Randy Chandler
Irritable bowel syndrome (IBS) is a chronic condition that affects about 10 to 15% of Americans, causing symptoms like bloating, gas, abdominal pain, and changes in bowel habits. While there is no cure, certain foods and medications can worsen or alleviate these symptoms. Cheese, a dairy product, is a versatile ingredient loved for its diverse textures and flavours. However, it has varied effects on the digestive system and can be a source of concern for individuals with IBS. So, is cheese good or bad for IBS?
Is Cheese Good or Bad for IBS?
| Characteristics | Values |
|---|---|
| Protein | Cheese is a good source of protein, which is essential for muscle maintenance, immune function, and overall health. |
| Calcium | Cheese is a good source of calcium, which is important for bones, teeth, and nails. |
| Lactose | Cheese contains lactose, which may be difficult for people with IBS to digest. However, cheese is fairly low in lactose compared to other dairy foods such as milk, yogurt, and ice cream, especially harder cheeses like cheddar or parmesan. |
| Fat | Cheese is high in fat, which can slow down digestion and cause cramping and pain. However, fat can also contribute to a feeling of fullness and satisfaction, potentially reducing the urge to overeat or consume problematic foods. |
| Histamine | Cheese contains histamine, which can trigger bloating, gas production, and diarrhea. |
| FODMAPs | Cheese contains FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols), which are poorly absorbed in the small intestine and can lead to digestive distress. However, not all cheeses have the same FODMAP content, with some varieties being lower in FODMAPs than others. |
| Individual Tolerance | The impact of cheese on IBS symptoms varies from person to person. Some individuals may tolerate certain types of cheese or specific serving sizes better than others. |
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What You'll Learn
Lactose intolerance and IBS
Irritable bowel syndrome (IBS) and lactose intolerance can seem similar, as they cause nearly identical symptoms, including bloating, gas, abdominal pain, and changes in bowel habits. However, there are distinct differences between the two conditions in terms of their causes and management.
IBS is a chronic condition that affects about 10 to 15% of Americans. It can be caused by various factors, including food triggers, stress, anxiety, and problems with the signals between the brain and the nerves in the gut. While there is no cure for IBS, certain foods and medications can make the symptoms worse. Avoiding these triggers, reducing stress, getting adequate sleep, and minimizing highly refined processed foods can help manage the condition.
Lactose intolerance, on the other hand, occurs when the body cannot digest lactose, a sugar found in milk and other dairy products. It is caused by a deficiency of the enzyme lactase, which is produced in the small intestine and breaks down lactose. Lactose intolerance is very common, affecting about two-thirds of people worldwide, and can run in families. It is not a harmful condition, but it can lead to a lack of important nutrients like calcium and vitamin D, typically obtained from dairy products.
The main treatment for lactose intolerance is to avoid foods containing lactose, such as milk, cheese, and other dairy products. However, some people with lactose intolerance may be able to tolerate small amounts of lactose or may not need to eliminate dairy completely from their diet. A hydrogen breath test can be used to diagnose lactose intolerance, and a doctor or dietitian can help determine the appropriate dietary changes and supplements.
While cheese may trigger IBS symptoms due to its lactose content, high-fat content, or histamine levels, it is not necessarily off-limits for people with IBS. Some people with IBS may be able to tolerate cheese in small portions or opt for low-lactose cheeses like blue cheese or harder cheeses like cheddar or parmesan. Additionally, yogurt, with its live cultures that break down lactose, is less likely to cause IBS symptoms.
It is important to note that IBS and lactose intolerance are separate conditions, and it is possible to have both. However, there is no conclusive evidence of a link between the two. The diagnosis and management of IBS and lactose intolerance may overlap, but they require distinct approaches.
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High-fat content in cheese
Cheese is a dairy product that contains fats, including saturated fats, which should be consumed in moderation. Fats can slow down digestion, so independently of lactose levels, eating a lot of cheese could trigger IBS symptoms. This is because eating a high-fat meal causes gas to travel more slowly through the gut, which could create more cramping and pain.
Some people with IBS may find that they struggle to break down fats due to a lack of lipase, an enzyme produced in the small intestine. This production can be impaired by SIBO, but some people may be able to digest more foods, including cheese, after resolving SIBO. High-fat content in cheese can trigger diarrhoea for people with bile acid issues. Bile is released when we eat, helping to emulsify fats so they can be absorbed and used in the body.
While cheese is generally considered safe for people with IBS in small portions, high-fat varieties can slow down digestion, leading to loose stools and diarrhoea. Fried foods, which are typically cooked in high amounts of unhealthy oils, can be difficult for people with IBS to digest and process. Foods with exceptionally high amounts of fat and sugar can move quickly through the body undigested, resulting in diarrhoea and abdominal pain. Fatty and processed meats can cause inflammation and worsen IBS symptoms, so it is recommended to avoid sausage, bacon, pepperoni, salami, and marbled cuts of meat.
However, it is important to note that not all fats are harmful to people with IBS. Fatty fish, such as tuna, mackerel, and salmon, contain high amounts of omega-3 fatty acids, which are beneficial for heart health and can reduce inflammation linked to IBS. Nuts, which are high in healthy fats, are also an ideal snack for people with IBS as they promote good digestion and prevent diarrhoea and constipation.
