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  • Kristen Campbell
    Kristen Campbell

    How Celiacs can Deal with Accidental Gluten Ingestion

    Celiac.com 01/03/2009 - Recently on a gluten-free forum, I found a post asking for advice on what to do after a woman had accidentally consumed a large amount of gluten.  After unknowingly eating from her daughter’s takeout box, the woman had realized her mistake and was simply devastated to have broken her diet and subjected herself to the old, too-familiar symptoms that were on their way.

    It was interesting reading the various responses, which resulted in a debate over whether or not to induce vomiting, drink pineapple juice, take enzymes or engage in a certain illegal activity.  In all the debate, the woman eventually disappeared off the forum, which probably meant that she took some action or another, though I never heard the final result.

    This whole subject inspired some research on my part.  I first consulted my extensive gluten-free library, which led me to one solitary, repetitive answer: do not eat gluten.  In a world where doctors and authors alike are so concerned that their advice on the subject will lead people with gluten sensitivities to forgo a gluten-free diet in favor of a “band aid” of sorts, that finding a documented recommendation is near impossible.

    These experts are right to reinforce the importance of maintaining a gluten free lifestyle, and the fact that there is no “cure” for gluten intolerance and celiac disease (other than complete avoidance of gluten from wheat, barley and rye).  But mistakes do happen, and from time to time people do get "glutened,” and when they do, which action is best?

    No matter what the size is of the offending dose of gluten, all experts agree, inducing vomiting is too dangerous and disruptive to the body to be considered.  But there is one option that at least two noted experts in field of celiac research agree upon: enzymes.

    When I contacted the renowned Dr. Kenneth Fine of EnteroLab, and asked him if perhaps a dose of enzymes that are designed to break down gluten might help, he had this to say: “The good news is that everyone will survive and recover from the gluten exposure.  The enzymes you mention might help, but not completely, unless they consumed at the same time (as the gluten) for best results.”  And like all good doctors, he did go on to warn, “Avoidance is still the best policy.”

    Shari Lieberman, PhD, CNS, FACN and author of The Gluten Connection very humbly admits that “gluten slips happen.”  She also devotes a couple of pages in her book to research conducted using digestive enzymes to help manage those occasions when gluten does make its way into your diet, citing a research example in which “The study demonstrates that enzyme therapy can substantially minimize symptoms in people with celiac disease who are exposed to gluten.” 

    The enzyme used in this study does not seem to be currently available, but other gluten enzymes are at your local health food store.  I contacted one company in regard to their product, which according to them helps to reduce inflammation caused by the introduction of gluten in an individual with celiac disease or gluten intolerance.  According to them their enzymes will not prevent all damage, but may reduce some inflammation and help the body to better digest the protein.

    Ultimately, gluten sensitive individuals should recover from one accidental “gluten slip” here and there, and keeping some digestive enzymes handy to help cope with such an accident is not a bad idea.  But do keep in mind that repeated offenses, even the most minute, will damage your body and prevent it from healing.  Enzymes help treat the symptoms, but only complete avoidance of gluten can treat the disease.


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    Great article, I am glad to see someone unafraid to touch on this subject. Too many authors are so afraid that we'll all go start eating gluten that they won't even touch it.

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    A very good article! Although general awareness of Gluten Free and Celiac is increasing, there are still too many times I have been the unwitting recipient of gluten at restaurants (sauce ingredients, dressings, etc). The dreaded symptoms normally show up after about an hour or so, and last a day or more...I would love to cut the side effects short, and feel like myself earlier!

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    Believe it or not, I have found that one shot of tequila within a few hours of ingesting gluten greatly minimizes my symptoms, almost to the point of negating any reaction! Just one shot, though!

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    Hi,

    I just had an accidental slip-up about an hour ago. I am on vacation and ate from the double-dipped peanut butter jar instead of the one intended for me...

    Anyway, when I slip up, I immediately take a dose of a product called Glutagenics by Metagenics. (I'm not at home so can't get any more specific than that for now). It aids in restoring the intestinal lining.

