Firstly, eliminating gluten from your diet without identifying the underlying cause of your bloating, abdominal pain or other digestive discomfort is definitely not the answer as gluten may not actually be the cause of your symptoms.
Coeliac disease is the autoimmune form of gluten intolerance. When someone with coeliac disease consumes gluten their immune system reacts abnormally by attacking and destroying the lining of their small intestine, which happens to be the main site of nutrient absorption in the body (Better Health Channel, 2014).
Although the symptoms of coeliac disease and gluten intolerance are often similar (bloating, abdominal pain, diarrhoea etc), the treatment of coeliac disease requires a life-long gluten free diet, even to the point of avoiding cross-contamination issues (e.g. using a separate toaster for gluten free bread if others in your household also consume regular bread).
In contrast, those with non-coeliac mediated gluten intolerance only need to reduce the amount of gluten they eat to stay under their symptom threshold. For example, someone with gluten sensitivity may be able to tolerate oats or a small amount of gluten as an additive in something like soy sauce, however may feel extremely bloated after eating a slice of bread or a large portion of pasta.
Unlike those with coeliac disease, if someone with an intolerance to gluten consumes it (either intentionally or unintentionally) they will most likely suffer from some uncomfortable symptoms but will not be causing any long term health issues. If someone with coealic disease consumes even trace amounts of gluten, it will take months (and perhaps up to 2 years or more in older adults!) for the lining of their small intestines to fully repair, risking nutrient deficiencies and bowel cancer in severe cases (NHS, 2014).
Gluten Vs Fructans
Gluten is the protein found in wheat, barley and rye. Fructans are the fermentable carbohydrates found in wheat, barley, rye, onions, garlic and some other vegetables (Fedewa and Rao, 2014).
Often those with a fructan intolerance will feel better on a gluten free diet as wheat, barley and rye are eliminated. However, if you have eliminated gluten from your diet and are still suffering from bloating or other digestive discomfort, an intolerance to fructans may be your problem instead of a gluten intolerance.
The first step in testing for coeliac disease is a simple blood test to test for antibodies to gluten. If results come back positive, your doctor will require you to undergo an endoscopy to take a biopsy of your small intestine to confirm diagnosis.
I cannot stress this enough; do not eliminate gluten from your diet until you have been tested!! You need to be consuming at least 4 servings of gluten for at least 6 weeks prior to the blood test, otherwise you will be running the risk of the test coming back as a false positive (Coeliac Australia, 2016).
If your doctor has ruled out the possibility of coeliac disease, the next step is to determine whether gluten (the protein) or fructans (the fermentable carbohydrate) is responsible for your symptoms.
I would recommend that you work with an Accredited Practising Dietitian who is familiar with the application of a low FODMAP diet. He/she will be able to guide you through the elimination and challenge process in order to determine what foods are causing your discomfort. It may be gluten, fructans (or both) or something else entirely.
Most importantly, don’t suffer in silence and don’t accept the diagnosis of IBS. You have a right to understand what is happening in your body and the impact of your food choices. Nobody has to live with these uncomfortable symptoms. Get the right diagnosis from a qualified health practitioner and find a dietitian specialising in food intolerances who can work with you in managing your symptoms, whatever the cause may be.
Coeliac Australia (2016), Diagnosis, available from: http://www.coeliac.org.au/diagnosis/.
Better Health Channel (2014), Coeliac disease and gluten sensitivity, available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/coeliac-disease-and-gluten-sensitivity.
Fedewa and Rao (2014), ‘Dietary fructose intolerance, fructan intolerance and FODMAPs’, Current Gastroenterology Reports, 16(1): 370.
NHS (2014), Complications of coeliac disease, available from: http://www.nhs.uk/Conditions/Coeliac-disease/Pages/Complications.aspx.