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Histamine in cheese
Histamine is a compound involved in several biological functions, including immune and digestive processes. It is produced by the body and can also be found in varying amounts in different foods.
The impact of histamine on IBS symptoms is complex and varies from person to person. While some individuals with IBS may experience digestive symptoms directly related to histamine intake, others may have issues with the absorption or breakdown of histamine. For example, people with Small Intestinal Bacterial Overgrowth (SIBO) may have higher histamine levels due to reduced production of certain enzymes or increased bacterial production of histamine.
Additionally, histamine-releasing foods, such as milk, wine, and beer, can also contribute to IBS symptoms. These foods don't directly contain high levels of histamine but stimulate the release of histamine in the body. This release of histamine can trigger similar symptoms as those caused by high-histamine foods.
Managing histamine intake can be challenging due to the lack of accurate information about histamine levels in foods. However, individuals with IBS can experiment with a low-histamine diet or the low FODMAP diet, which has been shown to lower histamine levels. Consulting with a healthcare professional or a registered nutritional therapist can help individuals with IBS navigate these dietary changes effectively.
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Low-fibre content in cheese
Cheese is a versatile ingredient in many cuisines, enjoyed for its rich and varied textures and flavours. However, for individuals with IBS, it can be a source of concern due to its potential to trigger digestive issues. While the impact of cheese on IBS symptoms varies from person to person, it is important to understand how this dairy product may affect the digestive system.
Cheese can be a good source of protein and calcium, which are essential for muscle maintenance, immune function, bone health, and overall nutrition. The protein and fat content in cheese can also contribute to a feeling of fullness, potentially reducing the urge to overeat or consume problematic foods.
However, cheese can also be high in fat, which can slow down the digestive process and lead to cramping and pain. Additionally, cheese may contain natural sugars like lactose, which can be difficult for some people with IBS to digest. Lactose intolerance is common, and the inability to produce the enzyme lactase can lead to bloating, gas, and diarrhoea.
It is worth noting that not all cheeses are equal in their lactose content. Harder cheeses like cheddar or parmesan tend to have lower lactose levels, while softer, unripened cheeses like cottage cheese, cream cheese, and ricotta are higher in lactose. Blue cheese, due to its aging process, is also very low in lactose.
While the low-fibre content in cheese may not be a primary concern for individuals with IBS, it is still important to consider overall dietary fibre intake. Fibre helps regulate digestion, and while some people with IBS may find high-fibre foods difficult to digest, others may benefit from the relief it provides from constipation. It is recommended to work with a physician and nutritionist to gradually increase fibre intake and determine the appropriate level for managing IBS symptoms.
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Personal tolerance to cheese
The impact of cheese on IBS symptoms varies from person to person. While cheese can be a trigger for some, others may be able to tolerate it in smaller portions or opt for low-lactose alternatives.
Lactose intolerance is a common issue for people with IBS, with an estimated 33% of sufferers also dealing with some degree of lactose intolerance. Lactose is a sugar found in dairy products, and those with lactose intolerance do not produce enough lactase, the enzyme required to digest it. Symptoms such as bloating, gas, and diarrhoea can occur within 30 to 45 minutes of consuming lactose-containing foods. However, not all people with IBS are lactose intolerant, and some may be able to handle small amounts of low-lactose dairy products.
Cheese, in particular, can be problematic for people with IBS due to its high fat content. Fats can slow down digestion, leading to increased cramping and pain. High-fat foods can also trigger diarrhoea in individuals with bile acid malabsorption (BAM), which affects 25-30% of people with diarrhoea-predominant IBS.
To determine their personal tolerance to cheese, individuals with IBS can experiment with different types of cheese and portion sizes while tracking their symptoms in a food diary. This can help identify which cheeses, if any, are better tolerated. Consulting a healthcare practitioner or registered nutritionist specialising in digestive health can also provide tailored guidance.
While managing IBS, it is important to remember that dietary preferences and tolerance levels can change over time. Therefore, individuals should be open to adjusting their cheese consumption based on their current health status and symptom management.
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Frequently asked questions
Cheese can be a source of concern for individuals with IBS. It can influence the composition of the gut microbiome, potentially affecting how the digestive system functions. However, not everyone with IBS experiences symptoms in the same way, and different foods may trigger symptoms for different people.
Cheese is a dairy product, and lactose, a sugar found in dairy, can be difficult for people with IBS to digest. However, cheese is fairly low in lactose compared to other dairy foods, especially harder cheeses like cheddar or parmesan. Cheese is also high in fat, which can slow down digestion and cause digestive discomfort.
Aged cheeses are usually lower in lactose, so they may be better tolerated by people with IBS. Examples include cheddar, parmesan, and blue cheese.
Yes, it is important to remember that diet is not the only way to address IBS discomforts. Digestive disease experts advise patients living with IBS to work on reducing stress, getting adequate sleep, and minimizing highly refined processed foods in general. Adding fiber-rich foods to the diet can also help relieve constipation, although high-fiber foods may be difficult for some people with IBS to digest.
It can take weeks or months to determine which foods trigger your IBS symptoms. It is recommended to see a gastroenterologist regularly and keep a food diary to help identify which foods trigger your symptoms.
