new member packet
2024 DIGESTIVE HEALTH:
CELIAC DISEASE GUIDE
Table of Contents
·
How It Develops; Symptoms:
Digestive Symptoms; Neurological Symptom; Skin Disorders; Bone & Joint Symptoms; Dental Issues
·
Causes of Celiac Disease Development
·
Treatment: A Strict Gluten-Free Diet
·
Prevention?
·
Talking to a Knowledgeable Provider or Dietitian
·
Maintaining a Gluten-Free Diet
Foods to
Avoid
Diet Tips
Frequently
Asked Questions (FAQ’s)
● How
Many Celiac Patients Don’t Follow a Gluten-Free Diet (GFD)?
● Consequences of Not Treating Celiac Disease
● What Should you Do When
You Accidentally Eat Gluten?
● What Triggers Celiac
Disease Later in Life?
● Celiacs Should Follow a
STRICT Gluten-Free Diet
● Irritable
Bowel Syndrome (IBS)
● Foods that May Trigger IBS Attacks
● Low
FODMAP Diet
● What Makes Gluten
Intolerance Different from Celiac Disease?
● Living
with Celiac Disease: A Guide to the Gluten-Free
Lifestyle
● Gluten-Free
Meal Planning
● Create
a Gluten-Free Pantry
● GF
Grains & Flours
● GF Alternative
Binders and Thickeners
● GF
Condiments, Sauces and Seasonings
● FAQ’s
● Protecting Yourself from
Possible Gluten in Medication. Look for
Wheat Starch
● Gluten in Vitamins and
Supplements
Currently, there is
no law mandating that drug manufacturers disclose the source of these
excipients in any public record or database, so we must rely on calling the
manufacturer to obtain information.
Some drug companies
are transparent with their information, while others either give incomplete or
even false information. Often, you are told that the company does not use any
gluten in the manufacturing of their product, but they won’t guarantee that it’s
gluten-free.
As a consumer, how
do you protect yourself when trying to obtain information regarding the gluten
status of a drug when the information you are receiving is either incomplete or
questionable? By looking at the excipients, you can get a pretty
clear picture of the potential for contamination. It is highly unlikely that any
excipient other than starch will contain any measurable amount of gluten.
As mentioned
earlier, the most likely source of gluten contamination will come from starch.
It is highly unlikely that any excipient other than starch will contain any
measurable amount of gluten.
When the excipient
listed for the product contains the single word “starch,” it can come from any
starch source. In the food industry, plain starch must be derived from corn,
but this regulation does not apply to the pharmaceutical industry.
A second type of
starch is pre-gelatinized starch. This is primarily derived from corn,
but it can be derived from any source. A third type of starch is sodium
starch glycolate. This is primarily derived from potato, but occasionally
derived from corn. Like pre-gelatinized starch, sodium starch glycolate can be
derived from any starch source. Often times, the ingredients are actually
listed as corn starch, which makes it easy to identify the source.
Finally, there is
the rare occasion when you see the words “wheat starch.” By
using the two FDA websites mentioned above, you can frequently find the source
of the starch.
Using the
information provided above, you can make an educated decision to take that
product or look for a substitute. If you are told by the company that they do
use gluten in their product, ask them to disclose what the source of the gluten
is.
If they tell you
they use wheat starch, naturally you would avoid using the product. If they tell you it is derived
from a wheat source, the chances are that they are referring to
one of the sugar alcohols, also known as polyols. These
are highly processed sugars that contain no wheat gluten, and
therefore cannot cause a reaction. Examples of these sugar alcohols are
mannitol, sorbitol, sorbitan, maltitol, xylitol, lactitol, erythritol, and
hydrogenated starch hydrolysates. Another misrepresented
ingredient is wheat maltodextrin, or plain maltodextrin.
Vitamin and mineral
therapy can be used in addition to the standard gluten-free diet to hasten a
patient’s recovery from nutritional deficiency. However, certain ingredients in
vitamins and supplements – typically the inactive ingredients – can
contain gluten, so extra care must be taken to avoid any gluten exposure.
There is a variety
of nutritional deficiencies associated with celiac disease, primarily caused by
the inability of the damaged small intestine to properly absorb enough of the
nutrients our bodies need. People recently diagnosed with celiac disease are
commonly deficient in fiber, iron, calcium, magnesium, zinc, folate, niacin,
riboflavin, vitamin B12, and vitamin D, as well as in calories and protein.1
Deficiencies in
copper and vitamin B6 are also possible, but less common. A study from 2002 by
Bona et. al.2 indicated that the delay in puberty in children with
celiac disease may partially be due to low amounts of B vitamins, iron, and
folate.
Patients with
celiac disease frequently report non-specific dermatological issues, including
dry skin, easy bruising, brittle nails, and thinning hair. Zinc deficiency is
particularly associated with these skin lesions. Iron, zinc, and fat-soluble
vitamins are most often deficient in patients with newly diagnosed celiac
disease.3
After treatment
with a strict gluten-free diet, most patients’ small intestine recovers and are
able to properly absorb nutrients again, and therefore do not require
supplementation. For certain patients however, nutrient supplements may be
beneficial.
The quality of
gluten-free products on the market today also poses some challenges to thriving
on the gluten-free diet. Though the gluten-free market has grown immensely over
recent years, and is still growing, many gluten-free products are not enriched
and have lower amounts of folate, iron, thiamin, niacin, fiber, and riboflavin.
Furthermore,
studies show that patients on a gluten-free diet tend to consume a higher
amount of calories from fat, and less from carbohydrates. Following a strict
gluten-free diet while maintaining proper nutrition can be very challenging.
Celiac
disease is an autoimmune disease in which the body mistakenly attacks itself,
damaging the lining in the intestine after ingesting gluten.
People
with celiac disease must avoid all gluten, a protein found in wheat, rye,
barley, and certain oats. The only treatment for celiac disease is following a strict
gluten-free diet.
This
article discusses celiac disease's symptoms, causes, diagnosis, and
treatment.
About 2
million people in the United States and 1% of the worldwide population has
celiac disease. However, many people have not been diagnosed.1 People
predisposed to celiac disease usually have a family history or specific genes
that increase their risk of developing it.
Celiac disease occurs mostly in people
who have a genetic predisposition
to the
condition, due to abnormalities
in the human leukocyte antigen (HLA) genes (opens in new tab) that are located on chromosome
6. These genes code for HLA proteins,
whose function is to bind
bits of infectious pathogens, like viruses, and alert the immune system to the
invaders' presence. Mutations in these genes can cause the body to mistake its
own tissues as a threat and attack them.
Multiple
factors can increase the risk of developing celiac disease. People who have
first-degree relatives with celiac disease are at increased risk. People
who develop celiac disease also are likely to have one of these two main genes:
HLA-DQ2 and HLA-DQ8. However, not
everyone with these genes develops celiac disease.
Celiac
disease occurs more often in people assigned female at birth. It is also more common in people with other
health conditions, such as:
Of the 30% of people who have the
HLA-DQ2 and HLA-DQ8 genes, about 3% develop celiac disease.
Celiac
disease can develop at any time, and symptoms are highly individual. Children
may experience symptoms as soon as gluten is introduced to their diet, while
others may not have symptoms for many years. Some people also get misdiagnosed
due to unconventional symptoms, while others can have celiac disease without
any symptoms.
Because celiac disease is a systemic (body-wide) condition that impairs
the body's ability to absorb nutrients, symptoms can affect any body system. Celiac disease manifests in a diverse range
of symptoms, making it challenging to diagnose.
Some people experience digestive
symptoms, while others experience symptoms affecting other parts of the body.
This wide
range of symptoms includes:
Children with undiagnosed celiac disease may
experience weight loss, failure to thrive, short stature, and delayed puberty.
Other symptoms
may include:
Who is at a Greater Risk? Anyone can develop celiac disease, but you
may be at a higher risk if you:
When Should you see a Doctor
or Go to the Hospital?
Do not start eating gluten-free until
after you have been tested for celiac disease, as doing so can affect your
results. You may even be
able to find GI at a medical center that specializes in celiac disease and
gluten intolerance (not
necessarily in Houston). Before your
appointment, try to keep a log of your symptoms and what you eat.
See your healthcare provider if you or
your child has had diarrhea or digestive discomfort for two weeks or more. You
should see your healthcare provider before you try a gluten-free diet as that
can change the test results.
All first-degree family members
(parents, siblings, and children) of people diagnosed with celiac disease
should be tested, as their risks increase to a 1 in 10 chance, even for those
with no symptoms.
Celiac disease can masquerade as many,
many other conditions. However, having some (or many) of these symptoms doesn't
mean you necessarily have celiac disease—it just means you should consider being tested for the condition.
To make a
diagnosis, your doctor may perform a combination of blood tests, genetic
testing, and a biopsy of the small intestine. Early diagnosis and intervention
of this autoimmune disorder can prevent long-term complications by making
lifestyle changes, following a gluten-free diet, and taking vitamins and
dietary supplements to counter any deficiencies.
How is
celiac disease treated?
If you are diagnosed
with celiac disease, your provider will likely recommend that you follow a strict
gluten-free diet for the rest of your life. This type of diet will help
treat or prevent many of the symptoms and other health problems caused by the
disease. Your provider may also provide medication to treat or prevent
dermatitis herpetiformis, corticosteroids for severe inflammation that is not
responding fast enough to the diet, and nutritional supplements to replace any
serious deficiencies.
People with untreated celiac disease may
have dermatitis herpetiformis, an itchy
blistering rash that usually occurs on the buttocks, back, scalp, elbows, and
knees.
To get diagnosed with celiac disease, you should
discuss your symptoms with a healthcare provider or gastroenterologist. They will
likely draw blood to check for antibodies associated
with celiac disease, as well as do an endoscopy. During the
endoscopy, a healthcare provider may also perform a biopsy by taking a small
sample of your intestine to be analyzed in a lab.
Diagnosing celiac disease can be complex, but it should
begin with a thorough patient history and physical examination. A combination
of any of the following suggests celiac disease:
In many cases, celiac disease can be
difficult to confirm, because other serious gastrointestinal conditions, such
as inflammatory bowel disease and ulcers, cause similar symptoms. These other
diseases can be ruled out through additional testing, which can include the
checking of stool samples for signs of blood, as well as imaging tests.
If a patient does not suffer from
malnutrition, doctors should consider that the person's gastrointestinal
problems might be the result of a very common condition called irritable bowel syndrome [IBS], which frequently results from intolerance to
one or more FODMAPs. One particular FODMAP to which people are
often intolerant is lactose, the kind of sugar that's in milk, but there are
other types of FODMAP intolerance that cause dietary distress following the
ingestion of other things, such as beans and grains.
If you suspect you have celiac disease,
you should not stop eating gluten before your tests. Avoiding gluten can impact your results.
The
only treatment for celiac disease is following a strict gluten-free diet. The best
way to adhere to and fully understand gluten-free eating while ensuring you
have an adequate intake of essential vitamins and minerals is to work with a
registered dietitian specializing in
celiac diseases.
