GUEST BLOG: IBS, Coeliac Disease or Both? The Overlap and What It Means for You

Geraldine Perez addresses the common links and misconceptions between IBS and Coeliac Disease

If you’re here, chances are you or someone you know is dealing with gut issues – bloating, stomach pain and cramping, excessive wind, diarrhoea, constipation or alternating between the two – and wondering, “Is it IBS? Could it be Coeliac Disease? Or maybe, is it both?”.

This article aims to unpack the overlap between IBS and Coeliac Disease, and what it means for you.

What’s IBS, and How Does Coeliac Disease Fit In?

Irritable Bowel Syndrome (IBS) is a functional gut disorder, meaning that the gut looks normal but isn’t functioning normally. Symptoms may include bloating, stomach pain and cramping, excessive wind, and changes in bowel habits (diarrhoea, constipation, or both).

Coeliac Disease, on the other hand, is an autoimmune condition where eating gluten (a protein found in wheat, barley, and rye) triggers the immune system to attack itself, specifically the small intestine, causing inflammation and damage.

If left untreated, this damage can lead to serious complications like nutrient deficiencies such as anaemia, osteoporosis, and infertility, to name a few.

Here’s the tricky part: IBS and Coeliac Disease share many similar symptoms; for instance, Coeliac Disease symptoms may be the exact same symptoms experienced by someone with IBS. And yes, you can have both conditions.

In fact, research shows that 20-30% of people with Coeliac Disease experience IBS-like symptoms even after starting a gluten-free diet.

When to Investigate IBS in Coeliac Disease

What happens when a Coeliac Disease diagnosis still follows IBS symptoms?

If you’ve been diagnosed with Coeliac Disease but continue to experience gut symptoms despite following a strict gluten-free diet, you may like to consider exploring the possibility of IBS if symptoms persist 6-12 months after diagnosis.

Your first step will be a visit back to your GP. The number one priority is to ensure that your Coeliac Disease is well managed, and this may be checked through blood tests referred by your GP. One of the blood tests should include Coeliac serology, as it can be used as a guide to measure your adherence to a strict gluten-free diet. You may also receive a referral back to your gastroenterologist, for further investigations, in some instances.

Assuming medical screening comes back clear, ask to be referred to a gut health dietitian such as the dietitians from our clinic, The Gut Friendly Dietitian, for personalised advice on managing the role that diet may be playing in your IBS-like symptoms.

Managing IBS: Non-Dietary Strategies

Diet isn’t the only way to manage IBS. Non-diet approaches are equally important for managing IBS symptoms, due to the complex nature of the condition, particularly involving the gut-brain connection, motility issues, and changes to the gut microbiome.

Some non-diet strategies may include:

1. Stress Management (targets the gut-brain connection)

• Gut-Directed Hypnotherapy: A specific type of hypnotherapy that helps you learn coping skills, which in turn addresses the miscommunication between your gut and brain and manages IBS symptoms.

• Cognitive Behavioural Therapy (CBT): A specific type of therapy that helps you to change unhelpful thoughts and behaviours to better manage stress, which in turn better manages IBS symptoms.

• Relaxation Techniques: Yoga, meditation, and mindfulness can switch off the stress response, which again, in turn, better manages IBS symptoms.

2. Medications

• Antispasmodics: Helps with pain and cramping.

• Antidiarrhoeals: Helps to slow diarrhoea.

• Laxatives: Helps to improve bowel regularity.

• There are also other medications and supplements not mentioned here that may help.

3. Probiotics

Some specific strains of probiotics may help reduce IBS symptoms; however, the evidence to-date remains conflicting.

4. Lifestyle Adjustments

Regular sleep, smaller and more frequent meals, and gentle exercise can help manage IBS symptoms.

Managing IBS: Dietary Strategies

In addition to remaining on a strict gluten-free diet, some dietary strategies that may assist in IBS management include:

1. Adjusting Eating Behaviours

Smaller, more frequent meals tend to be better tolerated, as is eating more slowly with thorough chewing of food.

2. Avoiding Gut Irritants

Limiting deep fried or fatty foods, spicy foods, excessive intakes of caffeine or alcohol, may help.

3. Adjusting Fibre and Fluid

Fibre intake may need to be adjusted up or down, and specific types of fibre may need to be considered. Fluid intake needs to be adequate for hydration, which is especially important in those with diarrhoea-predominant IBS; and for softening stools in those with constipation-predominant IBS.

4. Addressing Food Intolerances

A specialised and experienced dietitian, such as our dietitians from The Gut Friendly Dietitian, would be best suited for guidance in identifying potential food triggers, while providing support in maintaining good nutrition through the process.

Key Takeaways

Managing IBS in Coeliac Disease requires a holistic approach that combines strict gluten avoidance with strategies to address lingering gut symptoms. Whether it’s dietary adjustments, stress reduction, and/or medications, finding the right mix of strategies can help you regain control and feel better.

About Us: The Gut Friendly Dietitian

Image: thegutfriendlydietitian.com.au

At The Gut-Friendly Dietitian, Dietitians Geraldine and Chiara specialise in helping individuals navigate the complexities of digestive health. Whether you’re managing Coeliac disease, IBS, or other food intolerances, we provide personalised, evidence-based advice to help you feel better and enjoy food again.

If you’d like to book a consultation or learn more, contact us here:

• Email: dietitian@thegutfriendlydietitian.com.au

• Website: www.thegutfriendlydietitian.com.au

• Facebook/Instagram: @thegutfriendlydietitian

Listen to Geraldine In-Depth on IBS and Coeliac Links

We were lucky enough to have Geraldine as our guest on Episode 139 of A Gluten Free Podcast. Geraldine and Ben explore the symptoms, known causes and current management strategies for IBS. They also examine the low FODMAP diet, SIBO and how coeliac disease and a gluten free diet crosses over with IBS.