Another frustrating and confusing area for a lot of people (non celiac) and especially for those who have IBS. As a functional medicine doctor in Singapore, I see people come to my office with extremely restricted diets with a lot of fear about adding foods to the diet. Most are constantly concerned about distressing symptoms of bowel irregularities, bloating, headaches and much more. A lot of times, I find practitioners go on the gluten avoidance wagon and often it is the first thing on the list recommended to be avoided and a necessity for improving gut health. Now, this can get even more confusing as what I am suggesting is, gluten for some people is NOT the component causing your digestive issues!
If you look at a low Fodmap diet, the diet that is usually recommended in IBS, it is not a gluten free diet. You may wonder how could gluten be not be the thing when you have heard so much about gluten being the culprit.
But let’s look at a recent study that was done on people who had self-selected (as many do) as “gluten-intolerant”. They were given three bars to eat for one week each. One bar had gluten added to it.
One bar had fructans (fructans are found in wheat and other gluten products…but they are a carbohydrate that feeds the bacteria in your gut) added to it. And one bar had neither in it.
So what happened? When people ate the bar with the fructans in it, bloating and gas increased, along with other symptoms – more than double the rate of the gluten-containing bars!!
What we now know is that there is much more to the foods than gluten.
Although there are people who may have absolute issues with gluten, we are seeing that many people who don’t tolerate wheat or gluten containing grains, the problem is not the Gluten.
The interesting thing here is that if the problem is the carbohydrate that ferments due to bacteria in the gut, research suggests that these foods can eventually be added without symptoms when treated systematically and with a program of reintroduction that is suggested in the studies .
So, gluten is not always the culprit. That being said, one may notice great improvements initially when you eliminate gluten. This is because, often you are also avoiding a lot of processed foods that most gluten containing products have in common. Gluten is not required for health-nor the foods such as pasta, breads etc.
But, if you cant figure what is causing your perpetual gut issues and if you keep removing foods endlessly in a quest to feel better, seek help.
There has now been so much more updates to IBS treatments now than what we had 5 yrs ago. If you have been told to follow restrictive diets as only saviour, you need to get in touch. It is amazing to see people who lived an extremely restricted life to be able to be less afraid of food and enjoy life more.
Do get in touch, this can get better! If you need help, please call your local gastro doctor in Singapore.
Be reminded this post is not for people diagnosed with celiac disease. Celiac and non-celiac gluten sensitivity have to be carefully diagnosed by a skilled practitioner and will be discussed in a separate post.
References:
Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self- Reported Non- Celiac Gluten Sensitivity.
Gastroenterology 2018 Feb;154(3):529-539.e2.
Gluten and FODMAPS- Sense fo Restriction/When Is Restriction Necessary?
Nutrients 2019 Aug 20;11(8):1957.
