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  • Wendy Cohan, RN
    Wendy Cohan, RN

    When Mistakes Happen, Focus on Comfort (How Celiacs can More Quickly Recover from Gluten Exposure)

    Reviewed and edited by a celiac disease expert.

    Celiac.com 09/25/2008 - Even after identifying yourself as having a wheat or gluten allergy and asking for a specially prepared meal, it is a common mistake to have a server deliver soup with crackers, or the entree with a side of Texas toast.   I get frustrated just thinking about the number of times my salad has arrived with croutons.  However, getting upset, or pointedly reminding the server can ruin the ambiance of the meal, as well as leave a bad impression with your dinner companions. It is helpful to remember that you are in the very small minority of their customers, and simply consider it an honest mistake.  Do not remove the croutons, crackers, cheese, etc. and eat your contaminated food—SEND IT BACK TO THE KITCHEN—politely, please.  State that you cannot eat what they have brought you, and repeat that you are allergic to the offending food.  Use the opportunity to gently remind your server and educate them about gluten.  Hopefully the next time they will be more conscientious.

    If you are wheat or gluten intolerant, and have the genetic component that leads to celiac disease, there is no going back to gluten.  As your body heals, you may think that you will be able to cheat once in a while, and that your sensitivity to gluten will decrease once you are not getting "too much".  In fact, the opposite seems to be true.  Once the body begins to get rid of its toxic load, heal damaged tissues, and regain health, it becomes more sensitive to gluten.  I see this over and over again in the clients I counsel, and in my cooking class students.  You will know right away if you cheat, or if you are accidentally "glutened".  Your body, fortunately or unfortunately, will tell you.  It is important to learn techniques to sooth your symptoms as much as possible until recovery takes place.


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    Symptoms of gluten exposure in a gluten-intolerant person can vary widely, but some commonly reported ones are abdominal discomfort, bloating, pain, swelling (sometimes extreme) and cramping, followed by diarrhea, or loose stools.  For those with Dermatitis Herpetiformis (DH), even very minor exposure can provoke itching and a return of a healed or nearly healed rash.  Others report headaches, or experience a sudden decrease in alertness and clarity of thought.

    Short-term treatment strategies for gluten exposure include taking an over-the-counter anti-histamine (check with your pharmacist for gluten ingredients), drinking nettle leaf tea (a natural anti-histamine), and using a warm castor oil pack over your upper or lower abdomen, wherever the pain and cramping are centered.

    Longer-term strategies include rebuilding your intestinal health through following an anti-inflammatory diet, taking supplements like L-Glutamine, coconut oil, fat-soluble vitamins A, E, D, and K, Calcium, Magnesium, B-Vitamins, Essential Fatty Acids (EFA's), and probiotics.  Dr. Thomas O'Bryan, a nationally recognized speaker on celiac disease and gluten sensitivity, also recommends Carnitine, an amino acid, in the treatment of celiac/gluten intolerance.  L-Carnitine helps in the absorption and transport of essential fatty acids into cells, and also helps to protect nerve membranes from free-radical damage.

    You may have good results with the tummy rescue smoothie recipe below, which I developed in response to a "gluten emergency" of my own.  The healing properties of each ingredient are also listed.  Puree in blender until smooth, and slightly thickened.  It is most soothing when consumed while still warm from the hot tea

    Tummy Rescue Smoothie:

    • 1 cup hot freshly brewed nettle leaf tea (anti-histamine, anti-spasmodic)
    • ¼ cup Santa-Cruz pear juice (flavoring/sweetener - pears are the least allergenic of fruits)
    • ¼ - ½ teaspoon whole fennel seed (reduces gas & bloating)
    • 2 Tablespoons slippery elm powder (healing & soothing to mucous membranes and the gut)
    • 1 Tablespoon flax seed oil (soothing, anti-inflammatory)
    • ¼ - ½ cup rice milk (hypoallergenic, use to thin to desired consistency)

    This smoothie is best consumed in small sips over an hour or so.  Magnesium also helps with pain and relaxes muscle spasms, so taking a little extra magnesium may be of benefit. For severe symptoms, drink the smoothie while reclining in bed, with a warm castor oil pack over the abdomen, covered by a heating pad set on low.  Do not leave the pack in place for more than an hour.