While medications and vaccines have been
investigated, no alternative treatment to a gluten-free diet exists.
Eating a gluten-free diet may
seem overwhelming initially, but once you understand the fundamentals and know
what ingredients to avoid, it should become second nature. Many foods are
naturally gluten-free, including:7
Variations of your favorite
gluten-containing foods, such as pasta, are also available in gluten-free
forms. There is a variety of bean-based pasta on the market and gluten-free
pasta made from corn or other types of gluten-free grains.
Get used to reading food labels for
possible gluten when you shop or use products for cooking at home.
If you have celiac disease, you
must avoid all foods containing gluten. Gluten can be found in wheat, rye, and
barley. Wheat includes spelt, kamut, farro, durum, and products like bulgur and
semolina. Triticale, a wheat and
rye hybrid, also contains gluten. Products containing these ingredients include
bread, cereals, bread crumbs, crackers, bars, cookies, cakes, pastries, and
frozen pizza.
While oats are naturally gluten free,
it's important to check labels for gluten-free certification to ensure they
have not been cross-contaminated, meaning they have come into contact with
other gluten-containing products during processing.
Other food sources that contain gluten
are processed products that use malt, malt extract, and brewer's yeast. Colors,
flavors, starches, and thickeners can also contain gluten and are often added
to processed foods. You may need to avoid hot dogs, candy, condiments,
sausages, ice cream, salad dressing, and soups; read labels for possible
gluten.
Gluten free does not mean grain free.
Gluten-free whole grains provide important vitamins and minerals, including B
vitamins, iron, magnesium, zinc, and selenium. Whole grains also provide a rich
source of fiber, which helps balance the digestive system. Familiarize yourself
with:
● Amaranth
You also don't need to spend much money
on gluten-free foods by focusing on eating naturally gluten-free foods. Create
meals based on vegetables, lean proteins, and healthy fats. Nutrient-dense
carbohydrate choices may include regular and sweet potatoes, beans, peas, corn,
and squashes.
If you want to find gluten-free options
that are portable, quick, and comparable to your favorite snack foods, know
that there are plenty of options in that area, too.
When
preparing gluten-free foods, it is important to avoid cross-contact.
Cross-contact occurs when foods or ingredients come into contact with gluten,
generally through shared utensils or a shared cooking/storage environment. In
order for food to be safe for someone with celiac disease, it must not
come into contact with food containing gluten.
When unable
to verify ingredients for a food item or if the ingredient list is
unavailable do not eat it. Adopting a strict gluten-free
diet is the only known treatment for those with gluten-related disorders.
1.
According to
the FDA, if a food contains wheat starch, it may only be labeled gluten-free if
that product has been processed to remove gluten, and tests to below 20 parts
per million of gluten. With the enactment of this law on August 5th, 2014,
individuals with celiac disease or gluten intolerance can be assured that a
food containing wheat starch and labeled gluten-free contains no more than
20ppm of gluten. If a product labeled gluten-free contains wheat starch in the
ingredient list, it must be followed by an asterisk explaining that the wheat
has been processed sufficiently to adhere to the FDA requirements for
gluten-free labeling.
Look for the “Gluten Free” label. If it
doesn’t have that, you’ll have to look at the ingredients. Wheat, rye and
barley are obvious forms of gluten to avoid.
Oats do not have gluten, but they
are often cross-contaminated with gluten, so it’s best to avoid oats unless
it’s specifically stated that it doesn’t have gluten.
There are many sources of gluten that
it’s not at all obvious that it contains gluten. Soy sauce contains wheat
unless it’s specifically made without wheat. Look out for malt, it’s usually
made from barley and contains gluten.
If the label says “May contain wheat” or
“Processed in a facility that also processes wheat” use caution, as there is a
high risk of cross-contamination.
If gluten-free ingredients are used in a
fryer that is used for gluten-containing ingredients, the food isn’t going to
be gluten-free.
Rice is gluten-free—even glutinous rice!
In this case “glutinous” doesn’t refer to gluten, but to the rice being sticky.
Buckwheat is, despite the name, not at all related to wheat and is gluten free.
Sorghum is another gluten-free grain. Have it as an alternative to rice; I like the flavor.
Generally,
a gluten-free diet (GFD) is recommended for all patients with CD. Immune stimulation occurs with the ingestion
of gluten; therefore, all food components containing gluten and its derivatives
must be eliminated from the diet. Although
this diet restriction and its compliance are challenging for most patients,
adhering to GFD has shown improvement in symptoms and it promotes duodenal
mucosa healing. A study by Rubio-Tapia
et al. showed mucosal recovery in about 35% and 66% of patients in two to six
years after starting a GFD, respectively, with 82% of patients improving
symptomatically.
Several
studies tried to conclude a safe threshold for daily gluten intake. Catassi et
al. showed that chronic exposure to small amounts of gliadin can cause a
dose-dependent relapse of their symptoms, for example, the group that received
10 mg gliadin per day had minimal mucosal changes in jejunal histopathology,
whereas another group that consumed 50 mg gliadin per day showed a significant
histomorphology mucosal change. However, the debate on the tolerable threshold
of gluten ingestion is still controversial.
Different
studies showed that in some patients, complete resolution of symptoms and
mucosal recovery could not be achieved even with a GFD. These GFD non-responders might have
gluten contamination or other concomitant pathologies including small-bowel
bacterial overgrowth, lactose intolerance, functional bowel disorders, and
microscopic colitis.
Several
studies suggested that a strict GFD may help standard GFD non-responding CD
patients. The concept of gluten contamination elimination diet (GCED),
strict-GFD, was developed to remove the smallest amounts of gluten from the
diet. The strictest dietary regimen focuses on the use of naturally gluten-free
products rather than processed gluten-free food. In a study by Hollon et al. on
17 patients who did not respond to original GFD, the patients were started on a
GCED and 82% of them were symptom-free after three to six months of GCED.
Refractory
Celiac Disease refers
to cases still showing continuous clinical symptoms and signs as well as
histological evidence of villous atrophy despite adhering to a strict GFD for
at least 12 months. Many clinicians recommend maintaining a lifelong strict GFD
for all CD patients. Prolonged inflammation and mucosal damage in CD
patients can contribute to an increase in lymphoproliferative disorder and can
affect overall mortality. The risk of the development of malignancies such as
enteropathy-associated T-cell lymphoma (EATL) has been reported. This T-cell lymphoma originated from
intraepithelial T-cells of the small intestine, which may result from higher
and prolonged exposure to gluten and mucosal inflammation. Cases of small bowel
adenocarcinoma are also reported in CD patients, but the exact pathogenesis is
still unknown.
The GFD is still questionable in some
patients, so the GFD approach should be targeted and individualized by
patients. The data on GCED are limited in the current literature, but it is
worth considering in patients who are non-responsive to traditional GFD. In
addition to psychological problems, prolonged GFD can cause vitamin B
deficiency and therefore, repletion regimens are required.
And while Rajagopal
told John Hopkins that "there's no scientific evidence" that
discontinuing gluten causes withdrawal, she said there is anecdotal
evidence of trouble adjusting to a gluten-free diet. "Some people report
feeling dizziness, nausea, extreme hunger, and even anxiety and depression when
they suddenly go from eating a lot of gluten to being gluten-free," she
said. "These symptoms usually go away after a few weeks on a gluten-free
diet, but talk to your health care provider if they persist."
When you stop eating
gluten, it's important to make sure you're getting enough whole grains, fiber,
and other nutrients in your diet from other sources, say the experts at Johns
Hopkins Medicine. "Getting enough whole grains in your diet is especially
important if you're at risk for heart disease or
diabetes," they write, noting that whole grains help reduce cholesterol
levels and regulate blood sugar, and that certain foods that have gluten in
them also contain "important vitamins and minerals, such as B vitamins,
iron, and magnesium."
Rajagopal
said that for people who don't have celiac disease, removing highly processed
foods from their diets, rather than those containing gluten, may be enough to
resolve their symptoms—and points out that "a gluten-free label doesn't
necessarily make a food healthy. Some
processed gluten-free foods contain high amounts of unhealthy ingredients such
as sodium, sugar and fat. Consuming these foods can lead to weight gain, blood
sugar swings, high blood pressure, and other problems."
Untreated celiac disease is associated with long-term
complications, including:
It can also reduce quality of life, especially in
people experiencing symptoms daily.
Although
researchers continue to search for ways to prevent celiac disease, currently,
there is no proven method for prevention. Investigations into environmental
risk factors have not uncovered a way to prevent the condition before it
occurs.
NexVax2,
a desensitizing vaccine that works to restore the body's immune response to
gluten, was being tested in clinical trials. Still, it has yet to be approved
by the Food and Drug Association (FDA).
Early
detection and treatment can reduce the risk of complications, but researchers
acknowledge that diagnosing celiac disease can be challenging. Since
celiac disease is genetic, it's important for family members to be screened for
it, as well.
The symptoms will vary considerably from person to person and are also
significantly different for children and adults. Even symptoms in men and women
may differ.
Generally speaking, these are the most common celiac symptoms by age:
Symptom |
Adults |
Infants/Children |
Abdominal pain and bloating |
X |
X (chronic) |
Diarrhea |
X |
X |
Constipation |
X |
X |
Nausea/vomiting |
X |
X |
Weight loss |
X |
X |
Fatigue* |
X |
X |
Heartburn |
X |
|
Bloating |
X |
|
Flatulence |
X |
|
Iron-deficiency anemia* |
X |
|
Bone or joint pain; arthritis* |
X |
|
Bone loss* |
X |
|
Dermatitis herpetiformis (a skin rash)* |
X |
|
Mouth ulcers* |
X |
|
Headaches* |
X |
|
Peripheral neuropathy* |
X |
|
Anxiety or depression* |
X |
|
Irregular menstrual cycle* |
X |
|
Infertility* |
X |
|
Pale, foul-smelling, or fatty (floating) stool |
X |
X |
Mood changes, irritability |
|
X |
Damage to dental enamel (permanent teeth) |
|
X |
Slowed growth, short height, delayed puberty, failure to thrive |
|
X |
Attention deficit hyperactivity disorder (ADHD) |
|
X |
*Approximately half of adults with celiac
disease have some of these non-digestive symptoms.
Not everyone who's diagnosed with celiac disease experiences digestive
symptoms, but many do. Still, these digestive symptoms can be subtle, and you
might not necessarily associate them with celiac disease.
Chronic
diarrhea is
one hallmark symptom of celiac disease, and it appears to affect half or more
of those newly diagnosed. Frequently, the diarrhea is watery, smelly, and
voluminous, and floats rather than sinks.
However, plenty of people with celiac disease tend to have constipation rather than diarrhea, and some see
their symptoms alternate between the two.
Digestive symptoms can include diarrhea,
constipation, heartburn, bloating, flatulence, nausea, and even vomiting in
certain circumstances. People with celiac disease often are diagnosed with
irritable bowel syndrome.
