Figuring out what to eat when you have intestinal issues likeirritable bowel syndrome (IBS)can sometimes be a real challenge. It can make it even more challenging when nutritional science is contradictory.
One of the more confusing subjects of nutritional advice has to do with one of the mainstays of our Western diet—wheat!
We’ll look at some of the current research on wheat and IBS, to help you to make an informed decision as to whether or not you should be eating wheat at all.
Stefka Pavlova / Getty Images
Before we get into the science, it is important to recognize that most of us are eating wheat in amounts and in ways never seen before. Wheat is traditionally found in bread, pasta, crackers, cookies, cakes, and other baked goods, but wheat products have now found their way into soups, condiments, and even ice cream.
Is Gluten the Problem?
Wheat and all of the many food products made with wheat contain the proteingluten(as do rye, barley, malt, and brewer’s yeast).
It is estimated that approximately 5% of people around the world have a gluten-related disorder,which encompassesceliac disease,wheat allergy, and non-celiac gluten sensitivity (NCGS). NCGS is also sometimes referred to as non-celiac wheat sensitivity (NCWS).
Because the symptoms of gluten-related disorders can look very similar to IBS (especially if the IBS has diarrhea as a symptom), the American College of Gastroenterology (ACG) recommends that blood tests for celiac disease be performed in anyone presenting with IBS and diarrhea. The ACG does not recommend routine food allergy testing, citing low sensitivity of allergy tests.
Non-celiac gluten sensitivity (NCGS)is relatively new diagnosis that describes people who experience gastrointestinal orextra-intestinal symptomsafter eating foods that contain gluten. NCWS occurs in people who experience these symptoms in the presence of any wheat compound.
Researchers have been conducting studies to see if a subset of IBS patients actually has NCGS instead.
These possible sensitivities would be diagnosed only if they occur repeatedly in the presence of certain foods, and only if CD and WA had been ruled out. The ACG does not think that these sensitivities are an immune response, and they recommend only doing allergy and food sensitivity testing on people who have consistent, reproducible results when exposed to the same food.
Stepping away from gluten for a moment, it should also be noted that there are other compounds within wheat that might play a role in any connection between wheat and IBS symptoms.
Maybe It’s a FODMAP Problem
Wheat also contains the carbohydrate fructan. Fructan is one of the fermentable carbohydrates collectively known asFODMAPsthat have been shown to exacerbate gastrointestinal symptoms in people who have IBS.
Some researchers theorize that it is fructan sensitivity that is behind what looks like a gluten sensitivity in IBS patients.This hypothesis is based on a small study in which people who had identified themselves as having NCGS reported improvement in their symptoms when placed on alow-FODMAP diet.
Should You Be Eating Wheat at All?
In addition to considering the effect that wheat has on stomach problems, there is the question as to whether or not wheat has negative effects on one’s overall health.Most of the wheat that is being consumed in the modern diet has been refined. This means that its bran andwheat germhave been removed.
Refined carbohydrates, such as non-whole-grain wheat, have been linked to the skyrocketing rates of obesity, diabetes, and cardiovascular diseases within our population.
But refined carbohydrates are not the whole picture when it comes to wheat. The U.S. Department of Agriculture recommends the consumption of whole-grain products, including whole-grain wheat, as an important part of a healthy diet.
Whole grains are considered to be nutritionally important due to their fiber content, as well as the fact that they are a source of some important vitamins and minerals.
On the other hand, Paleo diet enthusiasts and the authors of books like "Wheat Belly" and "Grain Brain" link wheat consumption, whether refined or whole grain, to all sorts of health ills.
Some people assert that eating grain is a relatively new phenomenon, and that our bodies were not evolved to properly digest foods such as wheat. They recommend grain-free diets for optimal health.
The Bottom Line
The bottom line is that the relationship between wheat consumption and IBS is complex.
