Are You Reacting to Gluten, or Is It Something Else?
Published March 8th, 2021
The bloating. The nausea. The sharp, unrelenting pain in the gut. What could be the cause?
For those with celiac disease or gluten sensitivity, the onset of gastrointestinal symptoms brings up the question, “Did I just get glutened?” Unintentional gluten exposure is possible and should be considered, but other factors or conditions could cause similar symptoms.
Two of the more common food-related causes of gastrointestinal distress are foodborne illness and food intolerances. Let’s take a closer look at both.
Foodborne illness (also known as food poisoning) is caused by germs and can be experienced by anyone, regardless of their reaction to foods due to other conditions. According to the CDC, the five most common germs that can cause illness when present in the food you eat are
- clostridium perfringens,
- campylobacter, and
- staphylococcus aureus (Staph).
It can be hard to know whether you have a foodborne illness or are having a reaction to gluten. Food “poisoning” can cause symptoms similar to those of gluten exposure including
- stomach cramps, and
Seek medical treatment for a sudden onset of severe symptoms, particularly if you’ve recently eaten something questionable. Symptoms from foodborne illnesses should subside after the offending germs have left your system, although you may experience some milder residual effects.
If symptoms persist more than a few days, seeking medical help is important as some foodborne illnesses can become serious, especially for children, older adults, pregnant women, and people with compromised immune systems.
How can you avoid foodborne illness? If eating out, frequent eating establishments with clean bills of health from the local health department. At home, follow the four basic steps of “clean, separate, cook, and chill” to help stay safe from food poisoning. For more information and resources on avoiding foodborne illnesses, read 4 Steps to Food Safety.
A food intolerance is defined as an adverse response to a food or food component that does not involve the immune system. Food intolerances are quite common and can occur in reaction to many different types of foods or ingredients.
Non-celiac gluten sensitivity (NCGS) is a type of food intolerance. Celiac disease, on the other hand, is not an intolerance but an autoimmune disease. Individuals with celiac disease or non-celiac gluten sensitivity may have intolerances to foods or ingredients other than gluten, which may cause symptoms similar to those of gluten exposure.
There are two common food intolerances:
Lactose intolerance is also a common condition that may be experienced during the early stages of celiac disease. The production of the enzyme lactase is needed to digest lactose, but the presence of this enzyme is reduced when intestinal cells are damaged from undiagnosed and untreated celiac disease. In the case of lactose intolerance related to untreated celiac disease, once a person eliminates gluten from their diet, their intestinal cells are able to heal, which usually allows these cells to resume producing the lactase enzyme needed to digest lactose. If those symptoms do not go away, the person may be lactose intolerant in addition to having celiac disease.
A study from 2020 of 20 Austrian patients with non-responsive celiac disease showed that 90% had additional food intolerances and malabsorption issues. In the study, 11 of the 20 individuals were also lactose intolerant.
Lactose intolerance is quite prevalent in the general population. Not all people who are lactose intolerant have celiac disease.
FODMAP is acronym for various types of carbohydrates found in multiple foods, including in wheat, that could cause a reaction in people with celiac disease or NCGS:
- Fermentable oligosaccharides
Research has found that some people who believe they are sensitive to gluten may be sensitive to FODMAPs as well. Examples of foods containing FODMAPs include
- soft cheeses,
- blackberries, and
For more information on FODMAPs, check out our article on the topic.
If you continue to have symptoms after removing gluten from your diet and think you may have a food intolerance, consult with your personal healthcare team. Include a registered dietitian who can help identify potentially problematic foods.
In the case of any gastrointestinal disturbances, do not try to self-diagnose. Always consult with your personal healthcare team if symptoms persist.
There are other health conditions that could mimic a gluten-reaction. We’ll explore more of them in the near future.
- Foodborne Germs and Illnesses
- Non-responsive celiac disease may coincide with additional food intolerance/malabsorption, including histamine intolerance
Disclaimer: The information on this website is for educational purposes only. Consult your healthcare team when considering this information.
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