When Gluten Isn’t the Problem
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Gluten has been in the dietary doghouse for a while now. Some people have good reasons to avoid it, but others may be unfairly blaming it for symptoms like bloating, gas, and abdominal pain. And if that’s the case, a gluten-free diet may not make you feel any better.

Gluten is a protein found in wheat, barley, and rye. For some people with an autoimmune disorder called celiac disease, eating gluten damages the walls of their small intestines. That can cause symptoms ranging from diarrhea to brain fog and even block absorption of important nutrients, increasing the risk of conditions like anemia. 

It’s also possible to have something called non-celiac gluten sensitivity. That means you don’t experience intestinal damage (and don’t have the autoimmune condition) but still get symptoms from eating gluten.

Yet other people may be chalking up their symptoms to gluten when it isn’t actually the real issue. Some people with irritable bowel syndrome (IBS) may be sensitive to certain carbohydrates that include wheat but also many other foods like onions, beans, milk, and even the sugar alcohols found in sugarless gum. These carbohydrates are referred to as FODMAPs, for the names of the different categories.

For some people, especially those with IBS, one or more of those categories of carbohydrates can be hard to digest. Eating too many of these foods (or eating certain ones together in the same meal or on the same day) can lead to symptoms like cramping, gas, and bloating.

If that’s the case, just cutting out gluten won’t solve the problem. If you’re sensitive to wheat, you’re probably also sensitive to the other foods in that category, including onions, garlic, and asparagus. And some gluten-free products may contain other high-FODMAP ingredients you could be sensitive to as well, like fructose in gluten-free cereal.

How Can You Know?

To find out if you have celiac disease, you can get a blood test and an intestinal biopsy that checks for damage. Keep in mind that you shouldn’t cut out gluten before having the test, since that can lead to a false negative result. Your risk of having celiac disease is higher if you have a family history of it.

As for gluten sensitivity, cutting out gluten and noting whether your symptoms improve can help you pinpoint whether it’s the problem.

If you have IBS, trying a low-FODMAP diet can help you identify which foods are causing your discomfort. This involves eliminating foods in the FODMAP categories, then reintroducing them one by one while keeping track of your symptoms. It’s a lot to figure out, so you should work with a doctor or dietitian who specializes in this area.

 

Photo Credit: Maskot/Getty Images

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Sally Kuzemchak, MS, RD

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