I spent a few days recently in Hamilton, where I spoke at the Gluten Free Food & Allergy Show. The popularity of the show, which was attended by thousands of people, speaks for the fact that issues with food – intolerances, allergies and other adverse reactions – are on the rise.
One of the most common problems relating to food is IBS, or Irritable Bowel Syndrome. This tricky condition affects up to one in seven Kiwis. Many people think their ‘grumbly tummy’ is just the way they’re made. A more sensitive gut can certainly run in families.
Food can be at least an irritant, and at worst a cause of IBS. Symptoms vary and include bloating, pain, diarrhoea, constipation and sometimes debilitating pain or a combination of symptoms. Talking to experts in this field has made two things clear: people don’t have to just put up with IBS symptoms, and expert help in determining which foods are problematic for you is invaluable. Trying to diagnose yourself may mean you end up eliminating some foods completely, which you may not need to do.
So where to start? Once you have seen your GP and eliminated serious illness, the next step is looking at food. For people with IBS symptoms, it’s important to test for coeliac disease, to eliminate this as a cause, and it’s important to do this before you adopt a gluten-free diet. If you test once you’re already avoiding gluten, chances are the test will come back normal and you will be no further ahead.
Assuming you are not coeliac, there are other culprits that could be causing issues. This is where confusion often arises, and where the help of an expert dietitian could save time and angst (and money, long term).
It’s useful to know that food allergy – such as milk or egg allergy – is rare in adults. It usually occurs in children, who often grow out of the allergy by adulthood. Intolerance can be another story, and there’s no blanket answer here – everyone is different.
Food chemicals are a possible cause of IBS symptoms. They include:
- Salicylates: Found in many fruits and vegetables; nuts, honey, tea, coffee, wine and beer.
- Amines: These come from the breakdown or fermentation of proteins. They are high in foods such as cheese, chocolate, wine, beer and some fruits and vegetables.
- Glutamate is one building block of protein. It is found in MSG (additive 621) and is high in ‘tasty’ foods such as tasty cheese, yeast extracts, soy sauce, gravies and tomato paste. Some fruit and vegetables are also very high in glutamate.
- The other things to consider with IBS are FODMAPs. FODMAPs are a group of carbohydrates that occur in many foods, which are poorly absorbed by some people, causing gut issues. FODMAPs are found in many foods including onion, garlic, beans, lentils, pears, apples, honey and milk. Not everyone with IBS will have a problem with all FODMAP foods.
The best way to determine which – if any – food components may cause issues for you is an elimination diet followed by challenges with individual foods. Again, expert help here is hugely valuable. For people with IBS, identifying the problem foods can be truly liberating and well worth the effort.
We have published several articles on FODMAPs, which you can