    You mentioned enzymes, do you have a name brand? A lot of enzymes actually contain gluten, so I don't want to try anything without getting a name brand recommendation. Thanks for the article!

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    Guest Darci Frankel, Kauai, Hawaii

    Posted

    I found the article very informative, and I am so happy that there is more and more information about gluten intolerance in the world. I disagree with the bit about inducing vomiting being so gravely dangerous. When cats need to expel excess mucous from their stomachs, they instinctively eat a certain type of grass that makes them vomit. I don't have full blown celiac but I do get pain when I eat gluten, and the one time I ate a muffin that was assured to me to be gluten free, (well I only took a few bites) I realized that I didn't want to go through several days of discomfort, so I drank some water and stuck my finger down my throat and eliminated the few bites. Now I'm not advising that everyone eat whatever you want and then be bulimic, that is dangerous but I am saying we shouldn't be afraid of our bodies and its natural reflexive actions. Enjoy life and be well. Aloha!

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    Great topic! In my own personal experience, it is best to cleanse the small intestine of the mucosal inflammation. I use apple cider vinegar for this. Dilute a tablespoon or two in water and drink. Do this a few times per day. I find the greasy and/or loose stools disappear within a day or so.

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    My son was diagnosed with celiac when he was 13. He is now 18 and has always stuck to his gluten free diet. However, today he accidentally ate gluten. Not just a small amount, but a very very large amount. An entire half of a 16' pizza! That was at 6:30 pm. He threw up at 8:30 pm then 9:30pm then 10:20 and now again at 10:54.

    I have been searching the internet for hours (while caring for him) trying to find out how serious it is to be glutened this badly.

    Thanks

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    Wow, the tequila shot is one which I've never heard before, does it help you minimize your symptoms? I was wondering what the name of these enzymes are as I never purposely ingest gluten, but it would be nice to be able to minimize

    the gut inflammation, even slightly after an attack.

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    In the weeks before I was diagnosed, the ONLY thing that would ease my mysterious stomach pain/nausea/heartburn was Celestial Seasoning's Tummy Mint Tea. I know I might sound like a corporate plant here, but it's a completely benign thing to at least give a try. Even though I'm now on a gluten free diet, it seems my stomach upsets easily, and it is almost always effective. I'm sure other brands of tea with similar ingredients would work as well.

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    I ate 2 bites of a flour tortilla by accident. When I get gluten accidentally I usually lay in bed for three days with flew like symptoms, inflammation an achy body and no energy. I took Claritin 1 hour after. It seems to be helping, but I'm afraid to stop taking it because I am bloated and it seems to be helping the pain. I'm glad you had other suggestions.

    Sharon

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  • About Me

    Kristen Campbell is a gluten-free, natural beauty expert. Diagnosed with severe gluten intolerance, she tests and tries, then recommends only the very best and purest gluten-free cosmetic products on her website www.NaturallyDahling.com. She is also the co-founder of www.GlutenFreeFox.com the world's first gluten-free search engine.