In addition, other types of digestive
symptoms can appear. For example, flatulence and
excessive gas are common, as is abdominal bloating (many
people describe themselves as looking pregnant). It's also common to have abdominal pain, which can be severe at times.
Additional digestive symptoms of celiac
disease can include heartburn and reflux (some people
already have been told they have gastroesophageal reflux disease or
GERD), nausea and vomiting,
and lactose intolerance.
Undiagnosed people with celiac disease
sometimes develop pancreatitis or gallbladder disease, and many
already have been diagnosed with irritable bowel syndrome (those IBS
symptoms often lessen or disappear completely following a celiac disease
diagnosis).
In addition, not everyone loses weight as with undiagnosed celiac
disease. In fact, many people find they gain weight prior to diagnosis. Some
people report being absolutely unable to shed excess pounds, no matter how much
they diet and exercise.
Many people with undiagnosed celiac disease experience extreme fatigue that
prevents them from performing everyday tasks and impacts their quality of life.
Generally, fatigue seems to creep up on you, making it easy to blame it on
getting older (as opposed to a treatable medical condition).
At the same time, insomnia and other sleep
disorders are very
common in people with celiac disease. You're exhausted during the day, but then
can't fall asleep or stay asleep at night.
In addition, many
people with celiac disease get "brain fog" due to
gluten. When you have brain fog, you have trouble thinking clearly. You might
have trouble coming up with the right words to carry on an intelligent
conversation, or you might misplace your car keys or fumble other common
household tasks.4
Some people newly diagnosed with
celiac disease already have diagnoses of migraine headaches; in many cases
(but not all), these headaches will lessen in severity and frequency or even
clear up completely once you adopt a gluten-free diet.
Psychological symptoms such
as depression, anxiety, attention-deficit
hyperactivity disorder (ADHD), and irritability
occur frequently in people with undiagnosed celiac disease. In fact,
long-diagnosed people with celiac disease often can tell they've been exposed
to gluten when they become irritable—that
symptom can appear within hours of exposure and linger for several days. In
small children with celiac disease, sometimes irritability is the only symptom.
Peripheral neuropathy, in which you
experience numbness, a sensation of pins and needles, and potentially weakness
in your extremities, is one of the most frequently reported neurological
symptoms of celiac disease. In extremely rare cases, people are diagnosed
with gluten ataxia, which is brain
damage characterized by the loss of balance and coordination that's due to
gluten consumption.
Restless legs syndrome has also
been reported as a common symptom of celiac disease.
You might see signs of celiac disease in your largest organ: your skin. Up to
one-fourth of people with celiac suffer from DERMATITIS HERPETIFORMIS (a.k.a.
"the gluten rash"), an intensely itchy skin rash.
People with celiac disease also may
have a variety of other skin problems, including psoriasis, eczema, alopecia areata (an
autoimmune condition where you lose your hair), hives, and even such common
problems as acne and dry skin. There's no firm evidence that gluten ingestion
causes or contributes to these skin problems, but the gluten-free diet helps
clear them up in some cases.
If you have dermatitis herpetiformis
plus positive celiac blood tests, you have celiac
disease—no further testing required.
Although dermatitis herpetiformis can form anywhere on your body, it
is most frequently seen on extensor surfaces (areas of
skin on the outside of a joint) such as the elbows, knees, buttocks, ankles, groin, lower
back, and back of the neck.
The rash can be
intensely itching and is often accompanied by a burning sensation.
The rash has distinctive
reddish-purple, fluid-filled bumps. The
blisters can be as small as a pinhead or as large as a quarter-inch in size.
A dermatitis
herpetiformis rash tends to come and go. During outbreaks, a person may be
unable to resist scratching, which can leave behind purplish marks on the skin
that can last for weeks or months.
It usually takes several
days for the rash to heal, during which new bumps often develop nearby.
People with severe
dermatitis herpetiformis often have continuously reddened, speckled skin where
scar tissue has developed.
Currently, the only long-term treatment for dermatitis herpetiformis {DH}is
a gluten-free diet.
The oral antibiotic dapsone may provide short-term relief but
can cause significant side effects in some people, including nausea, vomiting,
dizziness, blurred vision, insomnia, ringing in the ears, and anemia. For this reason, dapsone is used sparingly to
help bring the rash under a control.
Bone and joint issues such as
osteoporosis, joint pain, bone
pain, rheumatoid arthritis, and fibromyalgia also occur
with regularity in those with celiac disease.
It's not clear what the connection is;
it may involve nutritional deficiencies related to
the fact that celiac causes intestinal damage, which makes it difficult for you
to absorb vitamins and minerals. In some cases, the gluten-free diet can
alleviate pain from these conditions.
People with celiac disease often have terrible teeth and
problematic gums. In adults with undiagnosed celiac disease, frequent
cavities, eroding enamel, and other recurring dental problems can signal the
condition. Children with undiagnosed celiac might have spots on their new teeth
with no enamel, delayed eruption of their teeth (either baby or adult), and
multiple cavities.
Canker sores (also known as aphthous ulcers) occur in both
adults and children with undiagnosed celiac disease (and in those already
diagnosed who ingest gluten accidentally). These painful mouth sores frequently
crop up on the inside of your lips in areas where you've had a very minor
injury (such as a scratch from a sharp piece of food, a utensil, or your
teeth). Once they start, they can take up to a week to subside.
It's also not unusual to identify celiac
disease in a person who has periodontal disease or badly
receding gums. In some cases, the gluten-free diet can help to reverse some of
the damage that's been done.
You can find lists of over 200 different
symptoms of celiac disease. It's actually very common to experience marked
improvement in other, minor ailments you never would have imagined were related
to celiac disease when you adopt a gluten-free lifestyle.
It is now rare that children present
with severe symptoms. These include chronic fatigue, very low blood pressure,
electrolyte imbalances due to fluid loss in diarrhea, and abdominal obstruction. In very
unusual adult
cases, the first obvious sign that a patient has unrecognized celiac is
non-Hodgkin lymphoma. Fortunately, this type of cancer is very rare, even in
people who have had celiac symptoms for years but remained undiagnosed.
People with celiac disease are at risk
of developing malnutrition.
You are unable to absorb enough nutrients due to the damage to your digestive
tract. This can result in anemia and weight loss.
Children with undiagnosed celiac disease
often fall behind the growth curve, and this delayed growth or "failure to
thrive" may be the only symptom of celiac disease in a child. If the child
gets diagnosed prior to puberty and begins a strict gluten-free diet, she often can make up some or
all of the height. Adults with longstanding undiagnosed celiac
disease often are quite short.
Osteoporosis, in which your bones become thin and
weak, frequently appears in concert with celiac disease. When you have celiac
you can't absorb the nutrients needed to keep your bones strong.
Celiac disease can affect your hormones
and other functions of your endocrine system, which controls everything from
your reproductive system to your moods. In fact, celiac disease is found in 2%
to 5% of patients with either thyroid disease or type 1 diabetes. The
consequences can include poor absorption of thyroid hormone medications. It is unclear whether these disorders stem from similar underlying
causes or whether one leads to another.
Reproductive health issues can be seen
in celiac disease, including infertility in both women and men, skipped periods, late puberty, and early menopause. Women with celiac are significantly more
likely than other women to experience pregnancy problems and repeated
miscarriages.
Celiac disease has differing effects on cancer
risk. It may lower your risk of breast cancer, but raises the risk of
cancer of the small intestine (a rare type of cancer), carcinoid tumors (a
rare, slow-growing type of cancer that can occur in the digestive tract), and
gastrointestinal stromal tumors (another rare form of cancer). It's not clear
whether people with celiac disease have an increased risk for colon cancer.
Celiac disease is a lifelong condition. To avert long-term
complications, you must follow a strict gluten-free diet. However, you'll probably be pretty happy to
learn that doing so generally resolves most or
all of your symptoms. You may even notice many minor health complaints disappearing once
you're diagnosed and on a gluten-free diet.
·
What protein causes symptoms of celiac disease?
A protein called
gluten causes damage to the small intestine that eventually leads to celiac
disease symptoms. Gluten is a protein in a variety of grains—among them wheat,
barley, rye, durum, semolina, spelt, farina, and farro. Gluten helps foods hold
their shape, which is why it's key to the formation of foods like bread and
pasta.19
·
How soon do celiac disease symptoms appear after eating gluten?
Certain symptoms of celiac disease can occur very quickly after eating
gluten. In one study, 92% of people with the condition experienced an increase
in interleukin-2, a protein associated with the immune response, within an
hour of eating gluten. The most common symptoms in this group were nausea and
vomiting, rather than the diarrhea, bloating, and abdominal pain most often
associated with celiac disease flares.
The symptoms may appear
·
How
does celiac disease affect the skin?
Celiac disease can cause a variety of skin conditions, including
psoriasis, an itchy rash called dermatitis herpetiformis, and blisters. Some people also develop canker sores inside
their mouths.
·
What
does a celiac disease bowel movement look like?
Stool caused by
celiac disease tends to be loose, foul-smelling, and pale. It
also contains a lot of fat, which is known as steatorrhea. It's a sign your
digestive system isn't breaking down the food you eat properly and your body
isn't absorbing the nutrients it needs.
·
Are celiac disease symptoms different for children than for
adults?
Children, including babies, are more
likely than adults to have diarrhea, vomiting, bloating, and other digestive
symptoms. Only a third of adults with celiac disease have diarrhea and most are
more likely to have anemia, fatigue, and bone and joint problems such as pain,
arthritis, and osteoporosis.
·
How does removing gluten from the diet eliminate symptoms of
celiac disease?
When you stop eating foods that contain gluten, you prevent further
damage to the villi in your small intestine that are responsible for
your symptoms. Doing so will not repair the damage already done but it will
prevent flare-ups of symptoms. Many people with celiac disease say they start
feeling better within days of cutting gluten from their diet.
·
What are the symptoms of non-celiac gluten
sensitivity?
People who have non-celiac gluten
sensitivity (NCGS) have symptoms similar to those of
celiac disease but do not test positive for the condition. The same is true for
non-celiac wheat sensitivity (NCWS), which is an allergy to wheat. Among the common symptoms of both, which occur
when gluten is eaten, are diarrhea or constipation, abdominal pain and
bloating, headaches, joint pain, inability to focus and concentrate, and
persistent tiredness.
·
What
are the symptoms of silent celiac disease?
Silent celiac
disease is an informal term for asymptomatic celiac disease. It's different
from classical celiac disease and non-classical celiac disease in that a person
doesn't experience overt symptoms as a result of damage to the cilia in the
small intestine. That said, people who have asymptomatic celiac disease say
they notice they feel better overall and have fewer mild digestive issues such as bloating
and gas when they stop eating gluten.
Celiac disease is caused by specific genes, eating gluten, and possibly
by some other triggers such as childbirth, surgery,
stress, or other autoimmune disorders. However, medical science is still
working to understand the roles of these potential causal factors.