As of now, most digestive health experts will agree that although there may be some crossover between IBS, wheat allergy, and NCGS, but most people eat wheat and don’t have IBS. Similarly, most IBS patients eat wheat without much problem.
The decision as to whether or not to continue eating wheat is a personal decision and one that is best made with a discussion with your healthcare provider.
If you think your IBS and overall health would benefit from a wheat-free trial, be sure that you have already been tested for celiac disease before trying anelimination diet.An elimination diet is the best way to see if eating wheat does make your IBS symptoms worse.
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17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.El Khoury D, Balfour-Ducharme S, Joye IJ.A review on the gluten-free diet: Technological and nutritional challenges.Nutrients. 2018;10(10):1410. Published 2018 Oct 2. doi:10.3390/nu10101410Shewry P.What Is gluten-Why is it special?.Front Nutr. 2019;6:101. Published 2019 Jul 5. doi:10.3389/fnut.2019.00101Elli L, Branchi F, Tomba C, et al.Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity.World J Gastroenterol. 2015;21(23):7110–7119. doi:10.3748/wjg.v21.i23.7110Roszkowska A, Pawlicka M, Mroczek A, Bałabuszek K, Nieradko-Iwanicka B.Non-celiac gluten sensitivity: a review.Medicina (Kaunas). 2019;55(6). doi: 10.3390/medicina55060222Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: Management of irritable bowel syndrome.Am J Gastroenterol.2021 Jan 1;116(1):17-44. doi: 10.14309/ajg.0000000000001036Sergi C, Villanacci V, Carroccio A.Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC Gastroenterology. 2021;21(1):5. doi: 10.1186/s12876-020-01568-6Barbaro MR, Cremon C, Stanghellini V, Barbara G.Recent advances in understanding non-celiac gluten sensitivity.F1000Res. 2018;7:F1000 Faculty Rev-1631. Published 2018 Oct 11. doi:10.12688/f1000research.15849.1Eswaran S, Goel A, Chey WD.What role does wheat play in the symptoms of irritable bowel syndrome?.Gastroenterol Hepatol (N Y).Okawa Y, Fukudo S, Sanada H.Specific foods can reduce symptoms of irritable bowel syndrome and functional constipation: a review.Biopsychosoc Med. 2019;13:10. Published 2019 May 8. doi:10.1186/s13030-019-0152-5Wong WM.Restriction of FODMAP in the management of bloating in irritable bowel syndrome.Singapore Med J. 2016;57(9):476–484. doi:10.11622/smedj.2016152Skodje GI, Sarna VK, Minelle IH, et al.Fructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity.Gastroenterology. 2018;154(3):529–539.e2. doi:10.1053/j.gastro.2017.10.040Koning F.Adverse effects of wheat gluten.Ann Nutr Metab. 2015;67 Suppl 2:8–14. doi:10.1159/000440989Aune D, Keum N, Giovannucci E, et al.Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies.BMJ. 2016;353:i2716. Published 2016 Jun 14. doi:10.1136/bmj.i2716U.S. Department of Health and Human Services and U.S. Department of Agriculture.Dietary Guidelines for Americans.Zopf Y, Reljic D, Dieterich W.Dietary effects on microbiota-new trends with gluten-free or paleo diet.Med Sci (Basel). 2018;6(4):92. Published 2018 Oct 18. doi:10.3390/medsci6040092Rej A, Sanders DS.Gluten-free diet and its ‘cousins’ in irritable bowel syndrome.Nutrients. 2018;10(11):1727. Published 2018 Nov 11. doi:10.3390/nu10111727Chey WD.Elimination diets for irritable bowel syndrome: Approaching the end of the beginning.Am J Gastroenterol. 2019;114(2):201–203. doi:10.14309/ajg.0000000000000099Additional ReadingBiesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR.No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.Gastroenterology. 2013;145(2):320-328.e3. doi: 10.1053/j.gastro.2013.04.051Sergi C, Villanacci V, Carroccio A.Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC Gastroenterology.Shahbazkhani B, Sadeghi A, Malekzadeh R, et al. “Non-celiac gluten sensitivity has narrowed the spectrum of irritable bowel syndrome: A double-blind randomized placebo-controlled trial"Nutrients.2015;7(6):4542-4554 doi: 10.3390/nu7064542
