12. Dec, 2017

Could your gluten sensitivity actually be IBS?

I went to an appointment with my son today, he's looking for work. The lady at the employment agency was busy doing his intake forms, but we were chatting in between. I'm a chatter. I don't like awkward silence. I guess it's from years in retail customer service, I'm used to making small talk, and I enjoy it. 

It turns out she's been feeling unwell, as have her whole family. Her husband is on epilepsy meds and they appeared to be wreaking havoc with his gut, so he's gone gluten-free and had a lot of relief. However the rest of the family are also having gastrointestinal issues such as diarrhoea, and other symptoms such as fatigue or generally feeling unwell. 

It's possible this family are suffering from Irritable Bowel Syndrome (IBS) and would benefit from trying the Low FODMAP approach. Some relief has been found by avoiding gluten-containing products, which is a clue that it might be something far more common than gluten intolerance/sensitivity, however Coeliac Disease must be excluded as a cause by their GP first. She was unaware that a high percentage of people avoiding gluten are actually intolerant of a carbohydrate component of wheat - fructan - rather than gluten (which is far more likely to be a true allergy as it is a protein, such as in Coeliac Disease).  People with IBS number as high as 30% of the population, and most of them are sadly suffering undiagnosed.

It's a tricky diagnosis, because it is dependent on people continuing to eat food that makes you feel terrible for a prolonged period of time. However many will eventually associate some foods with their symptoms and start avoiding them. This certainly appears to be the case with  wheat. The way people talk about it nowadays, you'd think gluten is it's only component, but it's just one of it's proteins. The carbohydrates being ignored include fructans, which we know cause gastrointestinal issues because they are fermentable. Normally this is a good thing, but not for people with IBS.

Fructan sources include inulin from chicory root & artichokes, but it is now also found in a variety of processed foods in a new push to increase consumer dietary (soluble) fibre intake.

Our single biggest fructan source is wheat, followed by beans/legumes/pulses (especially if you're vegan or vegetarian) and nuts.

After the appointment was over and we went home, I opened up my Facebook to see this very timely story on research into gluten avoidance. Coincidence or serendipity? 🙂

 

References

Arizona State University 2017, ASU experts put gluten-free diets under the microscope, <asunow.asu.edu/20171129-discoveries-gluten-free-diet-fad-health-benefits>

Encyclopaedia Brittanica 2017, Wheat, <media1.brittanica.com/eb-media/80/157180-004-C08E54B5.jpg>