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  • Jefferson Adams

    Nausea and Vomiting Are Key Symptoms of Gluten Exposure in Celiac Patients

    Jefferson Adams
    7 7
    Reviewed and edited by a celiac disease expert.

      Gluten-free celiac patients exposed to gluten are likely to suffer from nausea and vomiting, but not from IBS-like symptoms, according to a new study.


    I think I'm going to be very very sick. Image: CC BY 2.0--Sarah G...
    Caption: I think I'm going to be very very sick. Image: CC BY 2.0--Sarah G...

    Celiac.com 02/24/2020 - Low FODMAP gluten and sham challenges show that nausea and vomiting after a meal are key signs of acute gluten ingestion, and reflect an active immune reaction in celiac patients who are otherwise following a gluten-free diet.

    This became clear recently after a team of researchers set out to establish acute gluten-specific symptoms linked to immune activation in celiac disease.



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    The research team included A. James M. Daveson; Jason A. Tye-Din; Gautam Goel; Kaela E. Goldstein; Holly L. Hand; Kristin M. Neff; Leslie J. Williams; Kenneth E. Truitt; and Robert P. Anderson.

    They are variously affiliated with the Faculty of Medicine, University of Queensland, Brisbane in Queensland, Australia; the Immunology Division, The Walter and Eliza Hall Institute, Parkville, Vic., Australia; the Department of Medical Biology, University of Melbourne, Parkville, Vic., Australia; the Department of Gastroenterology, The Royal Melbourne Hospital, Parkville, Vic., Australia; the Centre for Food & Allergy Research, Murdoch Children's Research Institute, Parkville, Vic., Australia; the ImmusanT, Inc., Cambridge, MA, USA.

    For some people with celiac disease, FODMAPs in gluten-containing foods can trigger anxiety about a potentially harmful 'nocebo' effect, which can lead to acute symptoms after a gluten challenge.

    The team enrolled 36 celiac disease patients on a gluten-free diet who received placebo in the RESET CeD trial.  The team put each of the study subjects through a course of double-blind, bolus vital wheat gluten and sham challenges that were both low in FODMAPs with two weeks between courses. 

    The team measured daily Celiac Disease Patient Reported Outcome (CeD PRO) symptom scores on a scale of 0–10, adverse events and serum interleukin-2, at both baseline and 4 hours).

    The highest increase was seen in average CeD PRO score for nausea, with sham challenge score of 0 vs gluten challenge score of 5.5. 

    Apart from tiredness and headache, changes in other symptoms were small or absent. Only nausea increased significantly in occurrence with gluten. Without nausea, only tiredness and flatulence were common after gluten. 

    Nausea and vomiting were the only adverse events more common with gluten than sham. Nearly all of the patients fed gluten showed raised levels of Interleukin-2, which corresponded to the severity of the nausea and the presence of vomiting.

    These low FODMAP gluten and sham challenges show that nausea and vomiting after a meal are key signs of acute gluten ingestion, and reflect an active immune reaction in celiac patients who are otherwise following a gluten-free diet. However, IBS-like symptoms without nausea are unlikely to indicate recent gluten exposure.

    Lastly, these findings indicate that FODMAPs may be an issue for many people with celiac disease. Many celiacs on a gluten-free diet, who think that they are having issues with gluten, might actually be reacting to FODMAPs, and may benefit from a FODMAP elimination diet.

    Read more in Alimentary Pharmacology & Therapeutics; 2020;51(2):244-252.

    7 7

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    Me too. But I have severe chills and heavy sweating before and during the vomiting time. This is the indicator that I need to get to a bathroom or find a plastic bag quickly. 

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    My skin turns red now and my heart rate goes up.  Along with those symptoms I also get a temperature and then nausea, vomiting and diarrhea.  These all happen concurrently and within a few minutes of exposure.

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    If I ingest gluten within 2-3 hours I start vomiting continually every 15 mins. When no food is left to vomit, I then keep dry reaching. I also get severe headaches, horrendous stomach pains & chills. This lasts up to 6 hours or so, so I am bed ridden & feel totally ghastly & weak.The extreme tiredness lasts around 2 days. 

