An IBS flare-up can be a horrible thing, when carefully managed treatments seem to suddenly fail. One way many people avoid an IBS flare-up is with a controlled diet.
For some, it’s a gluten free diet for IBS that is used as a guideline. Cutting gluten from the diet is a choice that many with IBS make, in an attempt to remove trigger foods that lead to painful IBS symptoms.
Cutting certain foods out can reduce IBS triggers, leading to lessened symptoms and fewer flare-ups. The difficulty is determining which foods to remove for IBS.
Some have found a gluten-free diet the most effective way to manage their IBS.
Although a restricted diet is often recommended for those with IBS, it’s important to approach it carefully. Understanding the potential overlap between
IBS and celiac disease, as well as the reality behind gluten sensitivity, is vital to making the correct choice. With this guide, we discuss whether a gluten-free diet might be right for your IBS.
What Is Gluten?
Gluten is a term used to describe a family of proteins, found in grains such as wheat, barley, and rye. It’s a general name given to storage proteins, and they help food to maintain its shape, and to glue together.
This is why gluten tends to give food that soft and chewy texture.
Because gluten is a more generalized term than people realize, it pops up in some surprising foods. Breads, pastas, cereals, and baked goods are all widely recognized as containing gluten.
But gluten is also used as an additive, improving the texture of many processed foods.
Gluten proteins are resistant to the protease enzyme, which breaks down proteins for absorption. This digesting difficulty is why many IBS sufferers consider eliminating gluten.
Due to its wide application, cutting out gluten is often more difficult than people first realize.
About Celiac Disease And IBS
Irritable bowel syndrome, or IBS, is a gastrointestinal disorder. This common condition causes abdominal pain, and can also include symptoms such as diarrhea, bloating, and fatigue.
Despite being a widespread condition, there’s still much to learn about IBS. Including the exact cause, which can be confusing and broad.
Celiac disease is an autoimmune disorder, in which the consumption of gluten leads to inflammation of the intestine. This damage to the intestinal cells affects the absorption of nutrients.
Over time, celiac disease can lead to severe health implications. Anyone diagnosed with celiac disease must remove gluten from their diet.
Whether there is a link between celiac disease and IBS is currently unclear. Although some research has shown an increased likelihood of an overlap, more testing is necessary.
One issue with finding a link is that to test for celiac disease, consumption of gluten is necessary. If a patient diagnosed with IBS has found a gluten-free diet helpful, they’re unlikely to want to start consuming gluten again.
Another issue is that of bias. Some IBS sufferers may perceive having success with a gluten-free diet, even if there’s no clear link between gluten and their symptoms.
As there is a significant overlap in symptoms between celiac disease and some forms of IBS, testing is recommended in many cases.
What Is A Gluten Sensitivity?
Testing, treatment, and causes of celiac disease are all fairly well understood. Celiac disease can be tested for, and the treatment of this autoimmune disease is a total avoidance of gluten.
While this is true for celiac disease, things are more complicated when it comes to gluten sensitivity.
A non-celiac gluten sensitivity (NCGS) is still not a widely understood condition, and research is only just beginning. However, early signs show that some diagnosed with IBS may actually have NCGS.
With a gluten sensitivity, the intestine isn’t receiving damage in the same way it does with celiac disease. A person may be able to eat gluten and only experience symptoms common in IBS, such as diarrhea, constipation, and bloating.
The intestinal cells will remain unharmed, even in the long-term.
Diagnosing celiac disease and NCGS takes different forms. Celiac testing will often involve a blood test or biopsy. Diagnosing a NCGS involves eliminating gluten and then introducing it back in.
However, this should only be done under the care of a doctor, and it still isn’t a clear indication of an NCGS.
Many of the difficulties involving diagnosing a gluten sensitivity are related to other food intolerances.
What About Fructans?
When gluten is removed from a diet, it’s necessary to cut out a lot of foods. One thing rarely eaten on a gluten-free diet is wheat.
And when you eliminate wheat from a diet, it’s more than just gluten you aren’t consuming.
There is some research suggesting that those with IBS who benefit from a gluten-free diet aren’t actually responding to the removal of gluten.
Instead, the removal of fructans, commonly found in wheat, might be the cause of the benefits.
Fructans are natural carbohydrates consisting of chains of fructose. In a randomized study of subjects with self-reported non-celiac gluten sensitivity, more reacted to fructose than gluten.
As fructans and gluten are both found in wheat, it can be difficult to determine without rigorous testing what is causing the issue.
However, if you’ve found cutting out wheat has improved your IBS, then you may want to consider if you’re sensitive to fructans, rather than gluten.
Is A Gluten-Free Diet Right For Your IBS?
It might sound counterintuitive, but if you suspect you have celiac disease, the first thing to do is NOT cut out gluten. Consuming gluten is a vital part of the testing for celiac.
If you think you have celiac disease, then contact your healthcare professional. They will be able to confirm a diagnosis with either a blood test or a biopsy. Once a positive test has been confirmed, gluten must be removed from the diet.
In the result of a negative celiac test, things get a little tricky. Diagnosing a NCGS is often done via an elimination diet. In this case, the patient needs to stop consuming gluten, and monitor the symptoms. Gluten is then slowly introduced back in.
With an elimination diet, reintroducing the foods is a necessary step to understanding any potential intolerances. Speak with a healthcare professional before embarking on an elimination diet.
It isn’t clear if a gluten-free diet can reduce the symptoms of IBS. However, as it has benefited others, it may be something you want to consider. Adopting a gluten-free diet is easier now than it has ever been, with more and more gluten-free foods for sale.
But before embarking on an elimination diet, always discuss it with a medical professional, or a nutritionist.
There’s still much research necessary before a clear link between celiac disease and IBS can be established. Until then, it’s important that anyone who suspects they have celiac disease gets tested.
A gluten-free diet isn’t a guaranteed solution to IBS, but it may help to lessen the symptoms. A potential overlap between non-celiac gluten sensitivity and IBS does exist, even if more testing is needed.
The potential for a fructan intolerance does make establishing links more difficult.
Eliminating gluten may help to reduce the symptoms of IBS, and it’s now easier than ever. Discuss with a nutritionist to see if this is the right choice for you.
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