IBS and Sugar

IBS and Sugar – A Holistic Perspective

There’s a lot of polarization and controversy when it comes to the conundrum of irritable bowel syndrome (IBS) and sugar.  Is it okay to eat sugar when you have IBS? Or is it going to send you spiraling into a flare? Is sugar bad for IBS?  How do you explain symptoms of diarrhea after eating sugar?

The answer to each of those questions could be yes or no, depending on the context.

On the one hand, millions of mainstream healthcare providers are insisting that “sugar is sugar,” (or if it’s low FODMAP it’s fine), and hospitals throughout the U.S. continue to pump their patients with added sugar like it’s going out of style. (A conversation for another time!)

On the other hand, we’ve got “wellness culture” which villainizes sugar, insisting that if you have irritable bowel syndrome (IBS) and/or inflammatory bowel disease (IBD) and/or leaky gut, “sugar is evil.”

Then there’s me – a functional dietitian, holistic nutritionist, gut health expert and former IBS sufferer who likes to assess and address each and every case (and frequently asked questions) holistically from a multi-dimensional, 360-degree angle! 😎

This article about IBS and sugar is the culmination of evidence-based, cutting-edge research combined with a holistic mindset (aka discernment + critical thinking + reading between the lines), plus over a decade of hands-on personal and clinical experience via my own gut-healing journey and my functional nutrition practice.

Disclaimer:  This is not medical nutrition advice! Make sure to consult a doctor and registered dietitian if you’re navigating IBS or any type of medical condition.

Does sugar trigger IBS symptoms?

The good news is that table sugar (aka beet sugar, cane sugar, or “sucrose”) will usually NOT trigger IBS symptoms in most people.

Is sugar high or low FODMAP?

Many people with IBS and/or small intestinal bacterial overgrowth (SIBO) tend to react to carbohydrates that are higher in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols).  This is because high FODMAP carbohydrates are not well digested or absorbed, so they feed microbes in the intestines which ferment and cause IBS symptoms of gas, bloating, pain, cramping, diarrhea, heartburn, and/or constipation.

The good news is that table sugar is a low FODMAP sweetener, which means it’s not going to cause any kind of bacterial fermentation in your intestines.

On the other hand, there are always exceptions…

  • For example, if you have a sucrose intolerance, even though it is considered low FODMAP, sugar can most definitely trigger IBS symptoms.
  • People with a food sensitivity to cane sugar could be experiencing immediate or delayed-onset IBS-D symptoms from eating cane sugar.  Food sensitivities are tricky, becuase we can have a reaction up to 72-96 hours after consuming a reactive food.

There are also other ways that sugar can impact gut health, from a more chronic and functional standpoint (verses on the level of clinical, acute, symptom management) which I’ve noticed most practitioners are completely unaware of.

Candida and IBS

Candida albicans (“candida”) is a normal fungus that lives in the digestive tract of all humans.  It’s supposed to be a “symbiotic” dynamic which means we need it in certain quantities, and it needs us, in order to live.

However, when this type of fungus overgrows out of control in our gut and/or in our body systemically, it can create a whole bunch of problems.

  • For this reason, Candida is considered to be a type of “opportunistic” microbe which means we benefit from it in small amounts, but it will harm us from a chronic health standpoint when it grows in excess. (1)

An overgrowth or excessive amount of Candida albicans in the gut is often (not always, but in many cases) an underlying culprit and one of the root-causes associated with IBS and other types of gut issues. (2, 3, 4, 5)

If you can identify and address Candida overgrowth holistically, by depriving it of what it loves to eat, this is one way to help you reduce the degree of clinical or subclinical damage to your gut lining from the candida, gradually over time, via a root-cause approach.

Does sugar feed candida?

It depends on what you read and who you ask! For example…

  • A small study from 1999 didn’t find any correlation between refined carbohydrates (i.e. sugar) and the growth of candida.  (6)
  • A study from the 1993 found that mice who were fed water containing glucose (a form of sugar) had exponentially higher growth of Candida albicans in their poop, and they even had a 80% higher increase in “invasion of the gastric wall” by candida, compared to mice that were given plain water, or those given water with xylitol (a sugar alcohol). (7)
  • A more recent in-vitro study from 2017 concluded that glucose in the blood (but not fructose) directly feeds Candida albicans systemically. (8)
  • A very recent study from 2020 found that mice fed a high-sugar diet (versus those fed a low-sugar diet) ended up having much higher levels of E. coli and Candida, along with a slew of other problems linked to candida overgrowth and dysbiosis. (9)

In my clinic and in my online program, The Complete Gut Repair Roadmap, I meet my 1:1 and group clients where they are at, and make individualized recommendations case-by-case.

There are definitely people with IBS who end up having an underlying overgrowth of candida, and they seem to benefit from reducing their intake of refined sugars.

However, it’s not an “all-or-nothing” situation – sweeteners are on a spectrum, and no two people are going to benefit from the same set of parameters when it comes to sugar in their diet.

Dysbiosis and IBS

“Dysbiosis” is a fancy clinical way of describing an imbalance of microbes in your gut microbiome (the ecosystem of microbes that live in your gut).

Research is suggesting that IBS may also be caused by dysbiosis – aka, not enough healthy (probiotic) microbes in the gut, which allows for more “bad” unhealthy microbes to over-grow and interfere with our ability to digest food. (2, 3, 4, 5 , 10, 11, 12)

Does sugar feed bad bacteria?

Yes and no!

  • Multiple clinical studies over the years are finding that sugar seems to functionally pathogenic/inflammation-promoting “dysbiotic” microbes in the colon. (13, 13, 14, 15, 16,)
  • On the other hand, sugar doesn’t feed ferment in the intestines. (So, sugar isn’t usually a symptom trigger in cases of small intestinal bacterial overgrowth / “SIBO”).

Is sugar bad for IBS? (Final verdict)

Since sugar (“sucrose”) is low FODMAP, it isn’t likely to trigger IBS symptoms on the surface-level of symptom management.

But you notice sugar seems to directly trigger symptoms such as diarrhea, you may want to ask your doctor about running a sucrose breath test.  It might also be worth trying a low sucrose elimination diet (with clinical supervision and custom guidance), to rule out a sucrase-isomaltase deficiency.

If you’re thinking more long-term, and you’ve established via functional nutrition lab testing that you have a candida overgrowth and/or dysbiosis, replacing refined sugars with natural alternatives could potentially help to starve out candida or other unwanted, intrusive, unhealthy microbes in the colon over time, alongside other interventions as needed.  (This is not applicable if you have an eating disorder; make sure to consult your healthcare providers to get individualized recommendations around this.)

Related articles + more resources

I’ve got LOTS more to say about this stuff!  To learn more about how sugar and sweeteners impact your gut, check out the following articles:

There’s lots more to say about the complex world of IBS & gut health! If you’d like to keep learning, download my free guide: The 5 Most Common Diet Mistakes to AVOID When Healing Your Gut! Free Download - 5 Diet Mistakes to Avoid When Healing Your Gut - by Jenna Volpe RDN LD CLT

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Please feel free to share this article with someone you know who’s trying to navigate sugar and IBS. (Knowledge is power!) XX – Jenna

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