Thank you for this very interesting question. Patients with irritable bowel syndrome suffer from abdominal pain, abdominal bloating, loose bowel movements or constipation. Patients with lactose intolerance and luten sensitivity may share the same symptoms.

We are certain that symptoms of irritable bowel syndrome are triggered by certain foods. Multiple studies showed that exclusion of gas-producing foods can help. That means a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs), as well as lactose and gluten avoidance.

Multiple studies have also shown that gluten can alter bowel barrier function in patients with irritable bowel syndrome and lead to the development of symptoms. Lactose intolerance can coexist with gluten intolerance.

Patients should be evaluated for celiac disease prior to considering a gluten-free challenge.