So far, neither breastfeeding nor when
gluten is introduced to a baby's diet have been shown to play roles in childhood celiac disease. It's usually not clear what triggers celiac
later in life.
FREQUENTLY
ASKED QUESTIONS
·
Does
stress cause celiac disease?
Yes, it appears
that stress plays a role in triggering celiac and some other auto-immune
disorders. In one study, people with
celiac disease reported stressful life events in the year before their diagnosis. Pregnancy was a common stressor.
·
What
foods cause celiac disease?
Any food containing gluten can trigger celiac disease in a genetically
susceptible person. Bread, pasta, pizza, and other foods made with wheat or
some other grains may immediately
come to mind. But gluten is in less
obvious places, including:
o
Malt
(in beer and vinegar)
o
Brewer's
yeast
o
Lip
balm
o
Nutritional
supplements (Although many supplements
have good labels re gluten-freeness)
o
Play
dough
Factors that trigger celiac disease later
in life are not yet understood, but some trends have emerged. Some people
report symptoms developing soon after:
Researchers are also looking into whether some viral illnesses might
trigger some cases of celiac.
How Celiac Disease Is Diagnosed
It's hard not to be exposed to gluten due to the widespread use of wheat
and other gluten-containing grains in the Western diet. They're in:
With more awareness of celiac disease and non-celiac gluten sensitivity,
a wide array of gluten-free products now exist. That makes it easier to avoid
problem foods.
Experts can't say for sure whether early gluten exposure triggers celiac
disease in some children who carry the genes.
Ongoing research is examining whether feeding patterns in the first year
of life make a difference in developing celiac. So far, they've found no
associations with breastfeeding or when gluten is first introduced to the diet.
Weak evidence suggests that if a genetically prone child eats a lot of
gluten around the time they're weaned from the breast or bottle, it might
increase their celiac disease risk.
Besides genetics, health-related risk factors for celiac disease include
having:
The disease is also more common in people assigned female at birth
(AFAB) and in people of northern European ancestry.
Some people contend that the rise in
celiac disease and non-celiac gluten sensitivity is tied to
genetically modified wheat. However, genetically modified wheat isn't on the market anywhere,
so it can't be causing the increase.
Celiac disease is caused by specific genes, eating gluten, and possibly
by some other triggers such as childbirth, surgery, stress, or other autoimmune
disorders. However, medical science is still working to understand the roles of
these potential causal factors.
So far, neither breastfeeding nor when gluten is introduced to a baby's
diet have been shown to play roles in childhood celiac disease. It's usually not clear what triggers
celiac later in life.
FREQUENTLY
ASKED QUESTIONS
·
Does
stress cause celiac disease?
Yes, it appears that stress plays a role in triggering celiac and some
other autoimmune disorders. In one
study, people with celiac disease reported stressful life events in the year
before their diagnosis. Pregnancy was a common stressor.
·
What
foods cause celiac disease?
Any food containing gluten can trigger celiac disease in a genetically
susceptible person. Bread, pasta, pizza, and other foods made with wheat or
some other grains may immediately come to mind.
But gluten is in less obvious places, including:
o
Malt (in beer and vinegar)
o
Brewer's yeast
o
Lip balm
o
Nutritional supplements (although labels should help you avoid gluten
and wheat)
o
Play dough
Information and self-education ideally expedite the entire process, but
there are dangers of not
adapting your diet after you obtain a diagnosis.
"Constant exposure to gluten can
make the disease progressively more aggressive," said Joseph Shami, M.D., a
gastroenterologist with Gastroenterology Associates of New Jersey.
"[Symptoms range] anywhere from general malaise to abdominal pain,
headaches, rashes, joint pains, diarrhea, weight loss, anemia, confusion. There
has been one published report of a fatal case. However, fatal diseases can
develop from untreated celiac disease."
In the long term, untreated CD can foster malnutrition and lead
to osteoporosis. There's also a connection between
untreated celiac disease and certain types of cancer, such as a rare
non-Hodgkin lymphoma called enteropathy-associated
T-cell lymphoma (EATL) and adenocarcinoma
of the small intestine.
Neurological consequences of untreated
celiac disease include gluten ataxia and peripheral neuropathy.
Ataxia can emerge as the disease damages the cerebellum, resulting in a loss of
coordination. Peripheral neuropathy is the numbing and tingling of body parts. These two conditions, numbness and
clumsiness, can compound each other and could lead to dangerous falls. With
osteoporosis in the mix, the consequences can be dire.
Celiac disease is a shape-shifting disease that is sometimes even
invisible. Open and honest communication
with your healthcare professional team (physician
and dietitian) is essential in diagnosing the condition before it can cause
damage to the small intestine and beyond.
If you don't have a doctor you see regularly, you should find one,
especially if you're experiencing symptoms. Fortunately, telehealth makes it
easy to connect with a doctor who can answer your questions and evaluate your
situation. Many physicians offer video visits, which are a good way to see a
doctor quickly. And if follow-up testing is required, you've established a
relationship.
HOW MANY
CELIAC PATIENTS DON'T FOLLOW A GFD?!
-- Good
For You Gluten Free --
I was reading an article that shared
this fun fact: 20 to 50% of people with celiac disease don't follow a strict gluten-free diet. This number felt high to me, but after I did
some digging, I think it's more accurate than I'd like to admit.
So why is the rate of non-compliance
with the GFD so high?
The only treatment for the autoimmune disorder
is a strict, lifelong gluten-free diet.
Every time a person with celiac disease eats gluten, a protein found in wheat, rye, and
barley, their immune system becomes confused and attacks the healthy tissue
surrounding the small intestine.
For some people, this leads to a slew of painful and annoying symptoms, including gastrointestinal disorders,
serious skin disorders, growth issues in children,
chronic fatigue, low bone density, various brain disorders, and more.
One expert suggests
the rates of non-compliance with the gluten-free diet might be as high as 20 to
50 percent. This number sounded high to me, so I did a little digging and found
a few other data points that suggest the rate of non-compliance is just as high
or higher.
· Researchers analyzed six studies about
gluten-free dietary compliance; they found that adherence rates ranged from 45
to 90 percent. In other words, 10 to 55 percent were non-compliant!
·
A survey of adults with celiac disease found
that only 65 percent admit to “fully” adhering to the gluten-free diet, 31
percent say they are “partially” adhering, and 4 percent admit they don’t
adhere to the gluten-free diet at all.
While many people with celiac disease can’t imagine eating gluten ever
again; for others, compliance is not an easy feat and one influenced by a
number of environmental and socioeconomic factors.
Dietary adherence among celiac patients can be influenced by several
factors, including:
·
The high burden of strict compliance.
·
The complexities of label reading and keeping up with sometimes contradictory
dietary guidelines.
·
The high cost of gluten-free food.
·
Lack of availability of gluten-free food.
·
The low perceived benefits, especially for those
with asymptomatic celiac or less
impactful symptoms when they eat gluten.
·
Age at diagnosis.
·
Lack of support from family, friends, or even a local
celiac group.
Below, I discuss what I see as the three main reasons why some celiac
patients choose not to follow a gluten-free diet, of course, at the risk of
their health outcomes.
One reason people with celiac disease are not fully compliant is likely
due to the high burden associated with following a strict gluten-free diet.
Full compliance requires individuals to turn their lives upside-down,
and several studies conclude
that a gluten-free diet may lower one’s quality of life despite helping to
improve their health outcomes. This
is why a gluten-free diet is a Catch-22 for celiac patients.
On the one hand, if they want to feel physically better and put their
symptoms into remission, they must follow a strict gluten-free diet.
On the other hand, strict adherence can significantly reduce their
quality of life. For example, people with celiac disease must learn how
to read food labels for hidden gluten, plan their meals ahead of
time, learn how to cook, and significantly reduce their reliance on
eating out.
They are also forced to discuss their disorder repeatedly when they eat
at restaurants, attend professional and social events, and travel – no more
spontaneous weekend getaways or planning a dinner on a whim at a friend’s
house.
Such experiences can feel humbling, isolating, embarrassing, and even
attention-seeking, even though people with celiac disease don’t want to bring
attention to their disease time and time again. Who wants to discuss their
“disease” with every waiter they meet?!?
Furthermore, people with celiac disease fear being put in situations
where they have little control over the preparation of their food, making the
burden too heavy for some.
It’s in these moments when they need to decide if they want to advocate
for what they need, not eat at all, or take a risk by eating what’s provided
and hoping for the best. Some will even willingly cheat on their “diet” to fit in
and not make a fuss. (Please don’t!)
In a survey of single
British people, 44 percent said they perceive those on a gluten-free diet as
“high-maintenance,” which might as well be a code word for “undateable.” Understandably, some people sensitive to what
others might think of their dietary restrictions wouldn’t want to bring
attention to it on a first date.
Plus, it can still go wrong even when someone advocates for what they
need. An inmate with celiac disease died because prison officials
didn’t take her diet seriously despite her pleas for a safe meal.
Many people eat out and still get accidentally glutened. One study found that
approximately 18 percent of celiac disease patients were found to have gluten
traces in their stool.
The high cost of gluten-free food may also affect a person’s ability to
fully comply with the gluten-free lifestyle. Most gluten-free products cost 2-3 times more than their
non-GF counterparts, which can be a deterrent for those struggling to make ends
meet.
One study found that people with celiac
disease that come from “an affluent background” and have a “university
education” are more likely to adhere to a gluten-free diet, likely because of
their ability to seek nutrition help and pay for gluten-free food.
Another study found that people from high-income
backgrounds also experienced better overall health outcomes and fewer symptoms.
Another reason some celiac patients don’t fully adhere to the
gluten-free diet is they don’t have symptoms bothersome enough to incentivize
them to do so, or they may not have any symptoms in the first place (asymptomatic
or silent celiac).
Sixty percent of children and 41
percent of adults diagnosed with celiac disease are asymptomatic
(without any symptoms) even though they experience the same intestinal damage
(villous atrophy) as symptomatic celiacs.
Without symptoms, it’s understandable why this segment of the celiac
population may not feel they need to tackle a burdensome gluten-free diet,
given they don’t feel there are any symptoms to alleviate.
Doctors and nutrition professionals should strongly encourage people
with celiac disease to fully comply with a gluten-free diet despite the high
burden and high costs associated with the lifestyle.
Even people with asymptomatic celiac put their lives at risk every time
they eat gluten because regardless of symptoms, gluten damages their body,
impairs nutrient absorption, creates persistent inflammation, and eventually,
like a leaky faucet, leads to irreparable damage, health complications, and
early death.
Of course, celiac patients must carefully balance dietary vigilance with
quality of life. They must not restrict themselves beyond what is
necessary.
For example, there’s no need for someone with celiac disease to go on
endless elimination diets, or the FODAP diet, which are meant to be temporary.
They must avoid diet culture fads like keto, paleo, and no-carb diets that
restrict their diet beyond what’s necessary.
To encourage dietary vigilance, gluten-free dietitians and nutritionists
should be careful not to push or promote the elimination of all grains, dairy,
sugar, and other foods. They also should be mindful of their stance on oats, as there are
many alarmist calls for celiac patients to steer clear of oats, even if they’re
labeled “gluten-free.”
