The Link Between Irritable Bowel Syndrome (IBS) and Gluten Intolerance: Exploring the Evidence

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder that affects millions of people worldwide. It is characterised by symptoms such as abdominal pain, bloating, diarrhoea, and constipation. One possible trigger for IBS symptoms is gluten intolerance, also known as non-coeliac gluten sensitivity (NCGS). In this article, we will explore the potential links between IBS and gluten intolerance, supported by the latest empirical evidence and research.

Understanding Gluten Intolerance

Gluten is a protein found in wheat, barley, and rye. Coeliac disease is a well-established autoimmune disorder characterised by an immune response to gluten ingestion. However, there is a growing recognition of a milder form of gluten sensitivity known as NCGS, which does not involve the same immune response as coeliac disease but still causes symptoms similar to IBS.

Exploring the Link

Several studies have investigated the potential connection between IBS and gluten intolerance. A randomised, double-blind, placebo-controlled study published in the journal Gastroenterology, found that individuals with self-reported NCGS experienced significantly more severe IBS symptoms when consuming gluten-containing foods, compared to a gluten-free diet.

The study involved 37 participants with self-reported NCGS, who were randomly assigned to two groups. One group received a gluten-free diet, while the other group received a diet that included gluten. The participants in both groups were then given gluten or placebo capsules for seven days. The results showed that participants who consumed gluten experienced more severe IBS symptoms compared to those on a gluten-free diet.

Another study published in the American Journal of Gastroenterology explored the prevalence of NCGS among patients with IBS-like symptoms. The study involved 920 patients with IBS-like symptoms who underwent a double-blind placebo-controlled challenge with wheat. The results showed that 276 patients (30%) had a positive reaction to the wheat challenge, indicating a potential association between NCGS and IBS.

Mechanisms and Triggers

The exact mechanisms underlying the relationship between IBS and gluten intolerance are not yet fully understood. However, several theories have been proposed. One hypothesis suggests that the presence of certain types of carbohydrates, known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), found in gluten-containing foods, may trigger IBS symptoms in susceptible individuals.

A study published in the journal Gastroenterology demonstrated that a low-FODMAP diet, which restricts the intake of fermentable carbohydrates, including those found in gluten-containing foods, led to a significant reduction in IBS symptoms. This suggests that the presence of FODMAPs in gluten-containing foods, rather than gluten itself, may be responsible for triggering symptoms in some individuals with IBS.

This is not conclusive, however, and if you believe that you have a gluten intolerance or coeliac disease we recommend that you seek professional medical guidance to determine the status of your gluten intolerance, if any. 

Furthermore, the study also stated that a low FODMAP diet should not be adopted by healthy individuals because it will likely lead to nutritional deficiencies in the long term. Even those that do endure IBS symptoms are advised to reintroduce higher FODMAP ingredients to ensure a balanced and healthy gut, albeit in manageable quantities and frequency.

At JUVIA we hope to eliminate this dilemma so that you can enjoy your favourite foods without the uncomfortable symptoms that can follow. 

Managing and Treating Gluten-Induced IBS

If you suspect that gluten may be triggering your IBS symptoms, it is essential to consult a healthcare professional for a proper diagnosis. They can help differentiate between coeliac disease, NCGS, and other potential causes of your symptoms.

If gluten intolerance is confirmed as a trigger for your IBS, the primary treatment involves following a strict gluten-free diet. This involves avoiding foods and ingredients that contain gluten, such as wheat, barley, rye, and products derived from them. It is important to read food labels carefully, as gluten can be present in unexpected sources.

A registered dietitian who specialises in gastrointestinal disorders can provide guidance and support in managing a gluten-free diet. They can help ensure that your diet remains balanced and nutritionally adequate while avoiding gluten-containing foods.

Conclusion

While the relationship between IBS and gluten intolerance is complex and still being studied, the evidence suggests a potential link, particularly in individuals with NCGS. Gluten sensitivity may exacerbate IBS symptoms in susceptible individuals, and a gluten-free diet has been shown to improve symptoms in some cases, although this should not be relied upon as a long-term solution. 

If you suspect that gluten is triggering your IBS symptoms, it is crucial to consult a healthcare professional for accurate diagnosis and guidance. They can help determine the best course of action, which may involve following a gluten-free diet and potentially eliminating other triggers based on individual needs.

As research in this field continues, a better understanding of the mechanisms underlying the link between IBS and gluten intolerance will provide further insights and potentially more targeted treatment options for individuals affected by these conditions.

Having said that, it is also worth considering a low-FODMAP diet because there is a clear overlap between products containing gluten that rank higher on the FODMAP score, which can mislead you with regard to identifying potential triggers for your discomfort. Again, this is not a long-term solution and should only be used as a tool to eliminate your symptoms so you can rebuild your tolerance. 

Here at JUVIA we care deeply about your wellbeing and wish for everyone to enjoy a healthy gut. JUVIA has been specially formulated for those with a sensitive tummy, but it is not a substitution for medical treatment for those with serious medical conditions. We hope these articles help you understand your body better, so you can get the right treatment for your specific condition.