IBS or gluten?

In recent years, several articles have emerged discussing whether we should consume gluten or not and whether it is gluten or FODMAPs that is the culprit for digestive issues. Some experts caution against eliminating gluten from the diet, while others argue that gluten itself can lead to a variety of symptoms and diseases, with digestive problems being just one of them. Many people wonder whether they have “IBS or gluten” (actually gluten intolerance or coeliac disease).

Gluten intolerance, gluten sensitivity, and IBS

First and foremost, let’s distinguish between gluten intolerance, gluten sensitivity, and IBS. In the case of gluten intolerance, antibodies against the gluten protein are detected in the blood through a blood test, resulting in a diagnosis of gluten intolerance or celiac disease. The treatment for celiac disease involves a strict gluten free diet for life. Celiac disease affects approximately 1-3% of the population in Sweden and the UK.

Gluten sensitivity is a widely accepted term and phenomenon, especially in the USA. It refers to the 2% of individuals who do not show antibodies against gluten but still experience issues with the protein. The discussion often involves how the intestines can be affected by increased inflammation, becoming more permeable (leaky gut), which means the body may start producing antibodies against other organs, such as the thyroid.

Many individuals with hypothyroidism (Hashimoto’s) have autoimmune reactions that may have been influenced by previous gluten intake. Symptoms like fatigue, brain fog, joint pain, and body inflammations may be related to gluten consumption.

IBS, or Irritable Bowel Syndrome, is a functional gastrointestinal disorder, meaning that no structural abnormalities can be found in the stomach or intestines—they just don’t function quite as they should. Approximately 15-20% of the world’s population has IBS, and it is primarily treated with the low FODMAP diet. Symptoms of IBS often include a bloated stomach, gas, constipation, diarrhoea, or abdominal pain.

Treatment of gluten intolerance and IBS

In the case of IBS, it is a bit more challenging to determine what one is reacting to in food. Many individuals remove bread and pasta, feel better, and conclude that it is gluten they cannot tolerate. However, recent research indicates that most people with IBS primarily react to the fibres in cereal grains rather than gluten. The difficulty in distinguishing between the two lies in the fact that both fibres and gluten are eliminated when removing gluten-containing products.

Eliminating these fibres is part of the low FODMAP diet, a dietary treatment for IBS. In this approach, individuals undergo an elimination phase and then gradually reintroduce food groups to observe symptoms. The low FODMAP diet has proven to be the most effective treatment in eliminating IBS symptoms, and for some, avoiding gluten can be a positive side effect.

As we encounter many people with IBS, we notice that eliminating gluten makes a difference for some. Most experience improved digestive health, primarily due to the removal of fibres, while others report increased energy, better sleep, reduced joint pain, and headaches, potentially linked to gluten.

It is crucial to undergo testing before eliminating gluten to ensure that one does not have celiac disease. This also applies when starting the FODMAP dietary treatment. Hopefully, interest and understanding of how the body is affected by gluten will continue to grow. Sweden has much to learn from other countries’ perspectives on gluten, and perhaps it does not have to be a black-and-white issue. A reduced intake may be sufficient for many, and when it comes to FODMAPs, individuals are free to decide what they want to fill their IBS bucket with!

In the Belly Balance app, you can find FODMAP lists, recipes, a barcode scanner, IBS treatment, and much more to help you manage and minimize IBS symptoms.

Sofia Antonsson
Reg. Dietitian, Belly Balance