Eliminating gluten is one thing, but adding another food group to avoid
the mix is an unnecessary restriction that should only be encouraged when other
interventions fail or when the patient has a proven allergy or intolerance to
that food. Beyond gluten, another common
allergen is dairy, then soy.
Finally, eating gluten despite having celiac disease is someone choosing
to harm their body deliberately, and that’s not okay. While these people should not be judged or
admonished, interventions should be considered to help them correct their ways.
Understandably, they may need to seek nutrition coaching or mental health counseling to help
them “do” gluten free in a way that works for their lifestyle. This is a
treatable disorder that requires ongoing nutritional and mental health support.
The bottom line is
that it’s important that people with celiac disease are mindful of what’s at
the end of their fork.
The food they eat
(and don’t eat) can help them live a long, healthy life free from disease, or
it can slowly chip away at their health, force them to live in a prolonged
state of mortality, and even lead to an untimely death.
The choice is
personal, but the truth is most people need to consider if they’re willing to
pay now or pay later.
By Sarah Bence; Updated on November 08, 2023
Medically reviewed by Melissa Nieves, LND
Table of Contents
Gluten intolerance and celiac disease are
different conditions with similar symptoms. Celiac is an autoimmune
disease in
which the body's immune system destroys the lining of the small intestine when
you consume gluten. Gluten intolerance is when you react negatively to gluten
but do not have autoimmune markers, which are indicated on blood tests. The
only way to differentiate gluten intolerance from celiac is with proper
diagnosis and testing. In this article,
learn more about gluten intolerance and how it differs from celiac disease.
Gluten intolerance is also known by the terms "non-celiac gluten
sensitivity" or "gluten sensitivity." All of these terms refer
to the same condition.
When someone reacts negatively to gluten but does not have the
autoimmune response that is characteristic of celiac disease, nor the allergic
reaction that is characteristic of wheat allergy, they may be diagnosed with gluten
intolerance (non-celiac gluten sensitivity).
Gluten Intolerance
·
Not autoimmune
·
No damage to small intestine
·
No identified biological markers
·
Symptoms triggered by consuming gluten
·
Treated with a gluten-free diet
Celiac Disease
·
Autoimmune
·
Causes damage to small intestine
·
Genetic
·
Symptoms triggered by consuming gluten
·
Treated with a gluten-free diet
Gluten intolerance shares the same symptoms as celiac disease.
These symptoms can be gastrointestinal and non-gastrointestinal.
Symptoms of gluten intolerance include:
Everyone's experience of gluten intolerance is different. For some
people, the first signs of gluten intolerance are bloating or diarrhea after a
big pasta meal. For others, it may be fatigue, brain fog, or depression that
comes on gradually and is more challenging to associate with eating a specific
meal.
Scientists and medical providers don't fully understand the cause of
gluten intolerance, and this is an active area of research. According to some
researchers, gluten intolerance results from an immune response in some people
when they consume gluten.2 However, not all scientists agree.
If you think that your body is having a negative reaction to gluten,
consider starting a symptom diary. In it, record what you eat and the symptoms
that result.
Self-guided questions to ask yourself regarding gluten intolerance and
celiac disease include:
Gluten is a protein found in wheat, barley, and rye; it is
prevalent in the Western diet. Most people consume gluten every single
day in varying amounts.
Here are some of the most common
gluten-containing foods:
The only way to differentiate gluten intolerance from celiac disease or
wheat allergy is to go through the proper diagnostic process to rule out those
conditions first.
Testing
typically involves the following:
People with gluten intolerance will
test negative on blood tests and biopsies. However, they still have a suspected
response to eating gluten.
If you have a negative blood test, your
healthcare provider may guide you through an elimination diet
or gluten challenge to confirm that your symptoms are truly coming
from eating gluten and not something else. A dietitian and gastroenterologist specializing in
gluten-related disorders can help you with this.
Celiac disease tests only work accurately if you have gluten in
your system, so continue eating gluten before getting tested. If you go
gluten-free before testing, you may get a false negative result.
For accurate testing, you would have to start eating gluten again, which
could cause symptoms. For this reason, some people with gluten intolerance may
not know if they have celiac disease or not.
As with celiac disease, the only medical treatment for gluten
intolerance is to follow a gluten-free diet. However, the degree of strictness of
this gluten-free diet may differ for people with gluten intolerance vs. people with celiac.
People with celiac disease must avoid all cross-contact with gluten
since microscopic amounts can trigger an autoimmune response and damage the
small intestine, even without symptoms. This means using clean cutting boards
and utensils, clean water to boil gluten-free pasta, uncontaminated frying oil,
and more.
People with gluten intolerance do not have the same internal damage when
they eat gluten. As such, minimal gluten consumption is acceptable up to the
point that it causes symptoms. For this
reason, someone with gluten intolerance may be able to tolerate amounts of
cross-contact.
Going gluten-free doesn't mean you must cut out your favorite
foods. These days, there are many gluten-free alternatives on the market for
your favorite breads, pastas, cakes, cookies, and more.
Gluten-free foods will probably taste different from what you're used
to, but for most people, it's worth feeling better.
There are also many hidden sources of gluten, from ingredients including
(but not limited to) the following:4
You will have to learn how to read
labels and recognize gluten-containing ingredients.
It's normal to struggle to adjust to a
gluten-free diet. It is hard to learn an entirely new way of eating and living.
Consider seeing a dietitian who
specializes in the gluten-free diet to help you with this
process.
These foods must be verified by
reading the label or checking with the manufacturer/kitchen staff.
Most distilled alcoholic
beverages and vinegars are gluten-free. These distilled products do not
contain any harmful gluten peptides even if they are made from
gluten-containing grains. Research indicates that the gluten peptide is too
large to carry over in the distillation process, leaving the resulting liquid
gluten-free. However, some types of alcoholic beverages do contain an
unsafe amount of gluten for people with celiac disease, and include those with
added color or flavoring such as dessert wines, and those made from barley
malt, such as bottled wine coolers. For these, consumers should check the
label, and if in doubt, contact the company. Beers, ales, lagers, malt
beverages and malt vinegars that are made from gluten-containing grains are not
distilled and therefore are not gluten-free. There are several
brands of gluten-free beers available in the United States and abroad.
Gluten intolerance is different from celiac disease because
there is no autoimmune process. However, people with gluten intolerance can
have all the same symptoms as celiac, including bloating, nausea, vomiting,
diarrhea, skin rashes, constipation, brain fog, and more. The only treatment
for gluten intolerance and celiac disease is a gluten-free diet.
If you’ve already looked up anything on
the subject of foods that trigger IBS (Irritable Bowel Syndrome) attacks, then
you know the foods that most people tell you to avoid – greasy foods, alcohol,
caffeine, spicy foods, and you’ve probably heard about high FODMAP foods too.
If not, no worries. We’ll cover them all here.
But if you’re like
most people, avoiding those things hasn’t stopped your IBS attacks. It
may have helped some, but it probably wasn’t the answer that you really wanted.
And there is a very good reason for that.
Once your digestive system is compromised and you have IBS, it becomes
clear that there are certain foods that are usually more difficult to digest
than others. These are the foods that are
more likely to trigger an IBS attack. These are greasy foods, alcohol,
caffeine, spicy foods, heavy proteins, raw foods, and high fodmap foods.
So if you cut them
out, you might feel a little better. But those foods weren’t the things
that caused your IBS in the first place. They are only
irritating an already irritated digestive tract. And avoiding them may help,
but it won’t solve your IBS.
But why are those
foods so problematic? Let’s examine raw foods like salads and nuts, first.
These foods require a lot of energy to break down. You have to chew them really
well, and even then they require a lot more work to digest than processed food.
That’s good when you want to eat healthy. It’s bad when you have a compromised
digestive system.
The same is true for
greasy foods, and for big proteins like read meat. They require more work to
digest and absorb too. Not a big deal if your digestion is good, but wreaks
havoc if you have IBS.
Processed foods and
soft foods like soups and smoothies are super easy to digest. All of that
processing and/or cooking has basically already broken down those foods for
you. All you have to do is chew them and they fall apart and then you can
swallow them. That is very easy on your digestive system.
And alcohol,
caffeine, and spicy foods are always hard on your digestive tract. But when
your digestion is working well, it can deal with those. When it’s not working
well, it can’t.
There are two ways of
looking at this. One is to try to minimize the flare up by doing what is
statistically helpful, meaning that some people feel better when they do it.
You can do that. We will discuss it and how to do it. And you will probably
feel better. But it will only be temporary, and it won’t cure your problem.
The other way to
figure out what foods to eat during an IBS attack is to find out exactly what
is causing your IBS in the first place and then stop having flare-ups
altogether. The latter option may sound impossible. It’s not, and we’ll talk
about both options.
We’ll start with
things to eat or not eat that can help with an IBS flare up.
The latest fad diet
for IBS (and there have been many before it and will be many after it, that’s
why I call it a fad) is the low FODMAP diet. Just because it’s a fad doesn’t
mean that you shouldn’t try it. But know that it only helps a small percentage
of people.
FODMAP is an acronym
for fermentable oligosaccharides, disaccharides, monosaccharides and polyols,
which are short-chain carbohydrates. This is a really fancy
way of saying that there are different types of carbohydrate molecules in
foods, some of which you may have a problem digesting. Some foods have more of
these molecules than others.
The foods that you need to avoid
during a low FODMAP diet include the following:
§
Wheat
(that includes pasta)
§
Milk
§
Yogurt
§
Soft cheeses
§
Soy milk
§
Coconut milk
§
Apples
§
Pears
§
Garlic
§
Onions
§
Mushrooms
§
Beans
§
Anything with high fructose corn syrup in it
The foods that you CAN eat,
that are low in FODMAPs, include the following:
·
Beef
·
Chicken
·
Pork
·
Turkey
·
Fish
·
Egg
·
Tofu
·
Corn
·
Oats
·
Rice
·
Potato
·
Quinoa
·
Sourdough bread
·
Bananas (unripe)
·
Oranges
·
Grapes
·
Lettuce
·
Carrots
·
Broccoli
·
Cucumber
·
Spinach
·
Tomato
·
Lactose free ice cream
·
Wine
·
Beer
·
Spirits
·
Coffee
·
Sucrose sweetened things
These lists aren’t conclusive, but they are a really good start and hit
most of the highlights of the low FODMAP diet.
In our experience the
best way to approach any discussion of foods that trigger an IBS attack is not
about focusing on whether or not they are high or low FODMAP foods, it’s to
divide them into foods that are commonly the cause of digestive problems and
foods that are more difficult to digest when you have an IBS flare up.
The goal is to give
your digestive system a mini vacation, so that it can relax and heal. You don’t
want to challenge it with anything that will cause it to work hard.
You can go easy on
your digestive track by keeping any food intake very simple and soft. You want
everything you eat to either be well cooked and/or already broken down. For
example, all of your food should be in the form of a smoothie or a soup.
