These include Ulcerative Colitis and Crohn's which are both Inflammatory Bowel Disease (IBD) as well as Coeliac Disease. Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, meaning that unlike the other conditions there are no identifiable physical features such as inflammation, changes in tissues or abnormal blood tests.
All of these conditions have many common symptoms such as diarrhoea, abdominal pain, wind, bloating and distention. It is, therefore, vital that you have been diagnosed by a Doctor. Talk to your GP.
IRRITABLE BOWEL SYNDROME (IBS)
The diagnosis of IBS relies upon types of symptoms experienced, when they are experienced and how long they have been experienced for. IBS is not a food allergy but symptoms can be caused or made worse by reactions to short chain fermentable carbohydrates FODMAP's which are found in many foods.
There are commercially available tests claiming to diagnose food intolerance these include IgG blood tests, Vega (electrodermal), kinesiology and hair analysis. There is NO convincing evidence to support any of these tests. The only reliable way to identify problem foods is by eliminating them and reintroducing them. This should be done under the supervision of a Dietitian
The only exception to this is hydrogen breath testing. This can only test for malabsorption of fructose, lactose or sorbitol not the other FODMAP's and takes several hours. Results require very careful interpretation by an experienced practitioner. As these are some of the more easily avoided FODMAP's (see Low FODMAP Diet particularly monosaccharaides on the side bar) and there is often a combined effect with FODMAP's the dietary approach is still the best method.
Combined Effect: This means that whilst an individual FODMAP may cause very few symptoms all the FODMAP's together in the diet combine to overload the system and cause symptoms. The nature of testing is to test one substance at a time and so would miss this effect. The structure of the Low FODMAP diet, particularly the re introduction phase, is designed to identify this effect and test for level of tolerance in an individual.
An entirely gluten free diet is the only treatment for people with Coeliac Disease. Gluten is the protein found in wheat, rye and barley. A gluten free diet must be followed for life if you have this condition. Once the gluten has been removed from the diet the bowel begins to recover and the associated symptoms improve.
However, some people find that despite following a strict gluten-free diet symptoms continue. In this case it may be that IBS is occurring at the same time as Coeliac Disease. Firstly it needs to be established by a Dietitian that you are not accidently eating gluten. If it is found that you have been following a strict gluten free diet then you may benefit from trying the low FODMAP diet in combination with the gluten free diet to reduce symptoms.
It is strongly recommended that you consult a Dietitian, without professional advice it may be difficult to ensure a nutritionally adequate intake.
What separates these conditions is the area of digestive system (gastrointestinal tract) that becomes inflamed. In Crohn's this can be anywhere from the mouth to the rectum and in Ulcerative Colitis it is the large bowel (colon) and rectum only. Flare up of inflammation and remission is a feature of both conditions and together they are called Inflammatory Bowel Disease.
Although mainly treated by steroids and other medications temporary dietary change during a flare up of inflammation is sometimes required. Such as low residue diets (if there is narrowing of the bowel) and high protein & energy diets if there is poor absorption and/or weight loss. Diarrhoea, excessive wind, bloating and pain are common during a flare up but these symptoms can continue even when the inflammation is controlled and the person is in remission.
Fructose and lactose (both FODMAP's) malabsorption may be more common in people with IBD than the general population. The low FODMAP diet has been shown to effectively reduce these symptoms, in most people with IBD, when the inflammation has been successfully treated. If you have IBD but also experience the symptoms of IBS it may be beneficial for you to try the low FODMAP diet.
It is strongly recommended that you consult a Dietitian as without professional advice it may be difficult to ensure a nutritionally adequate diet.