  • Related Articles

    Janet Doggett
    This article appeared in the Winter 2008 edition of Celiac.com's Scott-Free Newsletter.
    Celiac.com 07/19/2008 - When I was 6 years old, I lived in Dallas, Texas, and I had a best friend named Judy. It was at her house that I first ate a bagel. I fell in love with its chewy, crusty texture. I didn’t know much at that age, but I knew that I loved eating those bagels – I couldn’t get enough.
    I also knew, from a very young age, that something was wrong with me. Something that they would one day discover and name after me. I had stomachaches all the time. I can’t remember a time when my stomach didn’t hurt at least a little bit.
    “You were so healthy when you were young,” my mother is fond of saying. Painfully shy and uncomplaining–yes. Healthy, no. We were just blissfully unaware of what lay in wait for future doctors to discover.
    In high school, I was anemic, and experienced several bouts of tachycardia that were written off to anxiety. And then after I was married, I twice struggled with infertility. Later, the “stomachaches” returned and worsened and doctors removed my gallbladder thinking that stones were to blame and then my uterus thinking it might be hormones causing my symptoms.
    Along the way, in trying to diagnose me, doctors discovered insulin-dependent diabetes, low thyroid and high cholesterol. I also have bipolar disorder. I take a combination of 13 medications a day for my health maintenance, and I’ve been to the hospital at least 18 times in the past year. But still, I felt that they hadn’t hit upon that one thing that was really wrong, that was causing my stomach to hurt so badly.
    Then, two years ago, I had added “severe bone pain” to my ever-growing list of symptoms and went to see a rheumatologist. He refused to believe it was a simple case of arthritis and tested me for malnutrition. I had no Vitamin D in my blood – a tell tale sign that something was wrong with my gut. Next came the antibody test and then a biopsy that proved that the tiny villi that lined my intestines were indeed “flattened.” We had a diagnosis after only 10 years of actively seeking one. I had celiac disease, an auto-immune disease where you can’t digest wheat or gluten, the wheat protein.
     “What? I can’t eat bread? I can’t have bagels?”
    I was sure I would starve to death when I heard that this removal of all glutens from the diet was the only treatment for the disease whereby the lining of a person’s intestines is badly damaged. If left untreated, it can lead to things like malnutrition, brain ataxia, osteopenia, and eventually a cancer called lymphoma.
    More specifically, what was happening was the lining of my intestines was shriveling, shrinking in reaction to the gluten in the bread or other products made with wheat. The damaged intestines repair themselves with the removal of gluten from the diet, but it must be strictly adhered to for life. Even the smallest taste of wheat or gluten would immediately return my villi that line the intestines to a flattened mass. 
    At first I was afraid to eat anything. All day long, gluten loomed at me from dark corners. At night I dreamt of bagels and pizza.
    The problem is that gluten is hidden in many foods. Obviously it is in bread, bagels, pizza, pasta, most fried foods (all wheat flour-based products) but it also is in many processed foods like canned soups and salad dressings, ice creams, foods made with caramel color, malt, barley, rye, HVP, spelt, and the list goes on. It also means that I must use separate utensils to butter my gluten-free bread, separate pots and pans to cook my food and separate colanders to drain my corn or rice-based pastas. Even certain toothpastes and lipsticks are suspect.
    To have celiac disease means that you no longer can rely on that convenience factor of ordering take-out or eating fast-food. It means that you have to be prepared each and every time you eat, bringing with you sauces and dressings, buns and breads.
    You learn, too, that part of the reason bread is bread is because of the gluten. It is what holds it together and gives it its chewy texture. Breads made from rice and corn and the like are mealy and fall apart. They must be kept frozen and then toasted, and even then are just not the same.
    Eating out is risky. You must carefully research a restaurant before you go, finding out if they offer any gluten-free foods and usually speaking to the manager and the chef. I usually go to one of two restaurants that I know to have gluten-free menus. Even then you risk cross-contamination or accidents. The other day, I found a crouton in the bottom of my salad bowl. This can be disastrous to a person with celiac disease.
    It signaled all things dark and dastardly, and sure enough, later that night, it started: a gnawing, a clawing from the inside out. Something akin to severe hunger but more raw than that. Then it settled in the pit of my stomach and churned into a piece of broken glass. A reaction to gluten can feel as though every time you move you’re stabbed by a shard of glass until you’re bleeding from the inside out. This can result in severe projectile vomiting and other gastrointestinal symptoms that are mostly unmentionable.
    The Other Celiacs
    There are those people who have celiac who are really upbeat about it all – perky even. There are also celiac patients who have mild or no symptoms of the disease. I’m not one of them. They will tell you that we are among the lucky ones, the ones who know they have the illness, the ones who have been diagnosed and now have all this healthy good-for-you food at our disposal. They laud the nature of the illness whereby the only treatment is dietary and does not require surgery or other invasive means. But if you ask me, I would much rather have one surgical procedure that would “cure” me and be able to digest wheat the rest of my life than to have to make such a lifestyle overhaul. To have celiac is to be socially awkward at best and to be in constant pain at worst. It is not something one wishes to have.
    The worst part is no one (other than another celiac sufferer) understands, from the family member who wants you to try “just one bite” of her homemade streusel to the restaurateur who mistakes white flour for a non-gluten product because it has been “bleached” to the medical professional who thinks it’s a simple allergy rather than an auto-immune disease. The lack of awareness of celiac is astounding given that nearly two million Americans are said to suffer from it.   The problem is it is widely under-diagnosed. One in 133 Americans are said to have celiac disease but only one in 2000 knows they have it.
    Lack of Awareness
    When we are little kids, we are taught that doctors are there to help us. I have very few doctors who actually help me. I had one doctor -- an endocrinologist – say that they would figure it all out at the autopsy. To have a chronic illness is to realize that there is no cure. You will not be cured. You will learn to live with some amount of pain and illness.
    This lack of awareness of the disease and its effects even among medical professionals is unnerving. I’ve shown up at hospitals vomiting blood, writhing in pain with blood pressure so low I should be crawling yet I’ve been told nothing was wrong with me, that all of my blood work was “perfectly normal” and therefore I should just go home and rest.
    Of course if they had checked my gluten antibodies, they would have found that they were twice as high as was normal, pointing to an accidental ingestion of gluten, which sent my body into a tailspin of auto-immune hell. Yet there is no “auto-immunologist” to which I can turn for help.
    What’s even more frustrating is that celiac disease is not a rare illness – it is estimated that it could even affect three million Americans!
    Lessons Learned
    I dream of bagels that I can digest that taste good. I dream of hospitals where treatment comes without scrutiny and care comes with respect.
     And I dream of a place I can go and be welcomed where “everybody knows the name” of celiac sprue. A place where people understand that it is not a simple thing to just“eliminate gluten” from one’s diet as gluten – the wheat protein – isin many, many foods, some obvious, yes, but many hidden, too.
    In the meantime, I’m learning to eat to live and not the other way around. And I’m enjoying the simple things in life – the friends who will drive far enough to find a gluten-free restaurant; the same friends who won’t devour the bread basket in front of you!


