Why Do I Need A Gluten Free Diet?

By Erika Krull 

You've just heard the news from your doctor. Or maybe you've come to the conclusion on your own, perhaps after conflicting medical tests and your unending list of symptoms. Still, this is the moment of truth - you're starting a gluten free diet. The kicker is you have no idea what you're doing. Going low-fat? Cut down on pizza and baby back ribs. Going low sodium? Throw out the salt shaker. Going gluten free? Hmm...can you repeat the question? That's how our family was when my husband had to start a gluten free diet.

We vaguely knew what gluten was, we knew how miserable he felt, but we didn't have any idea how they were connected. And once we heard the news, then what? Was this dramatic change really necessary, and would I have to throw out everything in my kitchen to make it happen? It was a challenge at first, but we survived it. Let me walk you through the basics of what gluten is, where it lurks, what your celiac or gluten sensitivity symptoms might look like, and how gluten can really hurt someone who needs to avoid it.

What Is This Gluten Stuff Anyway?

The first few weeks of grocery shopping after my husband's diagnosis were disorienting and exhausting. Gluten - really? If it jumped off the ingredient label and hit me in the nose, would I know it was gluten? Label-reading can be tough because gluten comes from a handful of different grains and is made into a million different ingredients not labeled as "this looks a lot like gluten." It's a protein found in wheat, barley, and rye. Kneading bread dough activates the gluten protein, creating a strong but flexible structure for the bread. Oats do not technically contain gluten, but it is so often grown and processed near wheat fields that the risk of cross-contamination is pretty good. So-called "clean" oats are grown and processed in isolated fields, with dedicated equipment, and with frequent testing to eliminate this contamination risk.

I Had No Idea Gluten Could Be In That

OK, so you ditch the bread, pasta, donuts, and pizza crust, and that big bag of flour on the back shelf. That'll do it, right? Well, it's a good start, but it's not enough. A gluten free diet goes way beyond the obvious sources. You'll need to crack out your reading glasses and get cozy with food labels from now on. Gluten can be found in malt flavoring (oh no - check nearly any mainstream cereal box), "natural flavoring" (one of those nebulous ingredients near the end of many labels), and random occurrences of wheat flour (like some potato chips or nut mixes). See what I mean? It's a lot like spotting Waldo in one of those books, except that Waldo sometimes moves around and changes his shirt without telling you.

Feeling Sick In A Hundred Different Ways

Did you hear something about "contamination"? Yes, you did. For some people, gluten is essentially a poison. It is to be avoided completely and consistently. Otherwise, they risk uncomfortable symptoms and potential bodily harm. Gluten sensitivity and celiac disease can share very similar symptoms. But according to current research only celiac disease shows evidence of true intestinal damage. These symptoms can include diarrhea, stomach cramps, marked or unintended weight loss, a "foggy brain" feeling, headaches, general fatigue, abdominal pain, bloating, joint pain, another medical condition seeming worse or failing to improve, depression, irritability, muscle cramps, mouth sores and other dental problems. Children may have stunted growth, "failure to thrive", or may appear sickly and have some of the other symptoms described above. Some have found that behavioral problems and autism have been linked to celiac disease and gluten sensitivity. While this is somewhat controversial and is not yet conclusive, more experts continue to look into the connections.

The list of possible symptoms is a long and winding road, and the end result for each person doesn't always spell something obvious like, "Hey, I have a problem with gluten!" Some have very few, if any obvious symptoms, and it's only confirmed when they get a colonoscopy (often because of some other ongoing medical treatment or evaluation). Others have a wide range of symptoms all the time. You may notice that not all of the symptoms are digestive in nature. The key thing to remember is that a person with true untreated celiac disease is also experiencing malabsorption of nutrients from their food. Food comes in, but their body can't get much from it. Over time, these symptoms or changes develop and take their toll.

Celiac symptoms are commonly overlooked, misinterpreted, mistreated, ignored, or minimized for many years before a proper diagnosis is discovered. And who could blame anyone for taking that long to figure it out? With that wide range of symptoms, problems could be easily written off as harmless issues with no connection to a larger picture. It's not reasonable to assume that any random stomach ache or period of fatigue is automatically the result of a lifelong medical problem. That sounds over-dramatic, right? When it starts to affect your life in a way you can't ignore, that's usually when the pieces fall together. Only when my husband started losing a dramatic amount of weight did we really take action to solve the problem. Once we got the diagnosis and looked in the rear-view mirror, we easily saw the symptoms we'd misread.

Inflammation Is A Very Bad Thing

Here's the biggest reason why anyone diagnosed with celiac disease absolutely needs to avoid gluten at all cost - bodily damage from chronic inflammation. Remember all that about malabsorption of nutrients? The reason that happens is because gluten causes an auto-immune response in the intestines, causing a lot of inflammation. Basically, the body attacks itself when gluten is around. This relentless inflammation causes obvious symptoms like pain and discomfort. It also starts to destroy the villi (tiny finger-like projections that line the digestive tract) that do all the nutrient absorption. As time goes on, the inflammation wears these villi down to a nub. Enter diarrhea, malabsorption, weight loss, fatigue, headaches, and general symptoms of poor nutrition.

Fortunately, there's a way to restore the digestive tract to its original purpose and structure. It's called...the gluten free diet. Yep, that's it. At this point, the complete avoidance of gluten is the treatment. Medication can sometimes help the symptoms, or you may need other treatments while healing up initially. But food is literally your medicine once you get a celiac diagnosis. And for those wondering about gluten sensitivity, you may get any of the above-mentioned symptoms but have no (or very little) evidence of damage to your digestive tract. But even so, who wants to be sick like that all the time? Your body can't function well if it's constantly reeling from symptom episodes and suffering from poor nutrition. In general, the treatment for any level of gluten sensitivity is a gluten free diet.

Gluten Free Diet - It's Good To Be Healthy Again

The entire goal of a gluten free diet is to help your body heal and keep it healthy. Yes, starting out can be confusing and frustrating. Yes, you will likely miss foods you used to eat (that's normal and OK). Yes, you may have to explain yourself for a while until people understand what you're talking about. But through all this, you gain a priceless gift - a healthier body for you to use and enjoy.

If you have other underlying medical problems, you may still have to deal with those. But chances are good you'll manage them better without all the symptoms, inflammation, and nutrient malabsorption. It's a new landscape with ups and downs, but you'll find that you can eat many delicious things on a gluten free diet. It's not like you're being told to go live on the moon (though it may feel like it at first). Every wonderful tasty gluten free food can be found right here on earth.

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