Is Gluten Sensitivity Really a Carb Issue?

Those with functional bowel disorder might benefit from an elimination diet to test sensitivities.

Functional bowel disorder is an umbrella term used to describe glitches in how your stomach and bowels function or work. Patients with FBDs may have symptoms such as nausea, bloating, stomach pain, diarrhea and constipation.

Unlike patients with inflammatory bowel disease (IBD), who may exhibit similar symptoms, the organs and digestive tract of an FBD patient may be appear normal on tests such as endoscopy and blood work. FBDs are very common and include irritable bowel syndrome and functional dyspepsia.

Patients with FBD do not experience any nutritional deficiencies because of absorption issues in the gastrointestinal tract, but they very often have restricted their food intake to the point that they are no longer eating a well-balanced diet.

Because FBD patients can experience gastrointestinal distress when eating specific foods, these patients start eliminating those foods from their diet. The problem is that without careful consideration and guidance, this self-restricted diet most likely eliminates more foods than necessary.

A careful nutrition plan, developed with assistance from your health care provider, can help address these issues.

The low FODMAP diet

One approach for patients with FBDs may be the low FODMAP diet.

FODMAP is an acronym that stands for fermentable; oligosaccharides; disaccharides (lactose); monosaccharides (excess fructose in a food); polyols (sugar alcohols). This approach involves eliminating a broad spectrum of carbohydrate groups, which can potentially cause gastrointestinal distress, for a month. Such foods include wheat, garlic, onions and certain fruits and vegetables.

After a month, the foods are slowly reintroduced to determine which ones trigger symptoms. This entire process can take up to 12 weeks and is most successful when guided by a dietitian.

For FBD patients as a whole, the low FODMAP diet approach has a higher likelihood of treating gastrointestinal symptoms than gluten elimination. The low FODMAP diet addresses many types of carbs and allows you to identify exactly what foods are causing problems.

This allows patients to make diet modifications without severely restricting their nutritional intake or without leading to a diet so restrictive that it affects their ability to dine out or enjoy meals with friends and family.