Written by Shaynie Ashkenazi, Founding Director, FodShop

Irritable bowel syndrome (IBS) is a common chronic condition characterized by symptoms such as bloating, constipation, and diarrhoea.

IBS can significantly affect the quality of life of those who suffer from it. It is estimated that between 10-15% of the global population has IBS, with women being more commonly affected than men.

There are different types of IBS, including IBS with constipation (IBS-C), IBS with diarrhoea (IBS-D), mixed IBS (IBS-M), and unsubtyped IBS (IBS-U).

The symptoms of IBS can also vary in severity and frequency, with some individuals experiencing only occasional symptoms while others present with chronic symptoms.

How to Manage IBS

There is no known cure for IBS, however various treatment options are available to manage symptoms.

These include dietary changes, stress management techniques, medications, and probiotics. Tap HERE for a comprehensive overview of IBS symptom management strategies.

It is essential to work with a healthcare provider to develop an individualised treatment plan that meets the unique needs of the individual with IBS.

The Role of the Low FODMAP Diet in IBS Symptom Management

A low FODMAP diet involves restriction of foods high in FODMAPs, such as certain fruits, vegetables, grains, dairy, and sweeteners, for a period of 2-6 weeks, followed by gradual reintroduction of FODMAPs to identify trigger foods that can should be limited in the diet.

Tap HERE for an in-depth overview of the FODMAP acronym and the role of the low FODMAP diet in IBS symptom management.

It is important that the low FODMAP diet is implemented under the guidance of a qualified healthcare professional, such as an Accredited Practising Dietitian, in order to ensure that the diet is nutritionally adequate and sustainable in the long term.

Should Gluten be Avoided in IBS?

Gluten is not a FODMAP, it is a protein found in wheat, rye, oats, barley, triticale and food products containing these foods.

Many foods high in FODMAPs, however, also contain gluten, particularly breads, cereals, and grain-based/inclusive food products.

For individuals with Coeliac's Disease or Non-Coeliac Gluten Hypersensitivity, it is important to differentiate between a gastrointestinal reaction stemming from consumption of the gluten protein, or a reaction to FODMAPs in the same food.

If an individual has Coeliac Disease, gluten consumption can still damage the small intestinal layer, even if the person does not present with symptoms, making the dietary trigger source difficult to identify.

A low FODMAP diet may be beneficial for managing IBS symptoms, but it's important to seek guidance from a healthcare professional to ensure a well-balanced and nutritionally adequate diet, and to ensure that gluten isn't being unnecessarily eliminated from the diet altogether if this isn't medically warranted.

References

1. Shepherd, Susan J; Lomer, Miranda C E; Gibson, Peter R (2013). Short-Chain Carbohydrates and Functional Gastrointestinal Disorders. The American Journal of Gastroenterology, 108(5), 707–717. doi:10.1038/ajg.2013.96 

2. Gibson PR. History of the low FODMAP diet: History of the low FODMAP diet. J Gastroenterol Hepatol [Internet]. 2017;32 Suppl 1:5–7. Available from: http://dx.doi.org/10.1111/jgh.13685

3. Barrett JS. How to institute the low-FODMAP diet: How to institute the low-FODMAP diet. J Gastroenterol Hepatol [Internet]. 2017 [cited 2022 Mar 17];32 Suppl 1:8–10. Available from: https://pubmed.ncbi.nlm.nih.gov/28244669/

4. Varney J. Practical tips for FODMAP reintroduction [Internet]. Monashfodmap.com. Monash Fodmap; 2020 [cited 2022 Mar 17]. Available from: https://www.monashfodmap.com/blog/practical-tips-fodmap-reintroduction/

5. Hill P, Muir JG, Gibson PR. Controversies and recent developments of the low-FODMAP diet. Gastroenterol Hepatol (N Y) [Internet]. 2017 [cited 2022 Mar 17];13(1):36–45. Available from: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5390324/

6. Biesiekierski, J. & Iven, J.(2015). Non-coeliac gluten sensitivity: piecing the puzzle together. United European Gastroenterol J. 2015 Apr; 3(2): 160–165. doi: 10.1177/2050640615578388.

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