Will Going Gluten-Free Help My IBS? A GI Dietitian Explains.
So you’ve been feeling crummy for a while. What you want to know most is how to feel better. You might be asking yourself: will going gluten-free help my IBS?
The answer is maybe. But IBS is a complicated condition with many potential root causes so let’s address that, first.
What is IBS?
IBS means irritable bowel syndrome. Symptoms of IBS vary by individual and with time and might include:
● Feeling full too soon after eating
● Unintended weight loss
● Abdominal pain
With gluten-free options becoming more plentiful by the day, it is easy to wonder if they’re the answer to your symptoms.
Will gluten-free help?
Unfortunately, I cannot say that for sure. And while I want nothing more than for you to feel better quickly, please know that jumping on the gluten-free bandwagon actually comes with some risks.
Have you ruled out celiac disease?
Celiac disease is an autoimmune condition where your body attacks itself in an overzealous response to eating gluten.
Gluten is a protein found in wheat, rye, barley and oats by cross contamination. In both people with celiac disease or with non-celiac gluten-sensitivity, your body is having a negative reaction to the gluten protein.
Celiac disease is lifelong - there is no cure. The good news is that eating a gluten-free diet should make you feel better!
And if you suspect that you might have celiac, it is really important to do testing to know for sure BEFORE removing gluten. If you remove gluten, your body stops producing the antibodies that you can measure in your blood and your gut will heal from the damage the gluten is causing. Without those measurable signs, you cannot get the diagnosis that you need.
While it is easy to assume that the terms are interchangeable, celiac and gluten-sensitivity are not the same things. But, there can be overlap. The research suggests that about 4% of people with IBS have celiac-disease (1).
FODMAPs vs. Gluten-free
Along with gluten, FODMAPs are also top of mind when investigating ways to feel better with IBS.
FODMAPs are carbohydrates found in many foods but in higher amounts in specific fruits, vegetables, dairy and grains. Some of us have issues with some, but rarely with all, of the FODMAPs. One thing to note is that FODMAPs are carbohydrates while gluten is a protein.
FODMAPs are found in a diverse group of foods that include lactose in milk, fructans in onions and garlic, high-fructose fruits (apples, cherries, apricots, watermelon), galacato-oligosaccharides (GOS) in beans and more.
And - whomp whomp - you can have issues with both the gluten protein AND the FODMAP carbohydrate in wheat.
Sleuthing with sourdough
So, how do you know if your digestive system is reacting to the gluten in bread or something else? Real sourdough might be better tolerated if your issue is the FODMAP in wheat and not the gluten (2).
Sourdough bread is made with a really long fermentation process. Sometimes the bread is slowly fermenting for 24 hours or more!
This slow and gentle fermentation makes the fructan easier to digest because the active bacteria are working to break it down a bit. The gluten in wheat will still be present and intact, even after a slower fermentation.
True sourdough bread may offer a bit of information to you about your gut health and what might be best. But it won’t offer a complete plan of action. For my patients, we may start with a low FODMAP diet first. Depending on their symptoms, we may also explore gluten-free, but it isn’t something that I would start with or recommend you jump too, first. There are simply too many possible root causes to IBS to be able to say that a single intervention will work for you.
Other root causes of IBS?
What makes getting to the root cause of your IBS symptoms tricky is that there are many possible root causes.
And you can have more than one root cause.
And when you feel like garbage, the last thing you want to do is waste time or precious energy trying an intervention that may or may not work.
IBS may be caused by many things. Some risk factors for IBS include:
● Having just had an infection (food poisoning)
● Small intestinal bacterial overgrowth (aka SIBO)
● Altered motility - the muscles propelling your food through the digestive tract are moving too fast or too slow (medications can be one culprit)
● Excessive stress
● Your genetic make-up
● Increased intestinal permeability (aka Leaky Gut)
Other changes that might improve IBS symptoms
Eliminating or reducing other foods and drinks might offer relief. These include:
● Eliminating alcohol
● Reducing or eliminating caffeine
● Avoiding additives, such as artificial sweeteners or preservatives
It is also important to have a good night’s sleep, be hydrated, to manage stress and so on. Even things like having smaller meals can influence your IBS.
Bottom line: will going gluten-free help my IBS?
But without ruling out other options and working through a systematic process, you’re just guessing.
I hope that this article sheds some light on just how complicated gut health can be. If you’re ready to get to the bottom of your gut health issues and find relief from your symptoms, I have the tools to help. I invite you to get started by scheduling an initial visit today!