FODMAP Life Blog

The Low Fodmap Diet and Celiac Disease

Leave a Comment
It's only fair to share...Share on FacebookPin on PinterestTweet about this on TwitterShare on StumbleUponEmail this to someonePrint this page

Intestinal Damage Of GlutenWhat is Celiac Disease?

Celiac disease is a chronic condition that affects the body for its lifetime.  Whenever someone with celiac disease ingests gluten, an abnormal immune system response is triggered, damaging the small intestine.

People with celiac disease need to avoid ALL gluten.  The same goes for people with Non-Celiac Gluten Sensitivity and Hashimoto’s Disease, an auto-immune condition (learn more here).  Tiny villi tissues line our small intestines.  They help us to absorb vitamins, nutrients and sugars from foods.  When a celiac patient ingests gluten, the villi of their small intestine flatten out, causing damage and the inability to absorb vital nutrients.  Sometimes someone with celiac who ingests gluten doesn’t feel or experience symptoms, but at the same time, they are slowly damaging the small intestine.  I thought that people with celiac are diagnosed at birth, but in actuality, more and more people are experiencing symptoms and being diagnosed in their 20s, 30s and 40s.  If you have abnormal liver blood tests, anemia or an  autoimmune diseases like diabetes or thyroiditis (Hashimoto’s makes the cut), get yourself checked for celiac disease.

According to the Celiac Support Association® common symptoms of celiac disease include:

  • Abdominal cramping/bloating
  • Anemia
  • Constipation
  • Diarrhea
  • Energy loss
  • Fatigue
  • Difficult to concentrate / foggy brain
  • Infertility
  • Irritable bowel
  • Joint pain
  • Menorrhagia
  • Mouth sores or cracks in the corners
  • Osteopenia or osteoporosis
  • Tooth enamel defects
  • Weakness
  • Weight loss

Gluten Free & Low Fodmap Diets

A gluten free diet must be adhered to at all times for people with celiac disease.  I have IBS and Hashimoto’s disease and have been instructed by my endocrinologist (who also has Hashimoto’s -except not as bad) to avoid all gluten, and it’s definitely made a difference in my life.  Though my health has improved, it’s still difficult at times to know all sources of gluten found in foods. Working with a Registered Dietitian or Certified Nutritional Consultant can help uncover all the hidden sources of gluten and possibly help to identify the cause of symptoms.

If consumed, low FODMAP foods should not cause damage to the small intestine.  Most gluten-free foods are almost always wheat-free, but not all gluten-free foods are low FODMAP (example, Rudi’s gluten free breads are delicious but contain HIGH FODMAP ingredients).

Patsy Catsos MS, RDN, LD suggests that if you are experiencing gastrointestinal symptoms to “ask your doctor if you should be tested for celiac disease before starting a low-FODMAP diet,” and that “once you’ve cut out wheat, barley and rye from your diet for a while, celiac tests are no longer accurate.”  Another interesting fact she shared:

  • “If you have celiac disease and already eat gluten-free, but still suffer from gastrointestinal complaints, FODMAPs may be to blame. Especially early in your diagnosis, before intestinal healing is complete on your gluten-free diet, you may be prone to poor absorption of lactose, fructose and sorbitol. Once you have been gluten-free for a long time, your ability to tolerate foods containing these carbohydrates may improve a good deal.”

Bread groupWheat Derived Ingredients

Be aware of wheat-derived ingredients that have gluten!  People with Hashimoto’s won’t feel the severity or threatening symptoms from gluten the way celiacs do, but sources say that gluten can stay in the body for up to six months, so do the absolute best you can to avoid gluten.  Here are some examples:

  • Barley is a grain that contains gluten.  You’ll find it in soups or malt flavoring.
  • Buckwheat is gluten-free but don’t assume all buckwheat products are gluten free.  Buckwheat can sometimes be combined with wheat flour in pancake and baking mixes.
  • Dextrin is gluten-free be wary, though rare, its sometimes made from wheat.
  • Gluten containing grains bulgur, durum, einkorn, farina, graham, kamut, semolina, and spelt are all forms of wheat.
  • Hydrolyzed wheat protein is not gluten-free.
  • Malt flavoring is usually made from barley and is not gluten free.  Malt extract, malt syrup and malt flour are made from barley and are not gluten free.
  • Modified food starch is gluten free unless it is made from wheat.
  • Oats – only those that are grown in such a way to eliminate cross-contamination can be labeled gluten-free.
  • Rice is gluten free but can sometimes come packaged as a rice mix with seasonings that contains wheat.
  • Seasonings can be gluten-free or not if they contain wheat starch or wheat flour.
  • Seitan is made from wheat gluten so it contains gluten.  There are some recipes out there for gluten-free seitan but consider ignoring those!
  • Soba Japanese noodles made from buckwheat are gluten-free, however always check to make sure they’ve not been made with wheat flour.
  • Several soy sauces are made with wheat.  If you’re out dining at a Japanese restaurant ask for tamari.  If at home try Bragg’s Amino Acids.
  • Spelt is not gluten-free.
  • Teriyaki sauces are usually made with wheat though you can still find gluten-free brands.
  • Tofu when plain and not flavored with soy sauce (made from wheat) is gluten-free.
  • Triticale is a cross bred hybrid of wheat and rye that contains gluten.  It was first “bred in laboratories during the late 19th century in Scotland and Sweden.” {source USDA}
  • Wheat starch is a starch made from wheat.  Even after processing some residual gluten can remain so it’s not considered gluten-free.

Gluten-Free Labeling

According to Food Safety Magazine: “Gluten-free” counts towards gluten-free foods or gluten-free ingredients. The U.S. Food and Drug Administration (FDA) has defined “gluten-free” as less than 20 ppm (mg/kg) of gluten. Other countries use this definition as well (and some countries have established a category of low-gluten foods that are defined as less than 100 ppm gluten). Here is the U.S., our regulations (at this time) don’t recognize low-gluten foods. Our gluten-free regulations also establishes other conditions that must be met by any U.S. food labeled gluten-free:
•    The food must not contain any ingredient that is a gluten-containing grain.
•    The food may only contain an ingredient derived from a gluten-containing source, if that ingredient has been processed in a manner to remove gluten residues to a level of less than 20 ppm.

Food Safety magazine goes on to say that from a clinical perspective “ingesting gluten-free foods containing less than 20 ppm gluten appears to be safe for celiac sufferers.”

Don’t forget to…

Subscribe to the Fodmap Life newsletter:

Check us out on Facebook and Instagram

And Subscribe to our Youtube page

Additional Sources for this post: – Ingredients Index

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>