Gluten May Not Be A Trigger For Your IBS

Irritable bowel syndrome, often known as IBS, is a complex condition that affects the large intestine, causing abdominal pain and digestive issues. It’s believed that the root of IBS is disturbances in gut-brain interactions. Between 10 and 15 percent of Americans live with IBS. It’s difficult to get a specific percentage, as IBS screenings don’t exist. Doctors generally rely on a patient’s symptoms and tests to rule out other diseases to diagnose a case of IBS.

There is also no cure. Fortunately, symptoms can be controlled through medication and lifestyle changes such as adequate sleep, stress management and dietary changes.

IBS and Gluten

One of the dietary changes doctors typically recommend is a gluten free diet. Gluten is the protein in wheat and other flours that causes celiac disease and can sometimes cause allergies.

But removing gluten from your diet might be ineffective in managing IBS, according to a study published in the American Journal of Clinical Nutrition. In fact, there may not be a connection between high gluten intake and increased IBS symptoms at all. IBS symptoms might stem from a certain type of carbohydrate in FODMAP foods.

FODMAP

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols – simple carbohydrates (or sugars) that the small intestine doesn’t absorb well, resulting in gastrointestinal distress. Many foods you probably eat daily are high in FODMAPs; examples include

• sweeteners
• fruit
• vegetables
• grains
• certain beverages
• dairy
• legumes/pulses
• garlic
• onions

FODMAPs have been linked to IBS (as well as SIBO) for a while. But they really came under the spotlight after researchers from Chalmers University of Technology and Uppsala University (Sweden) conducted their study.

IBS FODMAP Study

Researchers used a Swedish IBS online community to recruit men and women ages 18 to 70 with moderate to severe IBS diagnosed by a gastroenterologist. Additional recruitment criteria included no prior history of:

• another gastrointestinal disorder
• cancer treatments
• abdominal surgery (other than an appendectomy)
• bariatric/weight loss treatments
• smoking
• drug/alcohol abuse

Participants also weren’t pregnant or lactating, hadn’t donated blood within the last month and weren’t taking unstable medications, antibiotics or probiotics.

How the Study Worked

Participants ate rice pudding with 1.5 times the daily intake in a normal population of gluten, FODMAPs and a placebo each for one week in random order with the purpose of tracking which one triggered IBS symptoms and to what intensity. The randomization was computerized to allow for different possible sequences and optimal statistical analysis. The study was double-blinded, meaning neither the participants nor the researchers knew who was eating which rice pudding and when.

The Results

Researchers found a wide range of effects to the specific diet. But overall, gluten didn’t have a measurable effect on participants, while the FODMAPs did elicit symptoms – but not to the extent documented in previous studies.

This report is a portion of a larger study in which researchers are studying biomarkers in intestinal flora and blood. It will help them divide IBS patients into groups based on how an individual’s metabolism and intestinal flora respond to different diets and if they cause IBS symptoms.  

Irritable Bowel Syndrome Diet

To begin lowering FODMAPs in your diet, eliminate common foods and ingredients that are high in FODMAPs. Slowly reintroduce foods to see which cause symptoms. Once you’ve figured out which foods are problematic, eat them on a very limited basis or avoid them altogether.

“This study is an important piece of the IBS puzzle. However, a low FODMAP diet is very restrictive and can limit the amount and range of nutrients you’re eating,” says Bernard Kaminetsky, MD, medical director, MDVIP. “It’s very important to talk to your doctor before changing your diet, particularly if you’re interested in trying a low FODMAP diet.”

If you don’t have a primary care doctor, consider partnering with an MDVIP-affiliated physician. They have time to really work with you and develop a wellness plan that can help you manage chronic pain and conditions such as IBS. Find a physician near you and begin your partnership in health »