If you have celiac, despite your best efforts to stay gluten-free, there's always a risk that you'll accidentally eat something with gluten. Most of the time, there are symptoms that alert you to gluten exposure. Here are the symptoms you might expect, and how long before you'll feel better.
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Read more: What Effect Does Gluten Have on the Human Body?
Celiac Disease and Gluten Sensitivity
The Cleveland Clinic notes that celiac disease is a chronic autoimmune disease in which exposure to gluten, a protein in wheat, rye or barley causes damage to the lining of the small intestine. People with celiac are permanently intolerant to gluten and must avoid it for life. Any amount of gluten can cause both short- and long-term side effects.
Non-celiac gluten sensitivity is a related condition. It can cause the same symptoms as celiac, without testing positive for the disease. Much is still unknown about non-celiac gluten sensitivity. The Celiac Disease Foundation reports that this condition also seems to result in an immune reaction with accompanying intestinal cell damage — but at this point it's not clear if it's caused by all gluten-containing foods.
Regardless of which condition you have, a gluten-free diet is in order. When you're shopping and cooking for yourself, it's fairly easy to follow a strict gluten-free diet. However, the Gluten Intolerance Group says that eating away from home presents a risk of gluten cross-contamination if food is prepared in a regular (non-gluten-free) kitchen. Therefore, accidental exposure is always a possibility.
Symptoms of Gluten Exposure
Symptoms of gluten exposure can be different from person to person. Also, some people with celiac disease eat gluten and have no reaction, notes the Celiac Disease Foundation. That may make it difficult for you to know if you've accidentally exposed yourself to gluten.
A survey on gluten exposure symptoms in people with celiac published in the July 2016 issue of Alimentary Pharmacology and Therapeutics (AP&T) found that about 68 percent of people with celiac do have a reaction every time they eat gluten. In most cases, it happens quickly, within an hour. For a small percentage of people, though, the reaction can be delayed for 12 or more hours.
The authors of the study note the most common symptoms of gluten exposure:
- Abdominal pain or bloating.
- Diarrhea or constipation.
- Mouth ulcers.
When You’ll Feel Better
The good news is, symptoms tend to resolve fairly quickly, as long as you get back on your strict gluten-free diet. The AP&T study on gluten exposure symptoms found most people felt better within 48 hours.
However, it's important to remember that any amount of gluten can cause damage to the villi in your intestine, and your symptoms don't always correlate with the degree of damage. So, while you might feel better quickly, that doesn't always mean you're in the clear. According to the Celiac Disease Foundation, while the damage to your intestine can happen within hours, it can take months for it to heal.
Amy Keller RD, LD, is the chief dietitian at Mary Rutan Hospital in Bellefontaine, Ohio, and a celiac disease support group leader who stresses that everyone recovers differently. She says, "The speed of recovery likely depends on how much gluten was ingested, and if the person continues to accidentally be 'glutened' which may prolong symptoms."
How to Recover Faster
You might have read that supplements such as probiotics, activated charcoal and over-the-counter gluten-digesting enzyme products can help speed recovery from a gluten reaction. However, there are no evidence-based guidelines for recovery from gluten exposure.
According to Keller, "while some patients feel like these products help them get through being 'glutened,' there are no scientific studies that show benefits to recovery." Instead, she recommends resting, treating symptoms such as the headache or upset stomach, eating what you can, staying hydrated and waiting for it to pass.
The best way to recover faster is to limit your exposure as much as possible by eliminating any foods that contain wheat, rye or barley. Oats are gluten-free, but because they are often cross- contaminated with gluten, the Gluten Intolerance Group recommends only eating them if you're certain they are certified gluten-free.
Read food ingredient labels carefully and look for hidden gluten, especially in things like deli meats, prepared vegan foods and condiments. Most importantly, when eating out, be aware of the risk of cross-contamination and be proactive about avoiding it.
- Cleveland Clinic: “Celiac Disease”
- Celiac Disease Foundation: “Non-Celiac Gluten/Wheat Sensitivity”
- Gluten Intolerance Group: “Getting Started on a Gluten-Free Diet”
- Gluten Intolerance Group: “Going Gluten-Free One Step at a Time”
- Alimentary Pharmacology and Therapeutics: “Symptomatic Suspected Gluten Exposure Is Common Among Patients With Coeliac Disease on a Gluten-Free Diet”
- Amy Keller, MS, RD, LD, chief dietitian, Mary Rutan Hospital, Bellefontaine, Ohio; contributor, Gluten-Free Living; celiac support group leader, Marysville, Ohio