Can high-oxalate foods worsen IBS symptoms?

Question

Hello doctor,

My sister is 30 and has been dealing with IBS for almost two years now. She frequently experiences terrible bloating episodes, and some days, the stomach cramps are unbearable for her. Recently, I read about oxalate overload testing and how it might be linked to IBS symptoms in some individuals. Her gastroenterologist only performed basic stool tests and a colonoscopy, which came back mostly normal.

She eats a lot of spinach, almonds, and sweet potatoes daily, thinking they are healthy, but could this be making her symptoms worse? As far as I know, her oxalate levels have never been checked. I would like to know if someone her age with IBS should ask their doctor about oxalate overload testing. Would this test actually change her treatment plan, or is it not particularly relevant for IBS patients her age?

Please guide.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have read your query, and I am sorry to hear about your discomfort. It is important to note that oxalate overload is not commonly recognized as a proven cause of irritable bowel syndrome (functional disorder of the gastrointestinal tract characterized by chronic abdominal pain, cramping, bloating, and altered bowel habits), which is why routine oxalate testing is generally not recommended for most IBS (irritable bowel syndrome) patients.

Foods such as spinach, almonds, and sweet potatoes are high in oxalates and may exacerbate symptoms in some individuals; however, IBS symptoms are more frequently related to FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) sensitivity, the type of fiber consumed, stress, or food intolerances.

Oxalate testing is primarily considered if a person also has:

Kidney stones.
Malabsorption issues.
Inflammatory bowel disease.
Unexplained high levels of oxalate in urine.

For typical IBS (irritable bowel syndrome) cases, oxalate testing usually does not significantly alter treatment plans.

A more effective approach includes:

Keeping a food and symptom diary.
Trying a supervised low-FODMAP diet.
Discussing common IBS (irritable bowel syndrome) triggers with a gastroenterologist or dietitian.

If she experiences warning signs such as weight loss, blood in the stool, anemia (deficiency of red blood cells), fever, or nighttime diarrhea, she should seek reevaluation.

I hope you find this information helpful.

Thank you for reaching out.