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    I get sick for a whole month. Starts with not feeling well. Then I vomit and have to remember to drink something cause the dry heaves hurt. I also get a foggy brain which lasts for most of the month.  The severest symptoms last for about 8 days then eases off a bit. But there's a sick feeling that last for the whole month. Its horrible.  

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    On 2/25/2020 at 1:10 PM, Fenrir said:

    I know my primary symptom now directly after eating gluten is vomiting. It's almost like clockwork, 3 hrs after I eat gluten I get very nauseous and usually throw up and feel terrible for a day or two. 

    Those were always my symptoms - always about 3 hr after accidentally eating gluten (and how I found the Twizzlers have wheat). I never had diarrhea. In fact I never had symptoms until I stopped eating gluten and then accidentally ate gluten. My only signs before diagnosis (by endoscopy and antibody tests) were osteoporosis and iron deficient anemia with low hemoglobin. The anemia and low hemoglobin resolved after going gluten-free, but I still have the osteoporosis. 

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    13 hours ago, Guest Pindy said:

    If I ingest gluten within 2-3 hours I start vomiting continually every 15 mins. When no food is left to vomit, I then keep dry reaching. I also get severe headaches, horrendous stomach pains & chills. This lasts up to 6 hours or so, so I am bed ridden & feel totally ghastly & weak.The extreme tiredness lasts around 2 days. 

    This happens to my daughter. But if I can get her to eat 1-2 handfuls of babycarrots, she won’t throw up and it will pass! Been doing this for 2 years now and it’s amazing! Baby carrots help eith with any upset stomach. 
    I also give her activated charcoal if she’s getting signs of being sick and the. Give her carrots. If I do these things, she won’t throw up! 
     

    hope that helps!

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    Starts with a headache. A few hours after I get severe stomach pains, kind of like labor pains (I have 3 children) , chills, sweats, severe and painful diarrhea. For a few days after i have migraines, arthritis pains, brain fog, nausea, and stomach cramping (especially after eating). I typically fast for a while after. 

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    19 hours ago, RKBrumbelow said:

    I suspect both you and I are also allergic to wheat, or you also have Addison’s as we react similarly

    I have been diagnosed as a "Celiac" for over 25 plus years now.

     

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    I would be interested in a study that looks into the time after ingesting gluten to the point of nausea and vomiting. 

    Because until recently I too thought that when I was nauseous and vomiting after eating a meal, the last meal would be the blame for gluten exposure.  But after 3 separate experiences my understanding quickly changed. 

    The first time was after eating at a so called "safe" establishment.  After telling the server about my Celiac Disease the rice they served was pilaf.  After taking several bits I thought something was wrong, and I asked what kind of rice dish it was.  I was told rice pilaf!  Since I've already eaten it, I had more, to see what my reaction would be.  When we arrived home, I felt absolutely fine.  When I woke up the next morning I felt absolutely fine.  I was actually thinking maybe I was beating the severe reactions once experienced.  By mid afternoon I was starting to feel fatigued, and round diner time the wicked headache showed up.  The food I ate that evening was from home, and without a doubt 100% gluten-free, and within 3 hours or so after eating, I spent the entire night throwing up.

    This happened two other times, once with a frozen burrito that had the exact same colored packaging as the gluten-free version, and 24 hours later, I was throwing up the meal I just ate.  And again at an establishment that was "safe" for those with Celiac Disease while I was without a doubt eating 100% gluten-free the day of and prior, again 24 hours later, I was throwing up.

    Maybe the reaction is just me, maybe it is not.  But like others, after throwing up a meal, I would always blame that last meal.  But after my not so controlled scientific experiments I quickly realized there's a lot more to our immune systems.  Kind of like that door knob that had the cold or flue virus on it, we don't see the immune response to the virus 3 hours after touching the knob and exposing ourselves, it's more like 24-72 hours later, after our immune systems kicks into gear.  Maybe it's the same for those of us with Celiac Disease?

    * I was diagnosed with Celiac Disease 13 years ago.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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