No digestive work required.
Don’t eat any of the
following:
·
Raw foods (like salads)
·
Fruits with skins (like apples)
·
Nuts
·
Fatty/greasy foods
·
Steak
·
Whole grains
·
Brown rice
Also
don’t eat:
·
Sugar
·
Caffeine
·
Spicy food
·
Alcohol
All of these things will irritate an
already irritated digestive tract.
And
finally, don’t eat:
·
Dairy
·
Gluten
These are two of the most common causes
of digestive problems.
Up to this point
we’ve been primarily discussing foods to avoid that can trigger an IBS flare
up, not foods to eat. So here we’ll switch gears and focus on foods to eat
during an IBS attack.
What you CAN eat is
virtually everything else not in our list above, as long as it is well cooked,
cut into small pieces, or even better, made into a soup or a smoothie to make
it super easy to digest.
You want to eat
foods that are basically already broken down, so that your digestive system can
go on that well deserved vacation that it needs in order to recover from the
stress it’s been under.
DO eat:
·
Gluten-free Smoothies (But not sweet ones. Go easy on
the fruit too.)
·
Soups (GF)
·
Cooked vegetables (almost to the point of being overcooked)
·
Mashed potatoes (no dairy)
·
White rice
·
Fish (grilled or baked and cut into nice small
pieces)
·
Chicken (baked and cut into nice small pieces)
And chew everything (that isn’t a soup or smoothie) really well!
You’ve heard the old adage to “chew your food.” This is why! It will
reduce the amount of work that the rest of your digestive system has to do.
Do those things for a couple of days or so and there is a good chance
that you’ll start to feel better soon after an IBS attack.
The ideal goal is to
prevent IBS attacks from occurring, so that you don’t have to suffer through
them and worry about the super restrictive diets we just went over. That is
certainly our goal for all of our patients at the IBS Treatment Center.
They first key to
accomplishing this is to see an IBS specialist. Most people confuse this person
with a gastroenterologist, but they are two very different specialties. An IBS
specialist only treats IBS. They are very rare, but they do exist.
Gastroenterologists do a whole lot of other things, but they don’t go very deep
into IBS.
Up till now
everything that we’ve talked about is very generic and broad stroke. It may
help you, but it’s probably not going to cure your problem. An IBS
specialist can help you figure out exactly what is weakening your digestive
system and what is triggering your IBS attacks. And they can
fine tune all of the above dietary advice into a much more specific and dialed
in treatment plan.
That’s the
difference between reading about IBS online and getting treatments customized
to your body. There are some things that can’t be solved by
reading about them online or watching videos. This is unfortunately one of
them. But I hope that what I’ve covered here helps you feel at least somewhat
better sooner rather than later.
Can you tell what foods trigger your IBS?
Dr. Stephen
Wangen is
the award winning author of two books on solving digestive disorders, and a
nationally recognized speaker on IBS. He has been on ABC, NBC, and Fox as well
as public radio. He was recently named one of Seattle’s Top Doctors by Seattle
Magazine.
Seattle IBS
TREATMENT CENTER, 6100 219th St. SW, Suite 480;
Mountainlake Terrace, WA
98043; 206/264-1111
=================================================================================
Divya Singh; July 14, 2023
Celiac
disease is an autoimmune disease that attacks your small intestine, and as a
result, the body is unable to absorb nutrients properly. When
someone with celiac disease consumes gluten, their gut becomes inflamed. The
small intestine is gradually harmed by repeated exposure, which can cause
issues with food's ability to absorb minerals and nutrients.
Around 1 in 100 people globally have this
disease, and many more do not even realize they do. There could be 2.5 million
undiscovered cases of celiac disease in the US.
This autoimmune disease affects the digestive system. Here’s a list of
common symptoms which may vary from person to person in severity:
Even though they might not be as well-known as the typical
gastrointestinal ones, the symptoms of this autoimmune disease may still be
present, therefore it is important to be aware of them.
A skin disorder known as dermatitis herpetiformis causes itchy,
blistering rashes. It is a particular symptom of this autoimmune disease that
frequently affects the scalp, buttocks, elbows, and knees.
Some people may also experience this condition, alopecia
areata, which is
marked by sudden hair loss in patches.
Celiac disease can obstruct calcium and
vitamin D absorption, resulting in fragile and brittle bones.
Some people with this autoimmune disease may develop joint pain, swollen
joints, or symptoms resembling arthritis.
Malabsorption of nutrients, including iron, can result from this
autoimmune disease. Anemia due to iron shortage can cause shortness of breath,
weakness, pale skin, and exhaustion.
Yes, there is a large hereditary component to celiac disease. It is an
autoimmune condition that is brought on by consuming gluten, but it also
requires a particular genetic propensity. The presence of specific human
leukocyte antigen (HLA) genes, particularly the HLA-DQ2 and HLA-DQ8 genes, is
the main genetic component linked to this disease.
The HLA-DQ2 or HLA-DQ8 gene is present in around 95% of people with this
autoimmune disease, whereas the other 5% may have other, less frequent HLA gene
variations. Keep in mind that not everyone who possesses these genetic markers
will experience the disease. These genes raise the risk of the illness
occurring, but they do not ensure that it will.
When you consume
gluten-containing foods while suffering from this autoimmune disease, your body
reacts in an abnormal way. Your small intestine starts to experience discomfort
as a result of your immune system, which battles sickness. Your small intestine's
lining is attacked, including the microscopic bumps (villi).
Gluten free diet is recommended to
manage the symptoms. Gluten-containing
foods must be strictly avoided by people with this autoimmune disease since
even trace amounts of gluten can cause symptoms and harm the small intestine. A
few common foods and ingredients to stay away from are listed below:
Wheat and wheat products: Bread, cakes, cookies, semolina, durum
wheat, etc.
Barley: Barley
flour, barley malt, malted drinks, etc.
Rye: Rye
flour, rye bread, and other rye products
It is crucial to carefully study ingredient labels and check packaged
products for "gluten-free" certifications. In order to avoid cross-contamination, it is
important to make sure that gluten-free foods are not
prepared or cooked with gluten-containing items.
Understanding which
foods to avoid and how to live a successful gluten-free lifestyle can be
greatly aided by speaking with a qualified dietitian who specializes in celiac
and gluten-free diets.
By Kyle Umipig; July 31, 2023
Meal preparation for those with gluten sensitivities has
become essential to leading a healthy and full life in a society where dietary
restrictions are becoming increasingly common.
People with celiac disease or gluten sensitivity may experience negative responses to the protein gluten, which is present in wheat, barley and rye.
This thorough beginner’s guide aims to reveal gluten-free meal planning by giving you the information and resources you need to make delicious and healthy meals.
This guide covers everything, including how to deal with eating out and handle social situations as well as the basics of gluten-free foods.
You can experience
better digestion, more energy and general well-being by adopting gluten-free
meal planning.
Prepare to go off on a life-changing
journey of culinary discovery and self-care and full life in a society where
dietary restrictions are becoming increasingly common.
Embarking on a
gluten-free meal planning journey can seem daunting at first, but with the
right approach, it becomes a rewarding and fulfilling experience.
Here are essential
steps to help you get started:
Consider your specific dietary needs and goals before starting a
gluten-free food plan. Consider any particular dietary restrictions,
health issues and lifestyle considerations that may affect your meal planning
decisions. For instance, your approach to meal planning will be more
strict if you have celiac disease, gluten sensitivity or any other medical
condition connected to gluten.
It might be extremely helpful to get advice from a healthcare
practitioner or a qualified dietitian who specializes in gluten-free diets,
especially if you have specific conditions or medical problems. It may be
helpful to write down what you generally have for breakfast,
lunch, and dinners before you have the consultation with the dietitian.
They may offer
professional guidance, respond to any worries or inquiries you might have and
assist you in developing a well-rounded food plan that satisfies your
nutritional needs.
In order to maintain
a balanced diet, a healthcare provider or dietician can assist you in detecting
any nutrient deficits that may result from eliminating gluten and will offer
adequate substitutes.
Additionally, they
can offer advice on serving quantities, suggested dietary categories and any
required supplements.
You may approach your gluten-free meal
planning journey with assurance and clarity if you consult with a professional.
A key component of effective meal
planning is creating a gluten-free pantry.
Eliminate any gluten-containing items
from your pantry and replace them with gluten-free options.
Cooking delicious and varied gluten-free
meals will be easier if your pantry is stocked with gluten-free essentials.
Grain alternatives to wheat-based
grains, such as quinoa, rice, millet and cornmeal, are some pantry staples for
people following a gluten-free diet.
Almond, coconut and tapioca flours, all
of which do not have gluten, can be used in baking and cooking.
To fulfill your pasta needs, try
gluten-free pasta made from rice, quinoa or lentils. Gluten-free lasagna
noodles are available.
Stock up on gluten-free sauces,
condiments and spices as well to make your meals taste even better.
When it comes to gluten-free cooking,
it’s important to have a well-stocked pantry with essential ingredients that
can serve as alternatives to gluten-containing foods.
Here are some key ingredients to include
in your gluten-free cooking arsenal:
Bread, classic sweets and noodles are
among familiar foods that use flour or grain. It’s frequently used in soups and
sauces as a thickening agent.
Though generally not an issue, these two
kinds of flour should not be consumed by anyone who has celiac disease,
non-celiac gluten sensitivity, or who must avoid gluten for other
reasons.
You can try the following gluten-free
flour and grain alternatives:
It may be used as a side dish, in
salads, or as a base for stir-fries and risottos. Rice is a versatile
gluten-free grain. Different flavors and textures may be found in
varieties of rice such white rice, brown rice, basmati rice and wild rice.
A grain that cooks quickly, quinoa, is
packed with nutrients, and tastes great in salads, grain bowls and
pilafs. It is a good source of complete protein and gives food a pleasing
texture.
It is possible to use corn in a variety
of ways, such as cornmeal, cornstarch and corn flour. Corn flour and
cornstarch may be used as thickeners in sauces and mixes, while cornmeal is
excellent for baking cornbread. (Corn
gluten is gluten free. Jyr)
A grain without gluten, millet has a
delicate, nutty taste. You may cook it and serve it as a side dish,
include it in soups or use it in baked products.
Despite its name, buckwheat is not
related to wheat and is naturally gluten free. While buckwheat groats may
be cooked and used as a substitute for grains, buckwheat flour can be used to make
pancakes, crepes and other baked items.
These
gluten-free thickeners will come to the rescue when a soup is too thin or a
sauce is a little too runny. Here are some alternatives to gluten-free binder
and thickeners you can try:
A common gluten-free substance used as a
binder and thickening in baking is xanthan gum. It enhances the texture
and suppleness of baked goods made without gluten.
A soluble fiber that can serve as a
binder in gluten-free baking is psyllium husk. It helps to simulate the
structure of gluten and is very helpful in bread and dough recipes.