    Jefferson Adams
    Celiac.com 01/14/2010 - Most people with celiac disease will tell you that faithfully maintaining a gluten-free diet can be very challenging, especially for those who enjoy dining out or in the homes of friends.
    "Going to restaurants or dinner at a friend's house can pose dangers to a person with celiac disease," says said Dr. Ali Keshavarzian, vice chairman of medicine and gastroenterologist at Rush University Medical Center. "It can really impact a person's quality of life."
    For most people, maintaining a gluten-free diet will stop symptoms, heal existing intestinal damage, and prevent further damage, along with potentially preventing numerous associated conditions, such as diabetes. But setting up and sticking to a gluten-free diet can be a challenge.
    A team of Gastroenterologists at Rush have designed a new study to determine if mind and body techniques could help people with celiac disease adhere to the very strict diet.
    "Eating even a small amount of gluten can damage the small intestine," says Dr. Ali Keshavarzian, vice chairman of medicine and gastroenterologist at Rush. "The damage will occur in anyone with the disease, including people without noticeable symptoms."
    Hidden sources of gluten are sometimes additives such as modified food starch, preservatives and stabilizers made with wheat. Also, numerous corn and rice products made in factories that also make wheat products can be contaminated with wheat gluten.
    "The purpose of this study is to determine whether participation in one of two mind/body courses can help patients cope with the restricted diet," says Keshavarzian. "It can be very hard and stressful for people with celiac disease to stick to a gluten-free diet."
    Healing existing intestinal damage and preventing further damage means that people with celiac disease must go on a lifelong gluten-free diet. Patients must be trained by health professionals on how to understand safe and unsafe ingredient on food labels, and to spot foods containing gluten in order to make safer, more effective choices when grocery shopping or eating out.
    People with celiac disease or gluten intolerance usually begin to feel better within days of starting a gluten-free diet.
    The small intestine usually heals in three- to six-months in children, but can take several years in adults. A healed intestine means a person now has healthy intestinal villi that can properly absorb nutrients from food into the blood.
    Patients enrolled in the study on Celiac disease and mind/body techniques at Rush will be randomly assigned to two course assignments for eight weeks.
    To be eligible for the study, patients must be over 18 years of age, have received a diagnosis of celiac disease in the past four weeks or within two weeks of starting a gluten-free diet, and have not previously attempted a gluten-free diet.
    Source: ScienceDaily (Jan. 11, 2010)


