Navigating coeliac disease and IBS: How proper nutrition leads to symptom relief

Leading consultant specialist gastroenterologist and GI immunology researcher Dr Michael Fitzpatrick takes an expert look at coeliac disease and IBS, and how symptom relief can come through proper nutrition.

Understanding coeliac disease and IBS

Coeliac disease and irritable bowel syndrome (IBS) are two distinct conditions that affect the digestive system, yet they often share similar symptoms, making diagnosis and management a challenge. Coeliac disease is an autoimmune disorder, which is triggered by the ingestion of gluten. Gluten is a protein that’s in wheat, barley, and rye. When a person with coeliac disease consumes gluten, their immune system attacks the lining of the small intestine, causing damage and hindering nutrient absorption.

IBS, on the other hand, is a functional gastrointestinal disorder, meaning there is no structural abnormality, but the gut doesn’t function properly. IBS presents with symptoms such as abdominal pain, bloating, diarrhoea and constipation. Although the exact cause is unknown, triggers often include stress, certain foods, and hormonal changes.

How do coeliac disease and IBS differ?

While coeliac disease requires the complete elimination of gluten from the diet, IBS is typically managed through dietary adjustments that target specific triggers. It’s important to note that some individuals may have both conditions, making careful dietary management even more crucial. Accurate diagnosis of coeliac disease is important, as other aspects of an individual's care must be considered, including vitamin and mineral deficiencies, bone density and bone health, family screening for the condition, and follow-up to ensure intestinal healing. 

The role of nutrition in managing coeliac disease

For those with coeliac disease, the cornerstone of symptom relief is adhering to a strict gluten-free diet. This means avoiding all foods containing wheat, barley, and rye, as even small amounts of gluten can trigger a reaction and damage the small intestine. Proper nutrition for someone with coeliac disease involves:

• Reading labels carefully to avoid hidden sources of gluten
• Opting for naturally gluten-free foods such as fruits, vegetables, lean meats, and dairy
• Choosing gluten-free grains like rice, quinoa, and gluten-free oats

For many people, symptom relief and gut healing begin within weeks of starting a gluten-free diet, though full recovery of the intestinal lining can take several months or even years, depending on the severity of the damage.

How can I manage my IBS with nutrition?

Unlike coeliac disease, IBS doesn’t have a one-size-fits-all dietary solution. However, certain strategies can help alleviate symptoms:

• FODMAP diet: Reducing or eliminating foods high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) has been shown to help some individuals with IBS. These foods are poorly absorbed in the gut and can trigger bloating and discomfort.
• High-fibre foods: For those with constipation-predominant IBS, increasing fibre intake from sources like whole grains, fruits, and vegetables can improve bowel regularity.
• Hydration: Drinking enough water throughout the day helps prevent constipation and promotes digestive health.
• Regular meal times: Eating smaller, frequent meals can help reduce the intensity of IBS symptoms.

How does proper nutrition bring relief?

Both conditions benefit greatly from tailored dietary approaches that consider individual triggers and sensitivities. In coeliac disease, strictly avoiding gluten is essential to long-term health and symptom management. For IBS, identifying and eliminating specific food triggers, whether it’s through a low-FODMAP diet or other personalised plans, can significantly reduce discomfort and improve quality of life.

By following these nutritional strategies, individuals with coeliac disease and IBS can experience significant symptom relief, better digestive health, and an improved overall well-being.

Do you have coeliac disease, or looking for relief from your IBS symptoms? Arrange a consultation with Dr Fitzpatrick via his Top Doctors profile.