Food foes or IBS woes? Symptoms of digestive distress are often lumped together under the umbrella term of Irritable Bowel Syndrome (IBS), but deciphering a true diagnosis is the only way to beat bloating for good.
As April marks IBS Awareness Month, it is the perfect time to take a deep dive into the details of diagnosis.
Similar symptoms may cause confusion
Bloating, gas and diarrhoea could be the result of IBS or food intolerance, but an important diagnostic difference is the presence or absence of stomach pain and other accompanying symptoms.
A food intolerance may be associated with migraines, nausea. and nasal stuffiness but is not always associated with pain. IBS always includes recurrent stomach pain. The other discernible difference is that IBS may include bouts of constipation, whereas food intolerance only triggers diarrhoea.
How is IBS diagnosed?
There is no diagnostic test for IBS in South Africa. However, diagnosis is usually based on a collection of symptoms called the ROME III Criteria.1
The underlying causes of IBS
Many factors may contribute to the development of IBS, including:
- Chronic food intolerances
- Hormone imbalances
- Dietary changes
- Postoperative changes to gut bacteria
- Side effects from over-the-counter or prescription medications
- Stress and anxiety
The underlying causes of food intolerance
Food intolerance is simply the result of consuming foods which the body battles to digest. People with a food intolerance do not produce enough of the enzyme required to digest a particular food. Therefore, Intolerance symptoms will only occur after eating that specific food, and they can be mild or severe depending on the degree of intolerance or enzyme deficiency.
The process of elimination: Identifying food culprits
Elimination of a food intolerance is usually the first step in managing suspected IBS.
However, unlike food allergies, food intolerances cannot be detected by a blood or skin prick test. Identification of trigger foods is achieved by the use of a food and symptom diary or an elimination diet.
Food intolerance symptoms usually occur within 30 minutes to two hours of eating (as food makes its way through the digestive tract). Therefore, keeping a record of what was eaten and when symptoms appear, is the most simple and effective tool for finding a pattern.
According to the textbooks, removing possible dietary triggers for 4-12 weeks (to observe whether or not symptoms subside) is a standard investigative approach. However, when pursuing this route, it is crucial to remove only one food type at a time, otherwise making it impossible to single out the offending food culprit.
Since scientists estimate that are lactose intolerant, it would be advisable to start there.
Despite heightened media coverage, gluten intolerance appears to be much less common, with a comparative estimate of only 8.4% of the population,3 being affected. Furthermore, gluten intolerance can be divided into two sub-categories, namely, celiac disease and non-celiac gluten sensitivity.
Fortunately, celiac disease (a more serious version) only affects an estimated 1.4% of the population3, and this condition can be confirmed or ruled out by utilising a blood test or biopsy of the small intestine.
What next?
If elimination diets yield no luck with the identification of food intolerance, Next Biosciences can provide the logical next step. If intolerance triggers are not obvious, the Viome Gut Microbiome Test (available to order here) will offer further clarity.
Just as the skin microbiome calls for different moisturisers according to different skin types, there is no static list of ‘best foods for gut health’ as the list depends on you.
Backed by laboratory analysis, Viome can eliminate the lengthy process of personal trial-and-error by pinpointing exactly which foods may be troubling your gut. The test results will provide a personalised food prescription of gut-healthy foods, including ‘Foods to Avoid’ and ‘Superfoods.’
Viome will also provide recommendations for specific nutrient supplements and digestive enzymes to optimise gut health according to individual test-samples.
Can symptoms be permanently resolved?
While food intolerance symptoms should disperse with the identification and elimination of intolerable foods, IBS symptoms are, unfortunately, inclined to linger. IBS involves a persisting symptom complex, which means that symptoms are likely to return and will need to be managed accordingly.
Seeing that the Viome Gut Microbiome Test is designed to provide an acute assessment of gut health at a fixed moment in time, retesting for adjustment of advice is a recognised reality of long-term microbiome management.
Retesting after a few months is also beneficial because the list of restricted and advocated foods is likely to change as the health of your gut microbiome changes over time.
Find an accredited gut guru
Lastly, IBS management can extend to stress reduction techniques and exploration of a low FODMAP diet, both of which would require the instruction of an experienced healthcare professional. Finding an accredited practitioner in the field of gut health is advisable to assist with prolonged digestive distress.
Both food intolerance and IBS can be debilitating and complex, but with the correct management, the gut can be rehabilitated and -thanks to Viome – ‘complex’ can be made quite simple.
References:
- Lacy BE, Patel NK, Weber HC. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. National Library of Medicine – National Center for Biotechnology Information. 2017 October.
- Fisher R. Lactose Intolerance. National Institute of Diabetes and Digestive and Kidney Diseases. 2018 February.
- Sharma N, Bhatia S, Chunduri V, Kaur S, Sharma S, Kapoor P, Kumari A, Monika G. Pathogenesis of Celiac Disease and Other Gluten Related Disorders in Wheat and Strategies for Mitigating Them. National Agri-Food Biotechnology Institute Mohali, India. 2020 January.