Medically reviewed by Onikepe Adegbola, MD, PhD
Many people with irritable bowel syndrome (IBS) are advised to avoid foods containing gluten, but scientific data regarding the role of gluten in worsening IBS symptoms are lacking. Recent developments have proven that FODMAPs—short-chain carbohydrates that some people cannot digest—is the culprit rather than gluten.
IBS is one of the most commonly seen gastrointestinal disorders that predominantly affect adults and is slightly more prevalent in women. With distressing symptoms like abdominal pain and altered bowel habits, IBS significantly affects the quality of life.
A recent study revealed that irritable bowel syndrome symptoms can be improved when FODMAPs are removed from a person’s diet. The FODMAP stands for – Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.
The study “A Comparison of the Low-FODMAPs Diet and a Tritordeum-Based Diet on the Gastrointestinal Symptom Profile of Patients Suffering from Irritable Bowel Syndrome-Diarrhea Variant (IBS-D): A Randomized Controlled Trial” was published in Clinical Nutrition MDPI.
However, the study demonstrated that adherence to a low FODMAP diet plan (LFD) for more than 12 weeks can be challenging. LFD requires continuous nutritional support to meet body requirements; hence, considering other dietary interventions can help reduce IBS symptoms.
According to the study “Implementation of the low FODMAP diet in functional gastrointestinal symptoms: A real-world experience” published in the Wiley Online Library, treatment of IBS requires an effective diet strategy. It is generally seen that certain foods containing fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) worsen IBS symptoms. When FODMAPs are metabolized by colonic bacteria, gas is produced in the colon. They also work as osmotic agents, meaning they increase the amount of water in the stool.
Although the LFD is an excellent treatment for IBS, it is difficult to stick to. Other dietary regimens that are beneficial cannot be ruled out. Alternative grains, such as Tritordeum appear to perform well among them. Tritordeum is a Spanish cereal made from durum wheat and wild barley hybrids. It is grown in Spain and Portugal, as well as in southern Italy.
A study, “Tritordeum: a novel cereal for food processing with good acceptability and a significant reduction in gluten immunogenic peptides in comparison with wheat” published in the Science of Food and Agriculture, indicates that Tritordeum has significantly lower levels of gliadins—proteins that cause many health problems in people with gluten intolerance. It also contains more nutritional fibers, proteins, and antioxidants than traditional wheat, as well as lower carbs and fructans.
Because of its gluten and fructan content, this cereal is not suitable for celiac disease (CD) patients; however, it may be suitable for people with non-celiac wheat sensitivity or irritable bowel syndrome with diarrhea (IBS-D) who experience abdominal bloating and would benefit from eliminating wheat from their diet.
A 12-week study evaluated the effect of a Tritordeum-based diet(TBD) in IBS-D patients. By consuming bread, bakery products, and pasta, patients demonstrated improved symptoms and overall improvement of the gastrointestinal barrier. The results of this study recommend that replacing other cereals with Tritordeum-based foods may improve the severity of IBS-D symptoms. The improvements in IBS-D symptoms may be due to an overall improvement in the integrity of the intestinal barrier.
Researchers have found that both diets LFD and TBD equally improve gastrointestinal symptoms and quality of life in patients with IBS. However, TBD can be considered a good alternative, especially in certain cultures like Italians, where pasta is the main diet.
The pathogenesis of irritable bowel syndrome (IBS) is complicated, involving motility abnormalities, visceral hypersensitivity, altered mucosal and immunological function, brain-gut connections, and post-infection reactions. Many popular and nutritious foods are high in FODMAPs and are osmotically active. Flatulence, diarrhea, and bloating are all possible side effects of eating these meals.
LFD must be followed for at least 3 months to show significant reductions in IBS symptoms. Adherence to the LFD, on the other hand, can be difficult because it necessitates ongoing guidance from a certified dietician as well as a severe restriction of otherwise healthful foods. A more easy method, such as replacing wheat-based foods with those made from a less immunogenic cereal like Tritordeum, would be a preferable alternative.
References:
Lovell, R. M., & Ford, A. C. (2012). Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association, 10(7), 712–721.e4. https://doi.org/10.1016/j.cgh.2012.02.029
Russo, F., Riezzo, G., Linsalata, M., Orlando, A., Tutino, V., Prospero, L., D’Attoma, B., & Giannelli, G. (2022). Managing Symptom Profile of IBS-D Patients With Tritordeum-Based Foods: Results From a Pilot Study. Frontiers in nutrition, 9, 797192. https://doi.org/10.3389/fnut.2022.797192
Russo, F., Riezzo, G., Orlando, A., Linsalata, M., D’Attoma, B., Prospero, L., Ignazzi, A., & Giannelli, G. (2022). A Comparison of the Low-FODMAPs Diet and a Tritordeum-Based Diet on the Gastrointestinal Symptom Profile of Patients Suffering from Irritable Bowel Syndrome-Diarrhea Variant (IBS-D): A Randomized Controlled Trial. Nutrients, 14(8), 1544. https://doi.org/10.3390/nu14081544
