What’s the Trouble with Gluten?
The usual gas and bloating.
I had to laugh when a client wrote this on a symptom questionnaire, as if these conditions were a normal part of human development.
“Oh, look. Timmy’s front teeth are coming in.”
“That’s not all. He’s also getting the usual gas and bloating!”
Digestive complaints are common enough in America that we might think they’re normal, but in truth they’re the sign of a troubled gut. Symptoms such as gas, cramping, diarrhea, and constipation can be caused by any number of nutritional disorders, from insufficient hydrochloric acid in the stomach to sludgy bile in the gallbladder.
One common cause of these intestinal woes is the wheat protein gluten. This pesky compound, largely misunderstood and ignored by conventional medicine, can cause all sorts of trouble in the gastrointestinal tract of people sensitive to it—and possibly a whole lot more.
Amber Waves of Pain
There’s no debate that gluten impairs health in people with a bona fide genetic intolerance to it—an autoimmune disorder known as celiac disease that affects about one out of every hundred Americans (which is pretty darn high as far as chronic anything goes).
In people with celiac, gluten destroys the lining of the intestines, causing severe malabsorption of nutrients and “leaky gut,” a condition in which the bonds that bind the intestinal cells to each other break, allowing stuff into the body that shouldn’t be there, including gluten itself.
The body’s immune system reacts to these foreign invaders as you might think, and, accordingly, celiac disease is associated with just about every autoimmune affliction (and gastrointestinal complaint) known.
So far, so good—or bad if you happen to be cursed with this brutal condition.
Where conventional medicine and alternative health butt heads is the matter of how many people in the population are “gluten sensitive” or “gluten intolerant,” that is to say, not officially celiac but appearing to suffer an adverse reaction to the protein nonetheless.
More Common Than We Think?
Symptoms of gluten sensitivity can include the complaints one would expect from something beating on our gut—bloating, pain, gas, constipation, diarrhea—but some sufferers experience only “extra-intestinal” symptoms, which can include headaches, chronic fatigue, muscle numbness, joint pain, eczema, weight gain or loss, and even anxiety and depression.
Gluten’s connection to mental disorder is, in fact, beyond doubt, says Dr. Marios Hadjivassiliou, a neurologist who studies gluten sensitivity and brain disease.
He and other gluten experts have even gone so far as to say that gluten sensitivity should be entirely reclassed, defining it not as a mere intestinal disorder but rather a spectrum of diseases that can affect the brain and virtually every other organ in the body.
With scientific study of gluten sensitivity in its infancy, testing for the disorder is notoriously inconclusive. But enterologist and gluten expert Dr. Scot Lewey, basing his estimate on genetic research and observations in his own practice, puts the number of Americans sensitive to the protein at somewhere between 10 and 30 percent of the population.
Moreover, says researcher and physician Dr. Mark Hyman, “Ninety nine percent of people who have a problem with eating gluten don’t even know it,” attributing their symptoms to some other cause instead.
Fortunately, there’s a simple way to tell whether you’re gluten sensitive that doesn’t involve lab work or a doctor. It’s called a gluten challenge, which is a fancy way of saying get gluten out of your life for a while and see if you stop feeling like hell—kind of like that boyfriend or girlfriend you should have quit ages ago.
Usually, about three weeks of gluten-free living are enough to tell whether you might be sensitive. Is your digestion improved? Do you feel less tired or bummed out? Are allergies or headaches or mysterious aches and pains better?
All of these are signs that you might have a problem with gluten. Further confirmation comes by reintroducing gluten back into your diet and seeing whether your symptoms return or worsen. If so, you can be fairly certain you’re gluten sensitive.
Free to Be You and Gluten Free
Okay, so where do you start? Well, first, you’ve got to learn which foods contain gluten. You might be surprised at how long that list is.
Obviously, anything with wheat flour has to go. This means no cereal or toast or bagels or muffins for breakfast, no pretzels or crackers or cookies for snacks, no sandwiches or burritos for lunch, no pasta or couscous for dinner, no cookies or cake or pie for dessert. Even communion wafers are off limits.
And since barley contains gluten…no beer. I know. Sorry.
Other grains that contain gluten include rye, spelt, bulgur, and kamut.
And then there are oats. While food scientists continue to debate whether oats contain a gluten-like compound that could be a problem for people who are very gluten sensitive, the debate is moot in most cases because oats are usually processed in plants that also handle wheat and are therefore cross contaminated.
So, unless your oatmeal says “gluten-free,” steer clear.
And because wheat is everywhere in food manufacturing, just about any processed food is likely to contain gluten. This includes canned soups, sauces, marinades, broths, soy sauce, flavorings, etc. Seriously, if it comes in a package, has an ingredient list more than a few items long, and doesn’t say “gluten-free,” it’s probably trouble.
Other, non-food products can also be sources of gluten. Prescription drugs, over the counter medications, vitamin and mineral supplements, candy, even lipstick and lip balm can be hidden sources.
Fortunately, with gluten awareness at an all time high, information from manufacturers is usually just a Google away, as I discovered when I thought I’d blown a gluten challenge thanks to my Burt’s Bees pomegranate lip balm.
(Don’t worry, Burt’s Bee’s lovers, it appears all their lip balms are GF.)
Dang, So What Can I Eat?
Thanks to those ever-opportunistic food manufacturers, just about every popular food now comes in a gluten-free version. (These are usually made with non-gluten foods such as rice, corn, potato, quinoa, millet, teff, soy, and tapioca.) So, if you can’t live without that slice of toast in the morning or cookie prize after dinner, you can pull off your gluten challenge without changing your way of eating too much.
But why not take your gluten challenge a step further and go “Paleo” for a few weeks?
Try eating a diet of just meat, eggs, fish, vegetables, fruit, and nuts and see how you respond. You might find that gluten intolerance is really just a wakeup call from your body, which was not designed for a diet loaded with grains, refined sugar, and processed plant oils in the first place.
But whether you choose to do a simple gluten challenge or opt to go all hunter-gatherer, bear in mind that if you are sensitive to wheat’s main protein, you will most likely have to avoid it for the rest of your life.
On the bright side, after six to nine months of gluten-free living, your gut should be recovered and your digestion vastly improved—without the usual gas and bloating.
Fasano A et al. Prevalence of Celiac Disease in At-Risk and Not-at-Risk Groups in the United States: A Large Multi-Center Study. Arch Intern Med. 163:286-292; 2003.
Farrell RJ and P. Kelly CP. Celiac Sprue. N Engl J Med; 346:180-188. 2002.
Hadjivassiliou M.Gluten Sensitivity: From Gut to Brain. Lancet Neurol; 9: 318–30. 2010
Sapone A et al. Spectrum of Gluten-Related Disorders: Consensus on New Nomenclature and Classification. BMC Med. 2012; 10: 13.
Lewey S. Gluten Sensitivity: A Gastroenterologist’s Personal Journey Down the Gluten Rabbit Hole. Journal of Gluten Sensitivity. Winter 2007. http://www.celiac.com/articles/1101/1/Gluten-Sensitivity-A-Gastroenterologists-Personal-Journey-Down-the-Gluten-Rabbit-Hole-by-Dr-Scot-Lewey/Page1.html
Hyman Mark. Gluten: What You Don’t Know Might Kill You. Huffpost Healthy Living (blog). http://www.huffingtonpost.com/dr-mark-hyman/gluten-what-you-dont-know_b_379089.html January 2, 2010.