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Food Sensitivity and Irritable Bowel Syndrome (IBS)

Updated: Jan 3

When a person feels difficulty in swallowing or digesting any kind of food, it is represented by food sensitivity. People may be sensitive to carbohydrates, proteins, fats and other nutrients and usually excessive intake of these nutrients can trigger food sensitivity.

However, there are various reasons behind food sensitivity, such as the absence of enzymes, psychological stress, celiac diseases, and others but IBS is the most common reason for food sensitivity [1]. In many cases food sensitivity and Irritable Bowel Syndrome may represent similar symptoms.


What is Irritable Bowel Syndrome (IBS)?

Irritable Bowel Syndrome (IBS) can be considered one of the gut diseases characterized by the malfunctioning of the digestive system of a person, specifically with the small and large intestines. It can be viewed as the food passing through the gastrointestinal tract or gut either too quickly or slow, sensitiveness of the gastrointestinal nerves, gut stress, and a family history of IBS also contribute to the incidence of IBS.

Recent studies present that IBS is mostly due to the changes or imbalances in the composition of bacteria present in the intestines, which is commonly termed as intestinal microbiota. The common symptoms of IBS include abdominal pain, diarrhea, bloating, and constipation. These symptoms can be lifelong and appear or disappear occasionally, lasting for some days, weeks, or sometimes a month.

An American study investigated the reasons behind the appearance and disappearance of the symptoms characterized by IBS and found that IBS symptoms are usually triggered by food and diet intake. However, the exact cause of IBS is still unknown, but changes in food sensitivity and diet intake relate to this disease [2].


Food Sensitivity vs Food Allergy

Food sensitivity can be defined as the adverse reactions to certain food items indicated by vomiting, abdominal cramps, diarrhea, bloating, nausea, headaches and migraine, runny nose, and gas. The primary cause of food sensitivity is gastrointestinal diseases including stomach and intestinal disorders.

However, most people misunderstood food sensitivity as food allergy as there is a marginal difference in both terms because food sensitivity is caused by gastrointestinal disorders while food allergy is caused by immunological intolerance to the food. The confusion between the two terms is due to the similarities in the terms but it is needed to rule out food sensitivity and allergy so that effective and corrective measures could be taken accordingly [1,3].

Food allergy is caused when the immune system of a person does not accept certain nutrients and reacts differently by releasing different chemicals in the blood, resulting in itching, swelling, skin diseases, dizziness, and anaphylaxis (a life-threatening allergic reaction due to difficulty in breathing, increased heart rate, lightheadedness, and losing consciousness) [3].


The connection between food sensitivity and Irritable Bowel Syndrome

As food sensitivity is characterized by gut disorders, many medical researchers suggest that IBS is the most common underlying cause of food sensitivity. On the other side, researchers have also found that most IBS patients are reported with food sensitivity specifically to a certain kind of diet [2].


The prevalence of food sensitivity in IBS patients often coincides with the prevalence of food intolerance in the United States, which ranges from 1% to 4% in US adults and about 6% in US children, although these rates are rapidly increasing. Mostly food sensitiveness is diagnosed in childhood whereas only 15% of food sensitiveness is diagnosed in adulthood. In developed and developing countries, it is generally represented that about 5% of the population suffers from IBS, where wheat consumption is higher.


Studies have shown that IBS patients are four times more likely to develop food sensitivity than the general population. Although the accuracy of diagnosing the connection between food sensitivity and IBS is questioned, because between 20% and 25% of the world population report different food sensitivities, however, the wide range of side effects and variation in the symptoms makes it difficult to diagnose food sensitivities related to the gut diseases and IBS [4].


Based on these interpretations, a European study investigated 193 IBS patients to discover the types of food that trigger the IBS symptoms and found that 19% of IBS patients reported food sensitivity when they consumed canned foods, whole cereals, processed meat, sweets, legumes, and fruit compotes. This represents that highly processed foods form gas in the gastrointestinal tract due to the higher carbohydrate levels [5].


Another Swedish study observed 197 IBS patients and revealed that 70% of patients showed different IBS symptoms when they consumed carbohydrate-rich foods such as dairy, flour, legumes, plums, and apple. However, this study also found that more than 84% of IBS patients were sensitive to more than one food including carbohydrates, proteins, and certain types of fats. This study concluded that certain food restrictions, including carbohydrate restriction, protein restriction, and FODMAP restriction (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) can help to treat IBS symptoms[5].


Another Korean study showed that most IBS patients experience physiological reactions to foods such as repetition of esophageal movement to swallow food, delay in gastric emptying due to slow stomach response to the food intake, difficulty in absorbing different food items (sugar, carbohydrates, and fats) resulting in diarrhea or constipation, and excessive flatulence [6].

However, an American study supported the idea of physiological reactions to foods as it observed 56 IBS patients and found that 91% of food sensitivity is triggered by the intake of excessive food at a time. Some IBS patients consumed a higher amount of sugar-rich food in a day followed by eating sweetened cereal for breakfast, chocolates after breakfast, sweets and desserts after lunch, sweetened shakes at snack time, and ice cream after dinner.

Similarly, excessively fatty foods, excessive legumes, and non-absorbable carbohydrate intake within a short period can trigger IBS symptoms in a patient [7].


Therefore, IBS patients should be cautious while taking any type of food and they should avoid excessive intake of any food nutrient so that food sensitivity and related symptoms do not appear frequently.



Food Sensitivity and Irritable Bowel Syndrome
Food Sensitivity and Irritable Bowel Syndrome

References

[1] Smith, E., Foxx-Orenstein, A., Marks, L. A., & Agrwal, N. (2020). Food Sensitivity Testing and Elimination Diets in the Management of Irritable Bowel Syndrome. Journal of Osteopathic Medicine, 120(1), 19-23.

[2] Soares, R. L. S. (2018). Irritable bowel syndrome, food intolerance and non-celiac gluten sensitivity. A new clinical challenge. Arquivos de gastroenterologia, 55, 417-422.

[3] Yaseen, F. T., Kadhim, N. K., & Obaid, R. M. (2021). Comparison between Food Intolerance and Food Hypersensitivity: A Review. Annals of the Romanian Society for Cell Biology, 25(6), 19059-19067.

[4] Catassi, C., Alaedini, A., Bojarski, C., Bonaz, B., Bouma, G., Carroccio, A., ... & Sanders, D. S. (2017). The overlapping area of non-celiac gluten sensitivity (NCGS) and wheat-sensitive irritable bowel syndrome (IBS): An update. Nutrients, 9(11), 1268.

[5] Hammer, H. F., Hammer, J., & Fox, M. (2019). Mistakes in the management of carbohydrate intolerance and how to avoid them. UEG Education, 19, 9-14.

[6] Lee, H. J., Kim, H. J., Kang, E. H., Jung, K. W., Myung, S. J., Min, Y. W., ... & Park, K. S. (2019). Self-reported food intolerance in Korean patients with irritable bowel syndrome. Journal of neurogastroenterology and motility, 25(2), 222.

[7] Soares, R. L. S. (2018). Irritable bowel syndrome, food intolerance and non-celiac gluten sensitivity. A new clinical challenge. Arquivos de gastroenterologia, 55, 417-422.




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