When chia seeds are combined with water,
they form a gel-like consistency that may be used as an egg replacement in
baking. They provide moisture and aid in mixing ingredients.
Condiments are among
the most helpful ingredients for those who prefer to spice up their
meals. You may use them for flavoring a sandwich, to dip chips or carrot
sticks in or as a marinade for beef, chicken or fish.
However, when you
follow a gluten-free diet, you can feel as though your selections are
restricted to only a few products, such as ketchup, mustard and mayonnaise,
which you can be certain are free of gluten.
You might try the
following alternatives to add flavor to your meals:
As a tasty
substitute for normal soy sauce, which frequently includes gluten, tamari or
gluten-free soy sauce can be used. Stir-fries, marinades and sauces all
benefit from their depth and umami.
To guarantee they
are devoid of any hidden gluten components, look for pasta sauces labeled
gluten-free. Or read labels carefully
for any possible gluten.
Naturally
gluten-free, herbs, spices and seasoning mixes give your food depth and
taste. Basil, oregano, cumin, paprika and onion or garlic powder are a few
examples.
It is crucial to
carefully examine every spice blend to ensure that no additional ingredients
containing gluten have been added.
Celiac.com 09/23/2023; by Scott Adams
For those with celiac disease, gluten-free baking isn't just
about culinary preference; it's a vital aspect of maintaining their health and
preventing the symptoms and damage associated with gluten consumption. In
recognition of the unique challenges faced by individuals with celiac disease,
this article is dedicated to advancing the art of gluten-free baking. While
many are familiar with the basics of gluten-free substitutions and recipes, we
aim to take your culinary creations to the next level. Our purpose is to empower
those affected by celiac disease, as well as anyone interested in gluten-free
baking, with advanced techniques, innovative recipes, and creative ingredient
substitutions. We want to inspire you to go beyond the ordinary and create
exceptional gluten-free baked goods that rival their gluten-containing
counterparts in flavor, texture, and presentation.
We will explore the world of gluten-free baking, uncovering the secrets
to mastering flour blends, harnessing the potential of innovative gluten-free
ingredients, employing advanced baking techniques, elevating flavor profiles,
customizing and adapting recipes, and showcasing the artistic presentation of
your gluten-free creations. Whether you're a seasoned gluten-free baker or just
beginning your journey into this culinary realm, there's something here for everyone.
Together, let's embark on a delicious and satisfying adventure into the realm
of gluten-free baking beyond the basics.
The
Importance of Gluten-Free Flour Blends
For individuals with celiac disease or gluten sensitivity,
removing wheat flour from their diet is a necessity. However, wheat flour
contains gluten, a protein that contributes to the elasticity and structure of
baked goods. To replicate this essential texture, gluten-free flours must be
combined in precise ratios to create a blend that closely mimics the properties
of wheat flour. The right blend can make the difference between a crumbly, dry
product and a moist, tender one.
Creating
Your Own Gluten-Free Flour Blend
While pre-packaged gluten-free flour blends are readily
available, creating your own blend allows for greater control over taste and
texture. Here's a basic guide to crafting your custom flour blend:
Commercially
Available Gluten-Free Flour Blends
If you prefer convenience or are new to gluten-free baking, several
excellent commercially available gluten-free flour blends are worth
considering. Some popular options include:
Each of these blends has its unique characteristics and works well in
specific applications. Experimenting with different commercial blends can help
you find the one that suits your baking needs best.
In the journey of mastering gluten-free flour blends, patience and
experimentation are key. By understanding the importance of these blends,
crafting your own, and exploring commercially available options, you'll be well
on your way to creating exceptional gluten-free baked goods with the perfect
texture and flavor.
In the world of gluten-free baking, innovation often leads to delightful
surprises. Beyond the conventional gluten-free flours like rice and sorghum,
there exists a treasure trove of lesser-known ingredients with unique
properties that can transform your gluten-free baked goods into culinary
masterpieces. It's time to explore some of these innovative gluten-free
ingredients, understand their distinct qualities, and share recipes that
demonstrate their potential.
Almond
Flour: Nutty Excellence
Coconut
Flour: The Versatile Grain-Free Choice
Tapioca
Starch: The Textural Marvel
Teff
Flour: The Ancient Grain Secret
These
innovative gluten-free ingredients open up a world of possibilities for
elevating your baked goods. By understanding their unique properties and
experimenting with recipes, you can create exceptional gluten-free treats that
not only cater to dietary restrictions but also satisfy your culinary cravings.
The key is to embrace these ingredients as creative allies in your gluten-free
baking journey.
Advanced Baking Techniques
Elevating your gluten-free baking game goes beyond just using
alternative flours. Advanced baking techniques can make a substantial
difference in the texture, flavor, and overall quality of your gluten-free
baked goods. Now we'll explore three advanced techniques: sourdough starters, long fermentation, and managing
hydration levels. We'll delve into how these methods can enhance your
gluten-free creations and provide step-by-step instructions and tips for their
effective use.
1.
Sourdough Starters: Capturing Natural Fermentation
Why Sourdough for Gluten-Free Baking?
Sourdough starters harness the power of natural fermentation to
improve both flavor and texture. In gluten-free baking,
where the absence of gluten can lead to denseness, sourdough can create a
lighter, airier crumb. The beneficial microbes in sourdough help break down
starches, making it easier for the body to digest.
Getting Started with a Gluten-Free
Sourdough Starter:
Using Sourdough in Recipes:
2. Long Fermentation:
Developing Flavor and Structure
The Benefits of Long Fermentation: Long
fermentation allows the dough to develop complex flavors and improve its
structure. In gluten-free baking, this extended rest period enhances the
texture, making it less crumbly.
Steps for
Long Fermentation:
Tips for
Success:
3.
Managing Hydration Levels: Achieving the Right Consistency
Why Hydration Matters: Hydration levels in gluten-free dough
significantly impact the final product. Different flours absorb liquid
differently, so understanding and managing hydration is crucial for achieving
the desired texture.
General Guidelines:
Tips
for Hydration Adjustment:
Mastering these advanced baking techniques can transform your
gluten-free baked goods into culinary delights. Sourdough starters infuse
flavor and lightness, long fermentation enhances structure and complexity, and
managing hydration ensures the perfect dough consistency. Experiment, observe,
and adapt these techniques to your favorite recipes to create exceptional
gluten-free treats that will leave everyone craving more.
ELEVATING FLAVOR PROFILES
Elevating the flavor of gluten-free baked goods is a delightful journey
that can transform your creations from good to exceptional. In this section,
we'll share valuable tips and tricks for enhancing the taste of your
gluten-free treats. We'll explore the art of using spices, extracts, and
natural sweeteners to create delicious, flavorful baked goods. Additionally,
we'll provide recipes that demonstrate these flavor-enhancing techniques.
1.
Tips and Tricks for Flavor Enhancement
2. The
Power of Spices and Extracts
3.
Natural Sweeteners and Flavor Infusions
Adapting traditional recipes to make them gluten-free can be a
rewarding and creative endeavor. In this section, we'll provide guidance on how
to successfully transform your favorite recipes into gluten-free versions.
We'll discuss the importance of accurate ingredient measurements and adjusting
ratios to maintain the desired texture and flavor. Plus, we'll share examples
of successfully adapted recipes to inspire your culinary experiments.
1.
Adapting Traditional Recipes to Be Gluten-Free
2. The Importance of
Accurate Measurements and Ratios
3. Successfully Adapted
Recipes
Customizing and adapting recipes to be gluten-free allows you to enjoy
your favorite dishes without compromising on taste and quality. By following
these guidelines, paying attention to measurements, and experimenting
thoughtfully, you can successfully create gluten-free versions of your beloved
recipes that are just as satisfying and delicious.
Showcasing Artistic Presentation
The art of gluten-free baking goes beyond taste; it extends to
presentation and aesthetics. In this section, we'll explore the importance of
presentation in gluten-free baking and offer decorating and plating tips to
help you create visually appealing gluten-free desserts. We'll also share
inspiring photos of beautifully presented gluten-free baked goods to spark your
creativity.
1. The
Importance of Presentation in Gluten-Free Baking
2.
Decorating and Plating Tips for Gluten-Free Desserts
3.
Beautifully Presented Gluten-Free Baked Goods
Remember that the key to showcasing artistic presentation in gluten-free
baking is creativity and attention to detail. Experiment with different plating
techniques and decorations to make your gluten-free desserts not only
delectable but also visually stunning, ensuring a memorable dining experience
for all.
In the world of gluten-free baking, the journey is not only about
necessity but also about creativity and culinary innovation. Throughout this
article, we've embarked on a flavorful exploration of gluten-free baking beyond
the basics, uncovering techniques, ingredients, and presentation tips that can
empower individuals with celiac disease and gluten sensitivities to create exceptional
treats. Let's recap the key takeaways and celebrate the joys of gluten-free
baking.
Key
Takeaways:
Embrace the Gluten-Free
Culinary Journey
We encourage
every celiac and gluten-sensitive baker to embrace the gluten-free culinary
journey with enthusiasm and creativity. Don't be afraid to experiment, adapt,
and innovate in your kitchen. Gluten-free baking can be an art form in itself,
offering endless possibilities for delicious and safe treats.
Remember
that gluten-free baking is not just a necessity; it's an opportunity to explore
new flavors, textures, and techniques. Whether you're baking for yourself or
sharing your creations with friends and family, take pride in the fact that
you're not only enjoying safe gluten-free treats but also delighting in the
joys of culinary creativity.
So, go ahead
and embark on your next gluten-free baking adventure. Create, savor, and share
your exceptional gluten-free delights with the world. After all, in the realm
of gluten-free baking, the possibilities are as limitless as your
imagination, and the results are truly scrumptious.
The key to
effectively adjusting to a gluten-free lifestyle is meal preparation. You
can keep organized, save time, and always have wholesome, delectable
gluten-free meals on hand. Here are some practical tactics to include in
your routine for planning gluten-free meals:
The secret to
successful healthy eating is preparation. Fortunately, choosing nutritious
foods won’t need much thought if you plan and prepare your meals in
advance. The following are some weekly routines you can do for
convenient prepping:
Choose the meals you want to make during
the coming week to start. Consider your snacks, lunch and dinner. Assess
your tastes, any unique dietary restrictions and the ingredients you have on
hand.
Make a thorough
shopping list of all the gluten-free foods you’ll need based on your meal
plan. By doing this, you can ensure you have everything you need to make
your meals.
Prepare items in advance by washing,
cutting and cooking grains or marinating meats. This frees up time during
the week and facilitates speedy dinner preparation.
If you are on a tight
schedule and always on the go, it can be hard for you to prepare your
gluten-free meals every day. That is why, it is advised that you
batch-cook your meals and freeze them so you can easily grab it whenever you
are ready to go.
Here are some tips to
keep in mind:
Look for gluten-free
recipes for baked goods, soups, stews, casseroles and other dishes that can be
frozen. These may be prepared in greater amounts and frozen for later use.
