What about the gluten-free diet? Will this help my symptoms?
A gluten-free diet is used to treat a condition called celiac disease, which has symptoms similar to IBS. To a somewhat lesser degree, this diet is similar to the popular Atkins Diet in the sense that, in both diets, the person is reducing carbohydrates (sugars). In the case of a gluten-free diet, you are switching your carbohydrates more to potato starches and to rice, and therefore to more simple carbohydrates. The complex carbohydrates are the ones that come from grain cereals, and that’s where gluten, which is believed to be the protein that causes celiac disease, comes from.
Some people often feel that they might have celiac disease, even though all their tests for it came back negative, because they do feel somewhat better on a gluten-free diet. This makes sense because, when you eliminate gluten-containing foods, you are also eliminating complex carbohydrates, and carbohydrates, like sugar, are what bacteria thrive upon. If you starve bacteria of carbohydrates, they cannot sustain their large numbers, so the degree of bacterial overgrowth actually drops. We believe that explains why IBS symptoms are less pronounced, including bloating. Again, though, while a gluten-free diet may provide benefit for IBS patients, it rarely is enough for eliminating the bacterial overgrowth, which should be the primary aim of any IBS treatment program.
To some extent we have confirmed this concept. In a study we published recently, we were able to completely eradicate bacterial overgrowth and facilitate a dramatic improvement in IBS using a nutritional product from Novartis, called Vivonex™ (see Chapter 6 of the book for full details). Vivonex is an elemental diet, which means the food that it contains is already completely predigested.
Therefore, when a person consumes this product, the food is absorbed so readily into the blood that the food does not travel much beyond the first 2 feet of small intestine (the absorbing area of the gut; the full length of the gut is 15 feet). In the case of bacterial overgrowth where, in most cases, the bacteria are further into the small intestine than 2 feet, the patient’s eating this type of food starves them. The ability to get rid of bacterial overgrowth with this type of diet for two weeks is nearly 90%. The problem is that this diet is very difficult to tolerate even for brief periods of time.