Gluten May Cause IBS & Auto-Immune Disease

1. An overview

The word gluten comes from a Latin word meaning “glue”. Gluten’s adhesive and binding properties give bread and cakes their spongy texture. Gluten is a complex protein structure mainly made up of glutenin and gliadin, which in presence of water becomes elastic. 

From an evolutionary point of view, grains were introduced 10.000 years ago. It may not have been sufficient time for humans to have genetically adapted to a highly refined carbohydrates diet. Moreover, humans have been using this highly refined wheat flour for around 200 years. Before this, the flour was wholemeal. It contained more fibre, and it was also a mix of different grains and legumes flours.

The process of baking and making bread has also dramatically changed within the last century or so. In fact, bread dough no longer rises over night, but only for a couple of hours. To achieve the super spongy texture, bakers add extra gluten to the dough. This means that the enzymes within the yeast don’t have enough time to break down so much gluten. Which will result in a more indigestible end product. This may relate to the fact that gluten may cause IBS symptoms.

2. Non-coeliac-gluten-sensitivity

A growing number of people have reported intestinal and extra intestinal symptoms after ingestion of gluten containing cereals. These are wheat, barley, spelt and rye. Problems occurred even without having a wheat allergy or being gluten intolerant, like coeliacs do. Clinical trials have found that these symptoms improve after gluten withdrawal. This new syndrome called “Non-Coeliac Gluten-Sensitivity” (NCGS) was scientifically recognised in 2012. It may prove that gluten may cause or exacerbate IBS symptoms.

In most people, gastro-intestinal symptoms appear from few hours up to one day after ingestion of these grains. Extra-intestinal manifestations may take much longer to appear.

Gastro-intestinal symptoms of NCGS are:

Bloating

Abdominal pain

Diarrhoea

Acid reflux

Nausea

Constipation

Flatulence.

Extra-intestinal manifestations of NCGS are:

Lack of general well being

Headaches

Tiredness

Anxiety

Joint and muscles pain

Foggy brain

Skin rash

Allergies

Depression

Auto-immune disorders.

3. Not just gluten

There are different types of proteins found in wheat, other than gluten. They are α-amylase/trypsin inhibitors (ATIs), which may also contribute to NCGS by increasing innate immune activation. It may also produce pro-inflammatory cytokines and decrease digestive enzymes action. ATIs are present in wheat, rye and barley and serve these plants as pest controller. Moreover, ATIs are highly present in the modern types of wheat, compared to the more ancient varieties. This may result in IBS type symptoms in coeliac and non-coeliac patients.

In addition, recent studies have evidenced the possible role of fermentable-oligo-di-monosaccharides and polyols (FODMAPs) in the progress of NCGS. FODMAPs are short chain carbohydrates and sugar alcohols that might be poorly absorbed in the intestine. They are present in milk, legumes, honey, some fruits (cherry, watermelon, pear and mango,) and some vegetables (leek, chicory and fennel). FODMAPs also include wheat and rye, which also contain gluten and ATIs. This could be another link to explain why products containing gluten may cause IBS.

4. Hyperpermeability, aka “leaky gut”

Your gut wall has a very complex system of nutrients absorption and border control that only allows entry to minerals, vitamins, water, amino acids, fats, sugar and other nutrients.  

Sustained gut inflammation, over time, may lead to gut lining damage and “leaky gut” syndrome. This will allow entry into the body of harmful agents, like microscopic parasites, bacteria and undigested food particles.  

Entry of these microbes, through a damaged gut wall, into our blood circulation activates our immune system mechanisms. If leaky gut persists for a long period of time, the immune system will become over reactive. It may eventually miss place attacking and start destroying the self, “thinking” it is still battling an invader. This self-harming may develop into an auto-immune disease over time like diabetes 1, Hashimoto’s, eczema, MS, Ulcerative Colitis etc. This is because some microbes or undigested food particles may have a very similar DNA structure to our own.

Once ingested, gluten stimulates the release of a protein in the intestine called zonulin. This protein contributes to loosening and breaking the bonds between the gut lining cells, consequently causing or worsening “leaky gut” syndrome and increasing intestinal inflammation.

5. From a Nutritional Therapy point of view:

• If you suspect to have or being diagnosed with IBS, I invite you to read my article here, to understand where your gastro-intestinal issues are coming from.
• Cut right down your intake of processed meals, which might contain hidden gluten.
• Avoid gluten containing grains like wheat, spelt, barley, rye and oat, although some oat is free from.
• Avoid conventional bread, pizza, pasta, cakes and biscuits.
• Experiment with gluten free products. Please visit the free-from aisle at the grocery store and look for gluten free dishes at the restaurant.
• Do not rely on or abuse of gluten free processed foods.
• Implement a wholesome and varied diet aiming for a total of eight portions of fruits and vegetables per day, two to three fruits and five to six vegetables.
• Use gluten free grains, to include wholemeal, red and black rice, buckwheat, amaranth, millet, quinoa, non GMO corn and gluten free oat.
• Implement a strict gluten free diet for at least two weeks, but I will recommend extending it to one month. Be mindful of your gastro-intestinal symptoms and extra-intestinal manifestations named above while you do this.                                           
• I appreciate that it is pretty hard to avoid gluten completely, but do the very best you can. Do not forget to feed back to me on your findings, as I am always happy to hear about your stories.

6. Final thoughts

The word gluten comes from a Latin word meaning “glue”. From an evolutionary standpoint and considering GMO modifications of wheat, plus modern baking procedure, we can assert that humans have not yet genetically adapted to this high and processed carbohydrates diet. In 2012 researches discovered a new syndrome associated with gluten consumption called Non-Coeliac-Gluten-Sensitivity. So, scientists have developped the understanding that gluten may cause IBS type of symptoms, and to more systemic health problems. There are also other proteins in wheat that have proven to trigger gut inflammation, activation of the immune system and support the “leaky gut” pathways to auto-immune diseases. If eliminating gluten from your diet will solve all your problems, then great! If it does not, there may be other dynamics involved, for which I invite you to read my extensive article on IBS here.

Author: Cristiano Percoco, BSc (Hons) Nutritional Therapy

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References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119241/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526354/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772047/pdf/nutrients-08-00084.pdf

https://www.ncbi.nlm.nih.gov/pubmed/24533607

https://www.ncbi.nlm.nih.gov/pubmed/16635908

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5214347/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4053283/