Author of A Taste of The Good Life: A Cookbook for IC & OAB

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.