When freezing meals,
carefully provide the dish’s name and the date it was made on the
containers. This makes it easier for you to keep track of what is in your
freezer and guarantees that you will use the items promptly.
When it’s time to eat your frozen meals,
defrost them in the microwave or let them thaw overnight in the
refrigerator. To preserve food safety, fully reheat the meal before
eating.
By now, we’re all
aware that preparing gluten-free meals is much more time consuming and hard
than normal foods. That is why it is advisable sometimes to reuse your
leftovers and enjoy them for the next day. Here are some ways to effectively do this:
Prepare more food
than you would consume at one meal so that you have leftovers the next
day. Consider using the leftover chicken from roasted chicken, for
instance, in a salad or wrap the following day for lunch.
• Repurpose leftovers
creatively
Get creative with
repurposing leftovers into new meals. For instance, use leftover grilled
steak to top a salad or transform cooked vegetables into a flavorful stir-fry.
To keep leftovers
fresh and avoid cross-contamination, store them in the refrigerator in airtight
containers. For simple reference, mark them with the date.
Planning your gluten-free meals is
essential to leading a healthy and full life.
You may easily eat tasty and nutritious gluten-free meals by being aware
of gluten-free goods, practicing efficient meal planning skills, and using
smart cooking techniques.
We can simplify our
gluten-free meal planning process by adding these techniques into your routine,
whether it’s weekly meal preparation, bulk cooking or making the most of
leftovers.
Enjoy a gluten-free
diet’s variety of tastes while appreciating the advantages of well-organized
and mindful meal preparation.
Start preparing
gluten-free meals to open up a world of culinary opportunities.
Eliminating all sources of gluten from
your meals and snacks is one of the fundamental principles of a gluten-free
diet. This means staying away from all types of wheat, barley, rye, and their
derivatives. When preparing and eating meals, it’s crucial to carefully read
food labels, select naturally gluten-free items, and be aware of
cross-contamination.
Oatmeal itself is
gluten-free. However, cross-contamination (very likely in regular oats) can
occur during processing, harvesting, storage, and transportation where oats may
come into contact with gluten-containing grains. Avoid regular oats; only
eat gluten-free oats.
Keeping a gluten-free diet under control
entails choosing naturally gluten-free goods, carefully reading food labels,
and removing any sources of gluten from your meals and snacks. Planning and
preparing meals ahead of time is crucial. You should also stock your pantry
with gluten-free options and be cautious of possible cross-contamination
whether eating out or cooking at home.
[1] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gluten-free-diet/art-20048530
[2] https://wap.org.ng/read/gluten-free-meal-planning-made-easy-tips-and-recipes-for-beginners/
[3] https://glutenfreeonashoestring.com/stock-your-gluten-free-pantry-baking/
[4] https://www.beaumont.org/health-wellness/blogs/health-benefits-of-meal-planning
WHAT YOU SHOULD DO WHEN YOU
ACCIDENTALLY EAT GLUTEN?
Last
Updated September 12, 2023. Published FEBRUARY 27, 2019
This
article discusses what you should do when you accidentally eat gluten despite
following a strict gluten-free diet due to celiac disease or gluten
intolerance. I’ll also share home remedies that may help you recover quickly
after gluten exposure. This post contains affiliate links and is not a
substitute for medical advice or care.
The thing I fear most
happened to me: I ate a piece of gluten. My friend thought she bought
gluten-free cookies from Trader Joe’s, but she was confused by the packaging
and instead served me regular cookies made with wheat flour! I only ate a small bite of the cookie before
we realized the mistake. And my friend was extremely apologetic. I tried to
minimize the situation by telling her it was okay, but all the while, I was
secretly panicking.
Would I get sick? Would I have diarrhea and bloating for days? Would
my geographic tongue flare up?
Would I get annoying acne? I didn’t know what to expect because it’s
always hard to pinpoint exactly how I would react to gluten exposure. In the past, whenever I felt sick after
eating, I’d blame gluten. But the truth is, I had never knowingly eaten
gluten. I only suspected I had. But in this case, I knew with
absolute certainty that I had eaten a piece of gluten. I was
terrified.
Surprisingly, I
didn’t get sick or bloated after eating the gluten cookie. I was fine. How could this be? I ate gluten! I should be sick as a dog,
spending hours on the toilet, right?
While I got off lucky in this situation, most of the time, I’m not so
fortunate.
Most people who accidentally eat gluten, a sticky
protein found in wheat, rye, barley, and sometimes oats, feel sick. They
may race to the bathroom to violently purge the ill-gotten protein. Despite your or my best efforts, gluten
happens. When I suspect I’ve been
accidentally glutened, it takes about 60-90 minutes for me to bloat up like a
balloon. I become incredibly gassy. Eventually, I’ll race for the bathroom to
purge the offending protein. Others
might experience headaches, skin breakouts (acne, rashes), fatigue, or a
combination of these devastating symptoms.
And sometimes, we have no symptoms at all, leaving us scratching our
heads, wondering why gluten sometimes creates chaos in our bodies and sometimes
doesn’t. The
reaction varies from person to person and likely depends on how much gluten
someone accidentally ate.
I feel better once I
purge gluten from my system and take time for self-care. However, how “easily” you process gluten
depends on the strength of your digestive system and how much gluten you have
consumed.
The good news is that
if you’ve been on the gluten-free diet for a while, your body has had time to heal, and your intestinal lining is likely
stronger and more resilient than it was when you first started a gluten-free
diet.
It’s important
never to consume gluten when on a gluten-free diet, regardless if you have
celiac disease or gluten intolerance.
Continuously cheating on your gluten-free diet will harm your body, but one exposure to gluten probably
won’t, especially if you’ve put in the hard work to heal your body and gut.
The remedies detailed
below are for one-time accidental gluten exposure only and should not be used
as an excuse to eat gluten nor as a remedy for careless eating. Also, implement these strategies as soon as
you realize you’ve been glutened--don’t delay! The more quickly you get in
front of it, the faster you will likely recover.
Remedy #1: Hydrate Like Crazy
Drink a lot of water
after an accidental glutening to flush your digestive system and help eliminate
whatever you ate or drank more quickly.
I recommend adding a
squeeze of lemon to your water, too. Lemon is alkalizing, helping you more
quickly restore your body’s natural pH balance.
(Also, you may want to add some cranberry juice to the plain water to
augment the taste.)
Another herb to
consider adding to water is ginger. Ginger has natural anti-inflammatory
properties known to aid in digestion.
Warm tea with lemon
and ginger may help to settle your stomach and calm the inflammatory fire
inside you.
Drinking plenty of
water is also essential if you experience diarrhea after consuming gluten.
Water will replenish the lost liquid and ensure you don’t become dehydrated.
You can also drink
unsweetened coconut water as a natural remedy to replenish lost electrolytes. Coconut water contains sodium, potassium,
calcium, magnesium, and phosphorus. It’s a better alternative to electrolyte
drinks like Gatorade, which is loaded
with sugar and artificial dyes.
9/18/2023 - Vomiting and nausea are considered
common symptoms related to gluten ingestion in treated celiac
disease. However, the overall rates and associated factors of these
symptoms after chronic gluten exposure, and acute re-exposure during gluten
challenge, remain poorly understood.
Remedy #2: Consider Taking
Digestive Enzymes
Your body already produces a plethora
of digestive enzymes naturally.
These enzymes help break down and improve the absorption of food. Today, you can purchase gluten digestive
enzyme supplements to inflate the number of digestive enzymes in
your body and aid in the breakdown of food. This can be particularly helpful in
people with digestive diseases like celiac disease.
While I don’t recommend digestive enzymes for long-term use, as you
don’t want your digestive system to become dependent on them, they can be helpful
as an insurance policy that comes to your aid in times of need. For example, when you’ve been accidentally
glutened, a digestive enzyme may help to relieve some of the GI symptoms you
will likely experience.
However, a digestive
enzyme is much more helpful before a meal. A good time to pop a digestive
enzyme is before eating at a restaurant or a friend’s house, just in case you
get glutened despite your best efforts.
There are many digestive enzymes on the market, but I have personal
experience with the following enzymes:
· GlutenEase contains dipeptidyl peptidase (DPP-IV), a form of “protease,” an enzyme that assists in the breakdown of gluten and gliadin proteins.
·
Wheat Rescue has
received Dr. Tom O’Bryan’s stamp
of approval. It also contains enzymes that assist in the breakdown of glutenin
and gliadin proteins, along with probiotic spores
that aid in creating good gut health.
Digestive enzymes should
not be used as permission to eat gluten; they should only be used when an
accidental exposure could happen.
If you’re experiencing diarrhea after
accidentally eating gluten, you might find relief by taking Pepto-Bismol,
Kaopectate, or Imodium A-D.
I haven’t taken activated
charcoal, but when I asked my gluten-free community what they take after
accidental exposure to gluten, it was clear that many gluten-free people
already know about and take activated charcoal.
Activated charcoal is sometimes used to treat poisonings or drug
overdoses because toxins bind to charcoal, which helps the body get rid of
unwanted substances.
It’s also commonly used as a digestive aid due to its absorption
qualities in the digestive tract. It can provide some intestinal comfort by
absorbing gas and neutralizing diarrhea.
One community member told me that activated charcoal helps relieve
bloating and lessens the duration of her symptoms.
However, no studies validate the use of activated charcoal in
helping people recover after accidentally eating gluten. Consult your doctor
before taking it.
While you might be
kicking yourself for accidentally eating gluten after all the hard work you’ve
put into your gluten-free diet, go easy on yourself We all make mistakes; even veteran
gluten-free eaters like me have made a mistake or two (or 50!).
Stay close to home
when you’ve been glutened so you’re close to your bed and toilet, and give your
body time to rest.
Stressing about
something out of your control will only make you feel worse, and stress may
compound your symptoms.
My mom always says, “This, too, shall pass.” Tomorrow is
a new day to get it right.
Give your digestive
system time to rest and recover from gluten exposure. Focus on eating
easy-to-digest foods like bone broths, rice, bananas, gluten-free crackers, and tea
(with lemon and ginger). These foods will help settle your roaring stomach.
Avoid eating a big meal until you feel better. Also, avoid rich and hard-to-digest foods,
such as meats and dairy. Similar to gluten, dairy contains a hard-to-digest
protein called casein. Focus on easy-to-digest foods as much as possible.
Did you know that 80
percent of the immune system is in the digestive tract and gut? That means a
healthy gut is more likely to bounce back quickly after accidentally eating
gluten.
I recommend taking a high dose of
probiotics daily (at least 40 billion CFUs) to maintain
good gut health continuously, as you never know when gluten might
[accidentally] happen. I think my
well-nurtured gut was what helped me bounce back quickly when I accidentally
ate that Trader Joe’s cookie.
If you’ve been glutened, I recommend doubling on probiotics for a few
days to boost your gut health during this crisis.
While no one is perfect, there are measures you can take to
prevent accidental gluten exposure. I like to say, “When I know better, I do
better.” Use this as your mantra, too.
Return to Home Page Updated 9May24