Hello -

Is there any difference between the wheat intolerance typical of IBS and true gluten intolerance? And what's all this about celiac?

Many people with IBS already know that wheat bothers them. Does this mean that they are gluten intolerant?

Nope, not necessarily. There's a huge difference between an IBS intolerance to wheat and true gluten intolerance, otherwise known as celiac disease.

While many people with IBS are intolerant to wheat bran, and whole wheat, due to the insoluble fiber, this is not at all the same thing as the total gluten intolerance caused by celiac. It is possible to have BOTH celiac and IBS, but it's also very common for celiac to be misdiagnosed as IBS.

So - what exactly is celiac disease? Celiac is a genetic auto-immune disease that damages the small intestine and interferes with absorption of nutrients from food. People with celiac cannot tolerate the grain protein called gluten, which is found in wheat, rye, and barley.

Just FYI, gluten is not a FODMAP and is not related to FODMAPS. Gluten is also in countless processed foods, and even stamp and envelope adhesives, medicines, and vitamins.

Symptoms of celiac can include gas, recurring abdominal bloating and pain, chronic diarrhea, and constipation. Sound familiar? Since these are the hallmark symptoms of Irritable Bowel Syndrome, it's easy to see how celiac can be misdiagnosed as IBS. As an interesting note, the average length of time between the onset of symptoms and a diagnosis of celiac in America is five to ten years. Yes, that's right, up to ten years.

Many people with celiac are mistakenly told they have IBS, and in the years between misdiagnosis and celiac diagnosis, a diet with gluten can cause permanent physical harm. Untreated celiac can be life-threatening.

Celiac can cause:

* osteoporosis
* central and peripheral nervous system diseases
* pancreatic diseases
* internal hemorrhaging
* gall bladder, liver, and spleen disorders
* gynecological disorders
* increased risk of certain types of cancer, especially intestinal lymphoma

There is now a mountain of evidence that celiac is typically overlooked and under-diagnosed,, in part because many doctors mistakenly believe it is a diagnosis for infants, that symptoms must include weight loss and diarrhea, or that it is simply a disease too rare to bother considering.

All of these preconceptions have been repeatedly proven false in the past few years of celiac studies and research. I cannot stress this enough - it is absolutely critical that you do not accept an IBS diagnosis until celiac disease has been ruled out.

An initial screen for celiac disease will check your blood for antibodies to gluten, and if the results are positive, a small bowel biopsy will follow. Before you're tested for celiac, make sure you continue to eat foods with gluten, such as breads and pastas. If you avoid gluten before being tested, you may get a false negative test result.

If you do test positive for celiac, the only treatment is a completely gluten free diet. If you have both IBS and celiac, you can combine the dietary concerns by sticking to gluten free soluble fiber safe foods. Try rice, potatoes, oats, quinoa, root vegetables, tapioca, amaranth, buckwheat, and soy.

Following a gluten free diet is much more difficult than following the IBS diet, as even trace amounts of gluten need to be scrupulously avoided. It is completely possible, however, and certainly well-worth it.

There are also many delicious, nutritious IBS-friendly recipes that are also gluten-free, so don't be discouraged.

On a personal note, I sometimes hear from people who are convinced they have celiac disease but simply cannot get their doctors to test them for it. My own aunt was in this situation several years ago, and by the time she found a doctor who agreed that celiac was a likely diagnosis, she had already put herself on a gluten free diet (and her symptoms had resolved). She refused to start eating gluten again just so she could take the blood test and get a confirmation.

If you're in the same boat, and you're feeling much better on a gluten free diet even though you don't have a black and white diagnosis of celiac, listen to your gut. All that really matters is that you are happy and healthy. You don't have to have a lab test to prove what your body has already told you.

Check here for more information about celiac.

You are not alone!

P.S. If you have questions or comments I'd love to hear them - just reply to this email to reach me directly. I am overwhelmed with requests but try to answer everyone. For help today please join my private IBS coaching.

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To taming your tummy,

Heather Van Vorous
Heather Van Vorous
Over 40 years dealing with IBS
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