New research has shed light on the potential safety of gluten and wheat consumption among patients with irritable bowel syndrome (IBS) and self-perceived sensitivities to either ingredient. A randomized, double-blind, sham-controlled crossover study found that only some patients reacted to gluten or wheat, despite learning that neither was triggering their symptoms.
The study involved 28 adult participants who met Rome IV criteria for IBS and had previously reported improvement on a gluten-free diet. Participants were randomly assigned to receive sequences of wheat, gluten, and sham containing flour in three periods, separated by 14-day washout periods.
Results showed no statistically significant differences in the proportion of patients with worsening IBS symptoms after consuming wheat or gluten compared to a sham challenge. The study also found that adverse events were similar between challenges, including minor gastrointestinal issues.
Notably, despite learning that neither gluten nor wheat was triggering their symptoms, most participants continued a gluten-free diet. This raises important implications for the potential perpetuation of IBS symptoms and malnutrition due to unnecessary dietary restrictions.
According to senior author Premysl Bercik, MD, PhD, some patients may truly have a sensitivity to gluten or wheat, while others may be driven by their own expectations and subsequent choices to avoid these foods. The study’s findings suggest that clinicians need to work further with patients to address the psychological aspect of dietary triggers and provide guidance on reintroducing gluten and wheat safely.
The low FODMAP diet is currently one of the most common recommended for individuals with IBS, but evidence about the degree to which food components exacerbate symptoms and whether patients’ expectations contribute to their symptoms and behaviors is not well understood.
Source: https://www.hcplive.com/view/study-finds-gluten-wheat-safe-most-ibs-patients-despite-self-perceived-sensitivities