Although doctors tend to look for celiac disease -- an inherited, lifelong intolerance to the gluten protein in wheat and other grains -- in people with chronic diarrhea, the condition can also cause constipation. In fact, if you have either chronic constipation or diarrhea, it indicates that you should consider being tested for celiac disease. People newly diagnosed with celiac disease often find that their constipation dissipates once they start treatment for the condition.
Background
Celiac disease occurs in a little less than 1 percent of the overall population, according to the Celiac Disease Center at Columbia University. However, the condition is characterized by more than 200 symptoms, including constipation and diarrhea, which makes it very difficult for doctors to diagnose. In fact, some patients with celiac disease are mistakenly diagnosed initially with irritable bowel syndrome, which also can cause constipation and diarrhea. To get a proper diagnosis, you'll need blood tests, followed by an endoscopy to examine the lining of your small intestine. In celiac disease, gluten ingestion slowly damages that intestinal lining.
Details
At least 10 to 15 percent of celiacs suffer from constipation at some point prior to their diagnosis. In one older study, published in April 1972 in the "Archives of Disease in Childhood," researchers found that about 10 percent of all children eventually diagnosed with celiac disease reported either chronic or occasional constipation. Another study, this one reported in October 1992 in the "The Ulster Medical Journal," found that 15 percent of newly diagnosed celiac disease patients listed constipation as their primary symptom.
Remedy
If testing shows that celiac disease really is causing your constipation, you'll need to begin a lifelong gluten-free diet. That means you'll need to avoid more than just wheat gluten; the protein gluten also occurs in the grains barley and rye. Fortunately, you can purchase gluten-free substitute products for most gluten-containing food staples, including bread, cookies, flour and even beer. You'll also need to read food labels constantly, since food manufacturers often use gluten ingredients in unexpected places, such as in salad dressings and soups.
Considerations
It's also possible that you might find relief from your constipation by eliminating gluten even if you don't have celiac disease, although the evidence is less clear. According to the University of Maryland Medical Center, some people who have constipation related to irritable bowel syndrome find they can get some relief from their constipation if they drop gluten from their diet. Although there's no firm medical evidence yet to support this, you might want to work with your physician on an elimination diet to see if dropping gluten can help improve your constipation.
References
- Celiac Disease Center at Columbia University: What Are CD and DH?
- "Archives of Disease in Childhood"; Constipation in Childhood Coeliac Disease; Bridget Egan-Mitchell and Brian McNicholl; April 1972
- "The Ulster Medical Journal"; Coeliac Disease: Clinical Presentations, Correlations of Dietary Compliance, Symptomatic Response and Repeat Biopsy Findings; N.G. McElvaney, et al.; October 1992
- University of Maryland Medical Center: Irritable Bowel Syndrome
