Are you thinking about trying a gluten-free diet to see if it will help your IBS? The relationship between IBS and gluten is not yet fully understood (see "IBS and Gluten Intolerance"). However, some people with IBS have reported a significant improvement in their symptoms when they have cut gluten out of their diet. If you are thinking of giving this a try, there are a couple of important steps you should follow before you do so:
1. Get Tested for Celiac Disease
Do not skip this step! Speak with your doctor about your plan to go gluten-free so that you can be screened for celiac disease, as IBS patients are at higher risk (current IBS management guidelines from the American College of Gastroenterology recommends that all IBS patients be screened for celiac disease). It is essential that you are still eating gluten-containing foods, i.e. foods that contain wheat, rye and barley, at the time of testing to get an accurate diagnosis. There are several reasons why it is so essential to find out whether or not you have celiac disease:
- If you have celiac disease, you can never eat any gluten-containing foods without putting your health at serious risk. If you do not have celiac disease, but find out that you have a gluten sensitivity, you can be a little more flexible with your diet.
- Celiac disease involves follow-up care and testing that is not required for a gluten sensitivity.
- A confirmed diagnosis of celiac disease would be needed in order to obtain insurance coverage for this follow-up care.
Preliminary diagnostic testing for celiac disease is done through blood work. If your blood work comes up positive, or even if it comes up negative but your doctor still has a strong suspicion that you may have the disease, the next step would be to recommend that you undergo an endoscopy in which a biopsy of the small intestine is performed to check for damage to the villi, which cover the lining of the small intestine. If you are diagnosed with celiac disease, you will find much useful information at Celiac Disease at About.com.
2. Try an Elimination Diet
Once you have completed any necessary testing for celiac disease, you can try an elimination diet to see if going gluten-free has an effect on your IBS symptoms. The following articles will be of help:
In theory following an elimination diet should be easy. In practice, it can be quite difficult. Cravings and peer pressure can quickly overcome willpower! Try to avoid such problems before they arise. Tell your family and friends what you are doing and why you are doing it. Be sure that they understand that you are trying this because you are seeking a way to feel better. Be prepared for the fact that some may not be as understanding as others; spend more time with the ones who are more understanding, particularly in the beginning as you yourself are establishing new habits.
Try the gluten-free diet for a period of two to four weeks and assess the effect that it is having on your digestive system. If you are feeling much better eating gluten-free, then you may decide that gluten-free is for you. Make sure that you are eating a nutritionally well-balanced diet and that you are not relying on too many processed gluten-free products which can be high in calories.
If you see no real difference in your symptoms, (and you don't have celiac disease), you can slowly start to re-introduce gluten-containing foods back into your diet and again assess what effect they have on your digestive functioning. If you ultimately conclude that gluten has no relationship to your IBS you may find yourself back at the drawing board in terms of trying to figure out how to eat for your IBS. This article offers some other avenues to pursue:
American College of Gastroenterology IBS Task Force "An Evidence-Based Position Statement on the Management of Irritable Bowel Syndrome" American Journal of Gastroenterology 2009:S1-S35.
"Celiac Disease" National Digestive Diseases Information Clearinghouse (NDDIC) Accessed July 8, 2013.
DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.