    Jefferson Adams
    Celiac.com 05/03/2013 - Would you fork over five dollars just for browsing in a store?
    More and more brick and mortar stores are fighting against a practice called 'showrooming,' where consumers visit a store to view an item in person before buying it online. Charging a fee to visitors who do not buy anything is one new strategy in that fight.
    Adelaidenow.com.au reports that Brisbane-based Celiac Supplies, a gluten-free specialty food store in Australia, recently announced that it will charge customers $5 for browsing. The money will be refunded when the customers purchase an item.
    In an article that appeared on the Consumerist.com website, the store-owner, who gave her name only as Georgina, says that she implemented the fee to curb “showrooming.” Her store has seen a "high volume of people who use this store as a reference and then purchase goods elsewhere," according to a note, a photo of which appeared on Reddit.com
    Georgina's note adds that the showroomers she complains about "are unaware our prices are almost the same as the other stores plus we have products simply not available anywhere else.”
    The note closes by saying that the $5 fee “is in line with many other clothing, shoe, and electronic stores" that also face the same problem.
    Georgina told the website that she spent hours giving advice to as many as 60 people per week, who would go into the store, ask questions, and then leave without buying anything.
    “I’ve had a gut full of working and not getting paid,” Georgina was quoted as saying. “I’m not here to dispense a charity service for Coles and Woolworths to make more money.”

