Irritable Bowel Syndrome: It’s Not About The Gluten
Author: Dr. Mollie Brennan, Naturopathic Doctor
Gluten has been demonized for a long time, and as a naturopathic doctor I definitely contributed to the messaging. In certain situations and conditions I do recommend gluten free. However, in the world of irritable bowel syndrome (IBS) this may not be true all of the time.
Gluten is the major protein found in wheat products (breads, pastas, etc). Many people report their IBS is better when they eliminate gluten containing foods.
HOWEVER, a few studies have challenged wether gluten is truly the issue in IBS. Researchers added gluten back into people’s diet either with unlabelled wheat flour or capsules. People reported more stomach upset with the introduction of wheat flour, but not with capsules filled solely with gluten protein.
There are other components of pastas, cereals, and breads that can cause IBS symptoms. Right now we think it is other things called albumin proteins, and sugars called fructans that can cause gut inflammation.
Bottom line: In people with IBS who don’t have a true wheat allergy, there is a very real response to wheat products. Currently it is thought to be the fermentable sugars, not the gluten, causing symptoms. This is also why other grains, or fermentable sugars like lactose can also flare IBS.
Eating less wheat may help with IBS for reasons other than gluten. The goal is to have a wide and varied diet with IBS, not an ever restricted one. If you find your list of 'safe foods’ is getting smaller, speak with a naturopathic doctor for strategies around dietary changes and IBS.
References:
Skodje G.I., Sarna V.K., Minelle I.H., Rolfsen K.L., Muir J.G., Gibson P.R., Veierød M.B., Henriksen C., Lundin K.E.A. Fructan, Rather Than Gluten, Induces Symptoms in Patients with Self-Reported Non-Celiac Gluten Sensitivity. Gastroenterology. 2018;154:529–539.e2.
Biesiekierski J.R., Peters S.L., Newnham E.D., Rosella O., Muir J.G., Gibson P.R. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology. 2013;145:320–328.e1-3.
