Many people with Irritable Bowel Syndrome (IBS) misinterpret gluten as the culprit. Their symptoms manifest themselves as a result of eating wheat products. When you look at the chemical structure, there are two components that can cause trouble. The protein (ie. gluten) and/or the carbohydrate (ie. FODMAPs). It can be difficult to decipher which part of wheat is causing your symptoms. And many IBS individuals misdiagnose themselves with non-coeliac gluten sensitivity (NCGS). They assume that their gut is reacting to gluten, rather than to FODMAPs.
Why IBS and celiac disease aren’t the same
The symptoms of IBS and celiac are very similar. The mechanisms in the intestine behind the symptoms are very different.
When you have IBS and eat wheat, your body might react to fructan, a carbohydrate and FODMAP. FODMAP is the abbreviation for “fermentable oligo-, di-, mono-saccharides and polyols”. This is a group of carbohydrates that aren’t digested or absorbed in the intestines. Your microflora produces gas when it ferments FODMAP's which inhibits gut movement. Due to lower motility, all the undigested FODMAP's attract excess amounts of water. This is a downward spiral, and all the extra water and gas in your colon cause it to expand and stretch. This is what causes the symptoms of pain, bloating, diarrhea, constipation and gas.
When you have celiac disease eat wheat, your body has an immune response to gluten, the protein. Your body identifies the protein as a dangerous invader and fires off an immune reaction. It mobiles it's defense mechanism and in that process attacks your own cells. It damages the intestinal wall in the process. This leads to gastrointestinal symptoms and malabsorption of other nutrients. The consequences can also be severe in the long run, such as osteoporosis and infertility.
Low FODMAP vs. Gluten-Free Diets
The low FODMAP diet and gluten free are two different types of medical diets. A gluten-free diet restricts gluten intake on a daily basis. It's for people with celiac disease, gluten-sensitivity or dermatitis herpetiformis (skin disorder ).
The low FODMAP diet limits the intake of short carbohydrates, among which is fructan. This medial diet is for people with Irritable Bowel Syndrome, GERD and SIBO. When you follow a low FODMAP diet you, you also omit FODMAPs (ie. fructans) from other non-gluten-containing foods. Gluten-free diets fail to remove the real culprits of IBS symptoms, which are FODMAPs. During a gluten-free diet, you could still eat FODMAPs that cause your bloating and pain.
The impact of a gluten-free diets
Gluten-free diets, though on the rise, can also have adverse effects on health. Adapting an unnecessary gluten-free diet can have negative effects on your health:
- Eating less whole grains and fiber. Fiber decreases the amount of cholesterol in the body and facilitates bowel movements. Consuming less fiber can exacerbate symptoms, such as constipation.
- Potential micronutrient deficiencies in folate, iron, niacin, riboflavin & thiamin. Deficiencies of these micronutrients can have a whole range of implications. Such as anemia, fatigue, weakness, and increased risk of diseases (ie. cardiovascular disease, dementia).
- Certain gluten-free products may contain more fats, cholesterol, salt and sugar. This may increase risk of heart disease, stroke and diabetes.
- Gluten-free products tend to stale faster. This is due to the lack of gluten in the product, which helps keep elasticity and tenderness. To compensate for this, it contains more additives to elongate shelf life.
Should I go gluten-free?
With the “rising trend” of gluten-free diets in the past decade you might lean towards giving it a go. Understanding your diagnosis before adopting any dietary changes is important for your health.
After diagnosis it's important to work with a dietitian to identify trigger foods. When you make long-term dietary changes, it's crucial to take a look at your vitamin and mineral intake. Depending on your current diet you may need to supplement different micronutrients.