    Lauren Lindsey
    Cautions for Coffee and Caffeine Drinkers
    Celiac.com 10/31/2013 - I recently made a post on instagram that gained a significant amount of attention. A before and after photo with a caption that read “dairy and coffee free” had viewers confused. The attention was not due to my physique but instead to the concern of eliminating coffee as part of a wellness regimen. When over 1000 “likes” and 30 comments were made, I realized that little is acknowledged about the matter. There are certainly far worse things for your health than coffee and caffeine yet I’m compelled to share its undesirable effects. I do not claim that drinking coffee ruins your health and take into consideration that every individual has unique dietary needs and intolerances. Years following my celiac diagnosis, eliminating coffee (and dairy) changed my life. I hope it will do the same for you.
    Concerns:
        Chronic Fatigue     Suppressed Immunity     Increased Inflammation     Deflated Mood & Cognition     Acidic Content     IBS Symptoms     Weight Retention Fatigue & Immunity
    There are few things more frustrating than the lack of energy to perform normal tasks. Fatigue is one the most common and difficult symptoms to treat with celiac disease.  When speaking to individuals about coffee consumption typical responses are, "I need the energy, I MUST have my coffee. I can’t go without it.” The irony is that caffeine is a major cause of fatigue. Most of us are familiar with the 2pm crash that comes with the workday. “Well no worries, I’ll have another cup of coffee” you might say. – This is where trouble begins. When it comes to caffeine, fatigue is determined by the amount of milligrams consumed. Studies have shown that fatigue heightened in individuals who had three cups of coffee and was the highest in those who had five cups.
    Continuous coffee and caffeine consumption places the body into a chronic state of stress or emergency. Caffeine signals the adrenal glands to produce stress hormones that are responsible for the “fight or flight” response. While useful for outrunning grizzly bears, it’s not intended for constant and sedentary use. The perked attention after drinking coffee is the body’s response to the unnecessary secretion of stress hormones. The energy felt after drinking coffee is actually your body battling the stimulated fight or flight response.
    Studies have shown that constant stress impairs the immune system to respond to normal hormonal ques.  The excessive amount of stress hormones deters communication within the immune system posing for additional complications with auto-immunity conditions. Once in this state of emergency the body seeks out reserves and depletes vitamins and minerals the immune system rely on. With celiac disease, inadequate absorption of vital nutrients and immune deficiency already pose as threats absent of caffeine consumption.  Not to mention, B-vitamins are also depleted which aids in utilizing food for energy, thus exasperating symptoms of fatigue.
    Deflated Mood and Cognition
    Coming down from the caffeine high (you’ll have to eventually) may cause exhaustion, hindered cognition, and moodiness.
    “Wait, moodiness? But caffeine elevates your mood and helps you concentrate.”
    There are claims that coffee aids in treating depression and moodiness and here’s why; within minutes of drinking coffee, the central nervous system is firing neurons, sending signals to the brain, and pumps out adrenalin. The perked attention for someone exhibiting depressive symptoms would certainly feel beneficial. Unfortunately, this is short lived, fails to treat the underlying cause of depression/moodiness, depletes vitamins that aid in brain functioning, and slows oxygen to the brain.  Have you ever heard an athlete use the term adrenalin dump? If adrenalin becomes too high before an event, the athlete will crash too early during their performance. It’s the same idea with coffee; after the alertness dissipates, the individual is left to crash and potentially in a worse mood.
    Although mild in comparison, caffeine manipulates the same neurochemical activity as amphetamines, cocaine, and morphine. (I’m NOT implying that coffee is equivalent to the previous examples but simply presenting the connection). Although different drug types, each stimulate the central nervous system to a degree causing temporary feelings of elation, pain relief, attentiveness, and suppressed appetite. These sound like great things but most of us understand the potential danger and addictive nature of these stimulants.
    IBS & Acidic Content
    “It sounds like caffeine is the culprit not coffee. So I’ll have decaf more often.”
    That’s a good start, but first: Cutting back is useful in combatting issues associated with caffeine but the acidic make-up of coffee must also be considered.
    It’s commonly understood that coffee is a trigger for IBS.  Even in modest amounts, coffee produces a laxative effect within minutes after drinking. This applies to decaffeinated coffee as well and provides that caffeine is not the only culprit for IBS symptoms. Decaffeinated coffee is found to contain higher amounts of acid than regular coffee and stimulates acid production in the body. Excessive acid damages the intestines, resulting in absorption, immunity, and over-all health issues. There are numerous drinks containing a higher acid content than coffee. Sports drinks for instance, contain nearly double the amount of acid as coffee. Having sports drinks in effort to rehydrate from a cup of coffee enhances potential complications from acid damage.
    “I don’t have IBS. I like coffee because it keeps me regular”
    Achieving regularity by means of coffee consumption may indicate the need for dietary changes. Using pro-biotics and eating adequate amounts of fiber achieve regularity and are conducive towards overall health.  Even if the constant need for the bathroom is not an issue, consider caffeine’s diuretic effects such as dehydration, impaired digestion, and constipation.
    Weight Retention
    “I like coffee because it curves my appetite.”
    Adrenaline stimulation releases and emits stored blood sugar. Insulin releases and blood sugar drops below normal. You’ll be hungrier than before in no time.
    Keep in mind that excess insulin is known to:
     
        Promote the storage of fat = weight gain     Retain sodium = holds water weight and causes high blood pressure     Increase amounts of inflammatory compounds in your blood! Inflammation is a killer and especially dangerous in increasing symptoms for those with celiac disease. I believe that individuals suffering from gastrointestinal disorders could greatly improve their life by eliminating coffee. I also understand that making such claims are “fighting words” for those who love their daily brew. Although uncomfortable and challenging to give up, consider the potential hindrance coffee and caffeine poses for healing. It may be your answer and missing ingredient to feeling better.  
    Best of luck.
    Sources:
    Active Wellness By Gayle Reichler MS RD CDN, page 12 Disease Prevention And Treatment by Life Extension Foundation, page 739 Textbook of Natural Medicine Volumes 1-2 by Joseph E Pizzorno and Michael T Murray, page 433 Caffeine Blues By Stephen Cherniske MS, page 10 Lane, J.D. 1994. Neuroendrocine Responses to Caffeine in the Work Environment. Psychosomatic Medicine. 546:267-70. Rao, S.S., Welcher, K., Zimmermn, B. and Stumbo 1998. Is coffee a colonic stimulant?

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