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.El Khoury D, Balfour-Ducharme S, Joye IJ.A review on the gluten-free diet: Technological and nutritional challenges.Nutrients. 2018;10(10):1410. Published 2018 Oct 2. doi:10.3390/nu10101410Shewry P.What Is gluten-Why is it special?.Front Nutr. 2019;6:101. Published 2019 Jul 5. doi:10.3389/fnut.2019.00101Elli L, Branchi F, Tomba C, et al.Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity.World J Gastroenterol. 2015;21(23):7110–7119. doi:10.3748/wjg.v21.i23.7110Roszkowska A, Pawlicka M, Mroczek A, Bałabuszek K, Nieradko-Iwanicka B.Non-celiac gluten sensitivity: a review.Medicina (Kaunas). 2019;55(6). doi: 10.3390/medicina55060222Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: Management of irritable bowel syndrome.Am J Gastroenterol.2021 Jan 1;116(1):17-44. doi: 10.14309/ajg.0000000000001036Sergi C, Villanacci V, Carroccio A.Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC Gastroenterology. 2021;21(1):5. doi: 10.1186/s12876-020-01568-6Barbaro MR, Cremon C, Stanghellini V, Barbara G.Recent advances in understanding non-celiac gluten sensitivity.F1000Res. 2018;7:F1000 Faculty Rev-1631. Published 2018 Oct 11. doi:10.12688/f1000research.15849.1Eswaran S, Goel A, Chey WD.What role does wheat play in the symptoms of irritable bowel syndrome?.Gastroenterol Hepatol (N Y).Okawa Y, Fukudo S, Sanada H.Specific foods can reduce symptoms of irritable bowel syndrome and functional constipation: a review.Biopsychosoc Med. 2019;13:10. Published 2019 May 8. doi:10.1186/s13030-019-0152-5Wong WM.Restriction of FODMAP in the management of bloating in irritable bowel syndrome.Singapore Med J. 2016;57(9):476–484. doi:10.11622/smedj.2016152Skodje GI, Sarna VK, Minelle IH, et al.Fructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity.Gastroenterology. 2018;154(3):529–539.e2. doi:10.1053/j.gastro.2017.10.040Koning F.Adverse effects of wheat gluten.Ann Nutr Metab. 2015;67 Suppl 2:8–14. doi:10.1159/000440989Aune D, Keum N, Giovannucci E, et al.Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies.BMJ. 2016;353:i2716. Published 2016 Jun 14. doi:10.1136/bmj.i2716U.S. Department of Health and Human Services and U.S. Department of Agriculture.Dietary Guidelines for Americans.Zopf Y, Reljic D, Dieterich W.Dietary effects on microbiota-new trends with gluten-free or paleo diet.Med Sci (Basel). 2018;6(4):92. Published 2018 Oct 18. doi:10.3390/medsci6040092Rej A, Sanders DS.Gluten-free diet and its ‘cousins’ in irritable bowel syndrome.Nutrients. 2018;10(11):1727. Published 2018 Nov 11. doi:10.3390/nu10111727Chey WD.Elimination diets for irritable bowel syndrome: Approaching the end of the beginning.Am J Gastroenterol. 2019;114(2):201–203. doi:10.14309/ajg.0000000000000099Additional ReadingBiesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR.No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.Gastroenterology. 2013;145(2):320-328.e3. doi: 10.1053/j.gastro.2013.04.051Sergi C, Villanacci V, Carroccio A.Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC Gastroenterology.Shahbazkhani B, Sadeghi A, Malekzadeh R, et al. “Non-celiac gluten sensitivity has narrowed the spectrum of irritable bowel syndrome: A double-blind randomized placebo-controlled trial"Nutrients.2015;7(6):4542-4554 doi: 10.3390/nu7064542
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
