Coffee Consumption in Cholelithiasis Patients
Patients with cholelithiasis can safely drink coffee, and in fact, regular caffeinated coffee consumption may actually reduce the risk of symptomatic gallstone disease.
Evidence Supporting Coffee Consumption
The strongest evidence comes from large prospective cohort studies demonstrating a protective effect of caffeinated coffee against symptomatic gallstone disease:
In women, consuming 4 or more cups of caffeinated coffee daily was associated with a 28% reduction in risk of cholecystectomy (RR 0.72,95% CI 0.62-0.84) compared to non-coffee drinkers over 20 years of follow-up 1.
In men, those drinking 4 or more cups of regular coffee daily had a 45% lower risk of symptomatic gallstone disease (RR 0.55,95% CI 0.33-0.92) compared to non-drinkers 2.
The protective effect appears dose-dependent, with increasing coffee consumption correlating with progressively lower risk 1, 2.
Mechanism: Caffeine is Key
The protective effect is specifically attributed to caffeine, not other coffee components:
Caffeine intake from all dietary sources (>800 mg/day vs <25 mg/day) showed a 45% risk reduction (RR 0.55,95% CI 0.35-0.87) 2.
Decaffeinated coffee showed no protective association with gallstone disease risk 1, 2.
All brewing methods of caffeinated coffee demonstrated decreased risk 2.
Clinical Implications
There is no reason to restrict coffee consumption in patients with existing cholelithiasis:
No evidence suggests coffee worsens existing gallstone disease or precipitates complications 1, 2.
The metabolic effects of caffeine on hepatobiliary processes involved in cholesterol lithogenesis appear beneficial rather than harmful 1.
Important Caveats
Heavy coffee consumption (defined differently across studies but generally >6 cups daily) showed only borderline statistical significance in one study (P = 0.051) 3, though this finding conflicts with the stronger protective associations seen in larger cohorts 1, 2.
The evidence specifically addresses symptomatic gallstone disease; asymptomatic stones were not the primary outcome in these studies 1, 2.
Patients should consume coffee within reasonable limits and consider individual tolerance for caffeine-related side effects (insomnia, anxiety, palpitations), though these are unrelated to gallstone disease itself.