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Gluten Sensitivity or is it Fructan Intolerance?

Many people struggle with complaints of gas and bloating and while searching for relief, decide to give gluten free foods a try.  It may help alleviate your symptoms and you feel better, less bloated, less gassy, and therefore, self diagnose yourself with a gluten sensitivity.  But, is it really the gluten that is causing the uncomfortable digestive woes?  Millions of people voluntarily avoid gluten, a protein found in wheat, barley, and rye foods like bread, cereal and pasta. Those who have celiac disease (1% of the population) MUST avoid ALL gluten due to immune damage  it causes in the small intestine, which makes them very sick.  But is it really the gluten causing all the digestive symptoms for the 12% of people reporting a gluten sensitivity?

New research from Norway suggests it’s not gluten that is causing issues for these people… it’s a FODMAP called fructan.  FODMAP is an acronym for a group of short-chained carbohydrates which are poorly digested by the human body.   FODMAP stands for Fermentable, Oligosaccharide, Disaccharide,Monosaccharide, And, Polyols.

Since many people can’t break down FODMAPs, these molecules remain undigested until they reach your colon. From there, the bacteria in your colon “digest” or ferment these molecules, which produces gas, and causes digestive symptoms – ouch!  Typical symptoms of irritable bowel syndrome (IBS) are now treated with the Low FODMAP diet. Symptoms of IBS include:

  • Abdominal pain and cramping
  • Excessive gas
  • Bloating
  • Abdominal distention and swelling
  • Constipation
  • Diarrhea
  • Nausea
  • Fatigue

The Low FODMAP diet is also helpful for those diagnosed with SIBO (small intestinal bacterial overgrowth) and inflammatory bowel disease.

FRUCTANS are a FODMAP and  occur in large quantities in wheat, barley and rye, garlic, onions, chickpeas, raisins, watermelon

So what’s the problem with avoiding gluten?  There are gluten containing foods that you may be unnecessarily avoiding, such as sourdough spelt or wheat bread, as the cultures in sourdough breakdown the fructans.  We know that the microbiome in the intestine is very important for gut health.  We don’t want to unnecessarily elliminate foods that contribute to a healthy microbiome environment. The other issue is that most people with digestive issues don’t ever fully recover on a gluten-free diet. This is because FODMAPs (including fructans) are the likely culprit and gluten free is not always low in FODMAPs which is what’s actually required. The good news is the Low FODMAP diet is not meant to be followed forever!  There are 2 phases;

1). elimination phase and

2). challenge phase. 

You begin with eliminating High FODMAP foods for 4-6 weeks, if you notice a remarkable improvement, it’s time to challenge!  You will begin to see which FODMAPs are triggers and your tolerance level.  Yes, tolerance level!  That means you don’t need to follow a Low FODMAP diet indefinately.  Remember, alot of these foods contibute to good gut microbiome.  So, let’s not eliminate!  It’s about figuring out what YOUR triggers are, then finding your tolerance level.  You may tolerate a slice of wheat bread with your eggs in the morning, but have some awful digestive sympotoms after consuming a large pasta dish with a garlic sauce – that’s a no, no for me!

Consult with a Registered Dietitian prior to initiating a Low FODMAP diet or any elimination diet.  

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