El Khoury D, Balfour-Ducharme S, Joye IJ.A review on the gluten-free diet: Technological and nutritional challenges.Nutrients. 2018;10(10):1410. Published 2018 Oct 2. doi:10.3390/nu10101410Shewry P.What Is gluten-Why is it special?.Front Nutr. 2019;6:101. Published 2019 Jul 5. doi:10.3389/fnut.2019.00101Elli L, Branchi F, Tomba C, et al.Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity.World J Gastroenterol. 2015;21(23):7110–7119. doi:10.3748/wjg.v21.i23.7110Roszkowska A, Pawlicka M, Mroczek A, Bałabuszek K, Nieradko-Iwanicka B.Non-celiac gluten sensitivity: a review.Medicina (Kaunas). 2019;55(6). doi: 10.3390/medicina55060222Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: Management of irritable bowel syndrome.Am J Gastroenterol.2021 Jan 1;116(1):17-44. doi: 10.14309/ajg.0000000000001036Sergi C, Villanacci V, Carroccio A.Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC Gastroenterology. 2021;21(1):5. doi: 10.1186/s12876-020-01568-6Barbaro MR, Cremon C, Stanghellini V, Barbara G.Recent advances in understanding non-celiac gluten sensitivity.F1000Res. 2018;7:F1000 Faculty Rev-1631. Published 2018 Oct 11. doi:10.12688/f1000research.15849.1Eswaran S, Goel A, Chey WD.What role does wheat play in the symptoms of irritable bowel syndrome?.Gastroenterol Hepatol (N Y).Okawa Y, Fukudo S, Sanada H.Specific foods can reduce symptoms of irritable bowel syndrome and functional constipation: a review.Biopsychosoc Med. 2019;13:10. Published 2019 May 8. doi:10.1186/s13030-019-0152-5Wong WM.Restriction of FODMAP in the management of bloating in irritable bowel syndrome.Singapore Med J. 2016;57(9):476–484. doi:10.11622/smedj.2016152Skodje GI, Sarna VK, Minelle IH, et al.Fructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity.Gastroenterology. 2018;154(3):529–539.e2. doi:10.1053/j.gastro.2017.10.040Koning F.Adverse effects of wheat gluten.Ann Nutr Metab. 2015;67 Suppl 2:8–14. doi:10.1159/000440989Aune D, Keum N, Giovannucci E, et al.Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies.BMJ. 2016;353:i2716. Published 2016 Jun 14. doi:10.1136/bmj.i2716U.S. Department of Health and Human Services and U.S. Department of Agriculture.Dietary Guidelines for Americans.Zopf Y, Reljic D, Dieterich W.Dietary effects on microbiota-new trends with gluten-free or paleo diet.Med Sci (Basel). 2018;6(4):92. Published 2018 Oct 18. doi:10.3390/medsci6040092Rej A, Sanders DS.Gluten-free diet and its ‘cousins’ in irritable bowel syndrome.Nutrients. 2018;10(11):1727. Published 2018 Nov 11. doi:10.3390/nu10111727Chey WD.Elimination diets for irritable bowel syndrome: Approaching the end of the beginning.Am J Gastroenterol. 2019;114(2):201–203. doi:10.14309/ajg.0000000000000099
El Khoury D, Balfour-Ducharme S, Joye IJ.A review on the gluten-free diet: Technological and nutritional challenges.Nutrients. 2018;10(10):1410. Published 2018 Oct 2. doi:10.3390/nu10101410
Shewry P.What Is gluten-Why is it special?.Front Nutr. 2019;6:101. Published 2019 Jul 5. doi:10.3389/fnut.2019.00101
Elli L, Branchi F, Tomba C, et al.Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity.World J Gastroenterol. 2015;21(23):7110–7119. doi:10.3748/wjg.v21.i23.7110
Roszkowska A, Pawlicka M, Mroczek A, Bałabuszek K, Nieradko-Iwanicka B.Non-celiac gluten sensitivity: a review.Medicina (Kaunas). 2019;55(6). doi: 10.3390/medicina55060222
Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: Management of irritable bowel syndrome.Am J Gastroenterol.2021 Jan 1;116(1):17-44. doi: 10.14309/ajg.0000000000001036
Sergi C, Villanacci V, Carroccio A.Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC Gastroenterology. 2021;21(1):5. doi: 10.1186/s12876-020-01568-6
Barbaro MR, Cremon C, Stanghellini V, Barbara G.Recent advances in understanding non-celiac gluten sensitivity.F1000Res. 2018;7:F1000 Faculty Rev-1631. Published 2018 Oct 11. doi:10.12688/f1000research.15849.1
Eswaran S, Goel A, Chey WD.What role does wheat play in the symptoms of irritable bowel syndrome?.Gastroenterol Hepatol (N Y).
