Sourdough bread and rye bread are often considered ideal alternatives for those on a reduced-gluten diet, because they both fall into the category of low-gluten bread.
Gluten intolerance is more common than many people realize, and there are differences between gluten intolerance, gluten allergies and celiac disease.
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Read more: 5 Theories Why Gluten Intolerance Is Skyrocketing
What Is Gluten Intolerance?
Much like lactose intolerance, gluten intolerance can be defined as the body's inability to ingest gluten properly without adverse side effects and symptoms. These include abdominal pain, bloating, diarrhea, headaches, fatigue, rashes and joint pain.
There are three types of gluten sensitivities:
- Autoimmune celiac disease
- Allergy to wheat
- Non-celiac gluten sensitivity
Celiac disease is an autoimmune disorder and not strictly a gluten intolerance, as it is not an allergy. It is a condition in which the immune system attacks the small intestine when gluten enters the body. This results in damage to the lining of the gut and can disrupt the stomach's ability to absorb nutrients adequately.
An allergy to wheat occurs when the body reacts negatively to the proteins naturally found in wheat. Side effects and symptoms usually happen minutes after you eat wheat, so it is much faster acting than celiac disease or gluten sensitivity — which can take a few hours to show symptoms.
Non-celiac gluten sensitivity is a condition with all the same symptoms as celiac disease, but it generally does not cause the same damage to the gut lining or produce the antibodies associated with celiac disease.
Celiac Disease: In Depth
Categorized as a lifelong autoimmune disorder caused by a severe, negative reaction to the consumption of gluten, celiac disease is different from gluten sensitivity or allergy and is potentially more serious.
Celiac disease is far more common than many people realize — one in 100 Americans have the disease. An estimated 80 percent of those have no official diagnosis and therefore experience symptoms unnecessarily. In addition, if an immediate family member (mother, father, sister, brother) has celiac disease, then the chances increase to one in ten.
The Celiac Disease Foundation lists symptoms of the condition seen in adults:
- Unexplained iron-deficiency anemia
- Bone or joint pain
- Osteoporosis or osteopenia (bone loss)
- Liver and biliary tract disorders (for example, transaminitis, fatty liver, primary sclerosing cholangitis)
- Depression or anxiety
- Peripheral neuropathy (tingling, numbness or pain in the hands and feet)
- Seizures or migraines
- Missed menstrual periods
- Infertility or recurrent miscarriage
- Canker sores inside the mouth
- Dermatitis herpetiformis (itchy skin rash)
In addition, while diarrhea and vomiting are more prominently seen as symptoms in children or younger adults, they can occur in adults as well.
If you are experiencing any of these symptoms, including prolonged vomiting and/or diarrhea, contact your healthcare provider.
Risks of Celiac Disease
It is important to understand that celiac disease is not just a matter of bad indigestion or intolerance to food. It is an autoimmune disorder that is challenging in and of itself, but if left untreated it can cause severe medical ailments.
Some of these double as symptoms, because if gluten has been consumed for a while when an individual unknowingly has celiac disease, damage may have already started. These complications include:
- Osteoporosis (increased bone fragility and likelihood of damage)
- Neurological conditions (such as anxiety or depression)
- Neuropathy (nerve disorder)
And though rare, can even lead to:
- Cancer of the small bowel
- Intestinal lymphoma
In addition, an untreated case of celiac disease can manifest into a condition known as gluten ataxia, a more severe autoimmune disorder that negatively impacts the body's ability to control muscles, resulting in frequent spasms.
The most successful and prominent form of treatment is the adoption of a lifelong gluten-free diet. Though it may sound daunting at first, such a diet is entirely achievable with the correct considerations.
Read more: What Effect Does Gluten Have on the Human Body?
The Gluten-Free Diet
Gluten is found in a variety of foods, most commonly wheat, rye and barley. This does not mean that achieving a gluten-free diet is impossible, however. There are many alternatives available, and plenty of foods that are naturally devoid of gluten.
According to the National Health Service of the United Kingdom, the following foods contain gluten and should be avoided following a diagnosis of celiac disease or gluten sensitivity:
- Many sauces
There are gluten-free alternatives (or reduced-gluten options, such as low-gluten bread) available of many foods in an ever-increasing amount as celiac disease and gluten sensitivity become more widely understood conditions.
Food is not the only place gluten can be found. It can be a component of certain lipsticks, stamps and some medications. Check with your healthcare professional if you have any concerns regarding medication contamination.
Cross-contamination may also occur in factories where gluten-free foods are processed alongside foods with gluten or in restaurants where gluten-free food is prepared alongside foods with gluten. Make sure you check with the staff before ordering anything labeled as gluten free.
What Can People With Celiac Eat?
Beside gluten-free or low-gluten alternatives, naturally gluten-free foods include:
- Dairy products (milk, cheese, eggs and butter)
- Fruits and vegetables
- Meat and fish products (not breaded or battered)
- Rice noodles
- Gluten-free flours (rice, corn, soy and potato)
Though oats are gluten free, many individuals with celiac disease or gluten sensitivity should not eat them because of potential cross-contamination with wheat.
Many drinks are also safe to consume, such as:
- Fruit juice
- Flavored water
The only drinks that should really be excluded are those with ingredients that contain gluten, such as beer, lager, stout and ales.
There are many varieties of low-gluten bread or gluten-free breads. Sourdough bread and rye bread are just two examples that are often recommended, but they may not be as appropriate as you might think.
Sourdough bread, a low-gluten bread, is often hailed as a positive option for those with gluten intolerance or celiac disease, because it contains a reduced amount of gluten thanks to sourdough's slow fermentation process.
While this does make sourdough a potential option for those with gluten sensitives, people with celiac disease can often have a reaction even to trace amounts. So they may have negative side effects from sourdough bread despite it being a low-gluten bread.
- Science: "What's Really Behind Gluten Sensitivity?"
- National Library of Medicine: "Properties of Gluten Intolerance: Gluten Structure, Evolution, Pathogenicity and Detoxification Capabilities"
- Coeliac UK: "About Coeliac Disease"
- Celiac Disease Foundation: "20 Things You Might Not Know About Celiac Disease"
- National Health Service: "Coeliac Disease"
- Sustainable Food Trust: "Sourdough Digestibility"
- Beyond Celiac: "Is Rye Gluten Free?"