Is Gluten Making You Sick?
30% of the population are currently eating a gluten free diet, but less than 7% have actually been diagnosed with a gluten related condition.
You’d be hiding under a bush if you hadn’t noticed that eating gluten free has become incredibly popular over the last few years. This has raised awareness of gluten related conditions and meant that there’s a lot more choice for those that suffer with them. This is fantastic, but we also need to be aware that avoiding gluten may not be necessary for everyone.
If you’re struggling with gut related symptoms like bloating, diarrhea, constipation or cramping, you’ve probably considered gluten as a likely culprit. You might have been tested for Coeliac disease and it’s come back negative, but you swear that eating gluten is making you sick, and don’t know what to do next.
Well, Coeliac disease isn’t the only gluten related condition. There are 3 main conditions for which a gluten free diet is really necessary to maintain good health. There’s a bit of overlap between the 3, but they are totally separate conditions and it’s important to be clear on which one, if any, you are affected by. Aside from these 3 gluten related conditions, there are lots of things, other than gluten, that could be causing your problems. So, it’s a good idea to look at all the possible culprits to make sure you’re not avoiding gluten for no reason.
WHAT IS GLUTEN?
Firstly, let’s go back to basics on gluten. Gluten is a bracket term given to a range of proteins that are found in the grains wheat, rye and barley. It’s most commonly found in breads and other baked goods, but can also sneakily hide in sauces, dressings and other processed foods. There are 3 types of gluten related conditions, that are very different to each other.
GLUTEN RELATED CONDITIONS
1. COELIAC DISEASE
Coeliac disease is an auto-immune condition that affects around 1% of the population. This means that, every time someone with Coeliac disease eats gluten, the immune system attacks the intestines (I.e. the body attacks itself). What that does is destroy the villi in the intestines. These villi are the things that absorb nutrients from our food so, when they’re damaged, our body can’t absorb nutrients which leads to malnourishment and a whole host of other serious conditions such as anaemia, weight loss and fatigue.
Unfortunately, there’s no cure for Coeliac disease. However, following a strict, life-long gluten free diet will slowly reverse the damage caused to the intestines. Therefore, it’s really important that you rule out Coeliac disease first if you’re getting gut symptoms. There are a few different ways of testing for it (including blood tests + biopsy) which your doctor will be able to advise you on.
Symptoms include: anaemia, dental + bone disorders, mouth sores, skin rashes, tingling in the legs + feet, bloating, constipation, diarrhea, stomach cramps, flatulence
2. WHEAT ALLERGY
Wheat allergy is an allergic condition that affects only around 0.1% of the population. Again, the problems are caused by the immune system, but it’s different from Coeliac disease because, in this case, the immune system attacks the wheat, not the body.
As this is an allergy, you’ll notice symptoms immediately (less than 2 hours) and they can kill you, in extreme cases. Speak to your doctor if you suspect you may have a wheat allergy and they’ll be able to diagnose you via a blood test.
If you do have a wheat allergy, you don’t necessarily need to follow a strict gluten free diet. You’ll need to avoid wheat, but could have foods containing rye and barley.
Symptoms include: diarrhea, hives, rashes, sneezing, throat swelling
3. NON-COELIAC GLUTEN SENSITIVITY
If you’ve been tested for coeliac disease and a wheat allergy, but both have come up negative, NCGS might be your answer. If you have NCGS, you may likely experience very similar symptoms to Coeliac disease, but you won’t get any immune reaction or damage. This condition hasn’t been properly defined yet, but it’s estimated that is affects around 6% of the population.
This one is tricky because there is no test for it. In fact, even the existence of it is quite controversial. There’s only a small amount of evidence that says it’s actually a ‘thing.’ The evidence suggests that around 8-14% of IBS sufferers react to gluten, but this is hard to prove as there is no way to diagnose it. Therefore, it’s currently diagnosed by testing for the other 2 and excluding them. Then once they’ve been ruled out, you can do a gluten elimination diet to determine if gluten really is the trigger. This is where you cut out all gluten for a period of time (I’d recommend a month) and note whether your symptoms disappear.
Symptoms include: stomach pain, anaemia, depressions, diarrhea, eczema, fatigue, joint pain, headaches
IT MIGHT NOT BE GLUTEN…
If you are going to do an elimination diet to determine if gluten is triggering your symptoms, I’d really recommend doing it with the help of a health coach that’s experienced in gut related issues. This is because there may be other food components at play here, which will be hard to spot. Coeliac disease and IBS share very similar symptoms (bloating, flatulence, diarrhea, constipation). Whilst lots of people with IBS see improvements by cutting out gluten, that might not actually be the real cause, and it can be great to have support in working out what is
If you’re in this boat, you may have already tried cutting out or cutting back on gluten and found improvements in your symptoms. This is fantastic, but it may not actually be the lack of gluten that’s causing the symptom improvement. This is because, when you cut out gluten, you’re also reducing/removing a few other food components, including fructans from wheat. Because common foods (mainly wheat, barley and rye) trigger symptoms in both Coeliac disease and IBS, there’s a lot of confusion over which component of the food is actually responsible….in people with Coeliac disease, it’s the gluten, but in people with IBS, it’s the fructans.
So, if you see an improvement in your symptoms on a gluten free diet, it might actually be due to a reduction in fructans, which are FODMAP.
If this is the case, a low FODMAP diet could be the answer for you and could help you significantly reduce your symptoms.
WHAT TO DO
Think gluten or fructans might be affecting you, but not sure how or why? If you think you might have any one of the 3 gluten related conditions, I’d advise you to speak to a doctor and get a proper diagnosis first. As the symptoms of all these conditions overlap, this will ensure you treat the condition properly and don’t start following a diet stricter than you need to or a diet that’s not strict enough.
Once you’ve ruled out Coeliac disease and wheat allergy, try getting the support of a gut condition trained health coach. They can help you do an elimination diet to work out whether gluten, fructans, or something else, is causing your gut problems. You’ll be on your way to a calmer gut in no time!
More and more people are following a gluten free diet, but it's important to work out whether it actually is gluten that's causing your gut symptoms. It might be fructans, or another component, causing your symptoms, not gluten
There are 3 gluten related conditions:
Non-Coeliac Gluten Sensitivity (NCGS)
If you think gluten might be causing your symptoms:
See a doctor to get Coeliac disease or wheat allergy ruled out
Work with a health coach to do a formal elimination diet to determine whether wheat, fructans, or something else, is causing your symptoms
Thanks so much for taking the time to read this! Do you think you’re affected by gluten? Let me know in the comments below.