Okawa Y, Fukudo S, Sanada H.Specific foods can reduce symptoms of irritable bowel syndrome and functional constipation: a review.Biopsychosoc Med. 2019;13:10. Published 2019 May 8. doi:10.1186/s13030-019-0152-5
Wong WM.Restriction of FODMAP in the management of bloating in irritable bowel syndrome.Singapore Med J. 2016;57(9):476–484. doi:10.11622/smedj.2016152
Skodje GI, Sarna VK, Minelle IH, et al.Fructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity.Gastroenterology. 2018;154(3):529–539.e2. doi:10.1053/j.gastro.2017.10.040
Koning F.Adverse effects of wheat gluten.Ann Nutr Metab. 2015;67 Suppl 2:8–14. doi:10.1159/000440989
Aune D, Keum N, Giovannucci E, et al.Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies.BMJ. 2016;353:i2716. Published 2016 Jun 14. doi:10.1136/bmj.i2716
U.S. Department of Health and Human Services and U.S. Department of Agriculture.Dietary Guidelines for Americans.
Zopf Y, Reljic D, Dieterich W.Dietary effects on microbiota-new trends with gluten-free or paleo diet.Med Sci (Basel). 2018;6(4):92. Published 2018 Oct 18. doi:10.3390/medsci6040092
Rej A, Sanders DS.Gluten-free diet and its ‘cousins’ in irritable bowel syndrome.Nutrients. 2018;10(11):1727. Published 2018 Nov 11. doi:10.3390/nu10111727
Chey WD.Elimination diets for irritable bowel syndrome: Approaching the end of the beginning.Am J Gastroenterol. 2019;114(2):201–203. doi:10.14309/ajg.0000000000000099
Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR.No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.Gastroenterology. 2013;145(2):320-328.e3. doi: 10.1053/j.gastro.2013.04.051Sergi C, Villanacci V, Carroccio A.Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC Gastroenterology.Shahbazkhani B, Sadeghi A, Malekzadeh R, et al. “Non-celiac gluten sensitivity has narrowed the spectrum of irritable bowel syndrome: A double-blind randomized placebo-controlled trial"Nutrients.2015;7(6):4542-4554 doi: 10.3390/nu7064542
Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR.No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.Gastroenterology. 2013;145(2):320-328.e3. doi: 10.1053/j.gastro.2013.04.051
Sergi C, Villanacci V, Carroccio A.Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC Gastroenterology.
Shahbazkhani B, Sadeghi A, Malekzadeh R, et al. “Non-celiac gluten sensitivity has narrowed the spectrum of irritable bowel syndrome: A double-blind randomized placebo-controlled trial"Nutrients.2015;7(6):4542-4554 doi: 10.3390/nu7064542
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