The Gluten and IBS Connection

Consuming the smallest portion of gluten can leave you hunched over with stomach pain if you’re sensitive to it. But Irritable Bowel Syndrome (IBS) can bring some of the same symptoms as celiac disease. Whether you have gluten intolerance, IBS or both, it’s important to understand the differences and how there may be a connection between the two.

What is IBS?

According to the American Journal of Nursing, IBS is a chronic gastrointestinal condition that causes abdominal pain and disturbances in bowel habits. IBS is common and can reduce the quality of one’s life. Most doctors agree that belly pain, diarrhea, constipation and gas are major indications of IBS. Many people believe that the pain or uncomfortableness from eating gluten can be similar to IBS symptoms.

Comparing Symptoms and Causes

Celiac Disease

Symptoms

  • Abdominal Pain
  • Weight Loss
  • Diarrhea and/or Constipation
  • Fatigue
  • Nausea

Causes

Individuals with celiac disease can’t tolerate gluten. When they eat it, they experience the symptoms above. If they continue to eat gluten, their immune system will attack the small intestine. The inner lining that is used to absorb nutrients from food will become damaged as well.

Irritable Bowel Syndrome

Symptoms

  • Abdominal Pain
  • Bloating
  • Fullness
  • Gas

Causes

According to Dr. Alessio Fasano, director of the Center for Celiac Research and Treatment at Massachusetts General Hospital, stress is one of the most recognized triggers for IBS. “There are many other causes that seem to be involved in this pathogenesis, including food allergies, food intolerances, small intestinal bacterial overgrowth and other gastrointestinal infections, to name a few,” he said.

In the Facebook group “Gluten-Free,” a member posted to see who has both IBS and celiac disease. One of the members of the group, Elissa Ackerman Michaels, commented, “The higher the stress, the worse the IBS symptoms are…Celiac occurs when I ingest gluten, and when I’m stressed my IBS pain shows up as severe abdominal pain or heartburn.”

Dr. Amy Burkhart, founder of www.theceliacmd.com, agrees. She said, “One of the causes of IBS is stress. There are numerous papers linking IBS and stress, along with studies showing benefit to IBS patients by using stress reduction techniques like mindfulness.”

How to distinguish symptoms between celiac and IBS

Because abdominal pain is prevalent with both conditions, it can be hard to know which one you’re dealing with. According to Burkhart, “The answer is to test.” She strongly urges people to always test for celiac disease before implementing a gluten-free diet.

“Many people diagnosed with IBS will do a trial of a gluten-free diet to help eliminate symptoms, and at times they are even told to do so by their health care provider,” Burkhart said. “Once they do this, testing for celiac disease won’t be accurate. People need to consume gluten again for proper testing, and many people will refuse to do so if the gluten-free diet has been beneficial.”

Is there a connection?

When it comes down to the connection between celiac disease and IBS, further testing and research are needed.

“Celiac disease can be misdiagnosed as IBS if celiac testing isn’t done or isn’t done correctly,” Burkhart said. “Even after a celiac diagnosis, celiac patients are more prone to ongoing digestive symptoms than the average person and may be diagnosed with IBS, but often the issues creating the symptoms are treatable. People with celiac disease are at a higher risk to have other autoimmune conditions, which may create digestive symptoms that mimic IBS. Celiac patients also have an increased risk of other conditions, such as additional food intolerances and bacterial overgrowth syndromes.”

Fasano believes there is a connection between the two diseases “since abdominal pain, bloating, and irregular bowel movements, which are features of IBS, are common symptoms experienced by people with celiac disease.”

Gluten-free and IBS study results

According to recent research by 23 international experts, a gluten-free diet can provide significant benefits to not only gluten-sensitive patients but also to individuals living with IBS. The study found that the prevalence of IBS in the world is about 10-20 percent.

This study went in-depth regarding the prevalence of studies on non-IgE wheat allergy, gluten sensitivity, potentially harmful wheat ingredients and ways IBS is triggered by wheat, along with how symptoms from gluten sensitivity and IBS are similar. Researchers mentioned how the number of studies has roughly quadrupled in the last eight years. The most recent studies support the hypothesis suggesting that wheat components and gluten, in general, may trigger IBS symptoms. Current evidence reveals that a wheat-free, gluten-free diet can provide a major benefit to IBS patients who may have gluten-sensitive IBS.

While studies and research are ongoing and there is not a definite answer to this theory, it is highly possible that gluten can be a dietary trigger.

Other foods to avoid with IBS

If you follow a gluten-free diet and still experience IBS symptoms, it could be due to other dietary components. Every person’s body is different, and what may trigger one person may not necessarily impact another. Work closely with your doctor and try cutting out the following one by one to see how you feel.

  • Cereal and bread made with refined grains
  • Carbonated drinks and alcohol
  • Dairy (try eliminating just cheese at first)
  • Processed foods (pre-packaged)
  • High-protein foods

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