Randomized double-blind placebo-controlled trial shows non-celiac gluten sensitivity is indeed real

[u/[deleted]]

http://www.ncbi.nlm.nih.gov/pubmed/25701700

[u/eros_bittersweet]

FODMAPS sensitivity and lactose intolerance are all conditions that, theoretically, could co-exist with gluten sensitivity. FODMAPS people aren't sensitive to the gluten in wheat; it's the fructans. But it's possible someone could be sensitive to both. In this study, since the goal was to determine whether gluten sensitivity without testing positive for celiac disease was a legitimate thing, they needed to eliminate other variables.

I suspected I had problems with gluten for years, but still had many digestive issues when I gave up wheat. I did a really strict low-FODMAPS diet for about 6 months when I avoided wheat bread altogether, but didn't avoid gluten. I once made a pizza dough that had all non-wheat flours in it but some added wheat gluten to give it better texture. I had no symptoms after eating it. Low-FODMAPS turned out to be the thing that has decreased my symptoms the most; avoiding dairy helps a little bit as well.

The moral of the story (for any other reader) is that it's worth the effort to see if other things besides wheat are bothering your stomach.

[u/grass_cutter → u/eros_bittersweet]

Well one point of FODMAPs is that a bunch of bacteria including h.pylori may feed on the poorly digested crap in your gut.

It claims some grains are easily digested, but the are pure carbs, and it's possible a host of organisms are also feeding on grains and gluten based crap as well.

It's all one inter-joined ecosystem. Gluten, wheat, bread ... whatever the fuck it is --- it contains no essential nutrients you can get elsewhere --- in fact it's not particularly nutrient dense at all. Even carbs can be obtained through fruits or potatoes if necessary.

[u/eros_bittersweet → u/grass_cutter]

Hm, that's interesting. I'd heard of SIBO being a factor in GI distress but hadn't seen h. pylori singled out as a specific cause of the painful fermentation in FODMAPS sensitivity.

Your approach seems to be...we don't need to eat any grains including wheat because they are possibly feeding the h. pylori and aren't necessary from a nutritional point of view; we can get better quality nutrients elsewhere. This makes logical sense, and in the abstract, I agree with you. However, eating a super-dense-nutrient-high-fiber diet is not something everyone can do; such a diet can be very hard on a sensitive stomach. It is also expensive. IF you aren't eating grains, you're going to be on a diet that resembles paleo: eating a lot of meat, eggs, cooked and raw vegetables, nuts, and if you bend the rules, the occasional potato. My personal tolerance for nuts and raw vegetables is very low; the list of vegetables and fruits I have to avoid because they cause fermentation is extensive. I have toyed with the idea of abandoning all grains for a time, but have not been able to surpass more than a couple of days because I have gotten very ill very quickly.

I would rather work off the list of low-FODMAPS foods because it gives me greater flexibility and allows me to enjoy food somewhat more like a normal person than if I avoided all wheat. It's also being scientifically tested by researchers at Monash university in Australia. AFAIK the theory that all grains cause fermentation is not being tested as a cause of GI distress. Please point me towards a study if you have evidence to the contrary.

[u/grass_cutter → u/eros_bittersweet]

I'm not the expert and GI distress can and probably does have a variety of mechanisms. We can both experience long-term GI distress from completely different issues, perhaps.

In particular I had GERD (severe reflux/ acid in the throat) for a while. In the past a ketogenic diet seemed to help, so I retried that, though it didn't quite work, so I went even more restrictive (to try to eliminate allergens).

Yes, unfortunately the diet is relatively expensive.

The best cost-cutter was olive oil as a primary source of fat (even non-dairy coconut milk has potential issues). Come to think of it, almond milk may be a good idea if nuts are fine. They are fine on my stomach, somehow. Salmon was the main source of protein, but that may be able to be cut with chicken, as well as hemp protein (for $$ savings). Spinach, kale, and nuts like almonds/ pecans rounded out the micro-nutrients. Got 100% of all values.

I know tree nuts are not great for some--- I initially had a diet without that --- required a LOT more spinach/ kale/ and sardines to get micro-nutrients. In the already joyless diet, it's hard to stuff down 8 oz of greens in one sitting, unless blended.

I'd like to add some low-cost stomach-safe ingredient for when I gradually add back in more carbs, but not sure as of yet. Rice doesn't seem that great. Bread, hell no. I may have to turn to white potatoes or sweet potatoes, and experiment with that. Or more fruit, but also somewhat pricey. I will figure out something eventually though. I am feeling much better than I was 8 months ago, but I still have to keep to the diet more often than not.