Background: Patients with gastroesophageal reflux disease (GERD) are commonly instructed to reduce coffee intake. However, prior studies evaluating the effects of coffee on GERD yielded conflicting results. We aimed to perform a comprehensive systematic review and meta-analysis to assess the association between coffee use and risk of GERD and its complications. Methods: A protocolized search strategy was developed for PubMed, EMBASE, and Web of Science databases in accordance with PRISMA and MOOSE guidelines. Measured outcomes for GERD were compared between coffee drinkers and non-drinkers. Dichotomous events between unmatched groups were used to calculate pooled proportions with rates estimated using random effects models and effect size. Heterogeneity was assessed with I 2 statistics and publication bias by funnel plot asymmetry and Egger regression. Results: A total of 40 studies encompassing 122,074 patients were included (85,400 coffee drinkers vs 36,674 non-drinkers). GERD was more common among coffee users than non-users 34.9% (CI:28.5–41.8) vs 30.7% (CI:25.2–36.7); OR:1.18 (CI:1.03–1.36; I 2 =89.38). There was no significant association between coffee intake and Barrett’s esophagus 22.1% (CI:12.8–35.4) users vs 17.6% (CI:5.5–43.8) non-users; OR:1.13 (CI:0.79–1.61; I 2 =55.5). There was no evidence of publication bias based on funnel plot and Egger regression testing ( p >0.05 for all analyses). Conclusion: Coffee use was associated with a small, statistically significant increased rate of GERD, but not Barrett’s. The magnitude of this effect, however, is of unclear clinical significance. The role of routine avoidance/reduction of coffee intake as universal lifestyle modification for GERD needs further evaluation.
Muftah et al. (2026) studied this question.