    There is also an enzyme coming on the market that may help reduce some symptoms of gluten exposure, although this product is in no way meant to replace the gluten-free diet.  Use it only for emergencies.


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    With an accidental ingestion, would it help to fast for several days on juice, probiotic, and water only (plus the enzymes you recommend)? Problems seem to escalate each time I eat anything after being "glutenized" and this lasts for 5 or 6 days. Advice would be appreciated!! Thanks.

    I'm in GIG from the last 14 years and one bite of cake or bread can swell my tummy around 5 inches for 20-25 days... Flax seed is helpful in it, either in roasted form or boiled form if accidentally you are glutened. Turmurric powder is also helpful in soothing tummies.

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    my 3 year old daughter was diagnosed with celiac two years ago. It has been a battle. Recently while in the daycare at church, she was given pretzels for a snack by mistake. She was projectile vomiting for hours. Is there something I can give her after she ingests gluten by mistake? It's only going to get harder to make everyone aware when she's in school. Is there a website I can go to and get her a medical bracelet?

    It will get better when she gets older and can advocate for herself. My son and I are both celiac. He knows not to eat ANYTHING at school that I have not packed for him. He won't even eat hard candy or gum. He brings everything home and then we throw it away together. I make sure to pack plenty of safe snacks, Lara bars are great, as well as plantain chips from Trader Joe's. I send a bag of snacks to school that his teacher keeps in the cabinet just for him. If someone has a birthday, she gives him one of his special cookies so he doesn't feel left out from the cupcake fest. It's hard, but it will get better.

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    Last week, I too, suffered a severe reaction to gluten by eating chips with wheat and barley malt in them. I thought the label said they were gluten-free. This was the 6th time since being diagnosed in 2004, that I had a severe reaction to gluten. Each exposure is worse than the last. I was rushed by my husband to the ER. Within 20 minutes my symptoms are sudden nausea leading to projectile vomiting and explosive diaherra. Add in the inability to move or communicate to the medical staff exactly what is going on. I usually wind up on IV fluids and other medications to slow the violent reaction down. Finish that off with weeks of sudden weakness, panic attacks, migraines, lack of sleep and brain fog, and you have what I go through. I can't go out due to sudden panic attacks. I am on all kinds of medications but no other support for the emotional turmoil that continues for quite some time. But what really gets me angry is the non-support from the ER staff who whisper in the background while I am vomiting my guts out that this is either a drug overdose or something else similar. All I can say to them is thank your lucky stars you don't have to go through what I have. And read up on what Celiac Disease is. Despite all of the medical articles that have verified that this is a real DISEASE, there are still many in the "medical profession" who really don't or won't understand what we go through. Should this happen to me again (and Lord I hope not) I will vomit on them.

    I will try the recipes listed and hopefully get my life back together again. And good luck to all of us who have few choices.

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    Thanks for the help, Wendy. In addition to gastro symptoms, I also get a migraine for days. Any ideas?

    A migraine or severe headache is my main symptom, too, Allison. It generally starts about 1.5-2 hours after accidentally eating gluten. Frankly, I would rather have the gastro symptoms, but perhaps mine are not as bad as others on this blog.

     

    For me, Ibuprofen does not help. I have to take real aspirin to get any relief at all, and then it just relieves the worst of it for a few hours. At least I can function when taking aspirin, which would be mighty difficult without it. If I keep my blinds shut the eye pain is diminished. The only real blessing is that the migraines don't last the 3-5 days that they used to before I found out that they were caused by gluten.

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    Hello, I sympathize with you gluten symptom sufferers but do be thankful (though it may be difficult for you) that you do get a reaction to gluten to alert you. My daughter has no external symptoms though her biopsy showed her gut to be in a very bad state... there is literally no way of knowing when a mistake has been made and therefore no way of avoiding food with hidden gluten ...

    Hi Guadelupe. I would suggest the help within this website for your daughter, also its probably best for her to only eat at home. For school, she should perhaps take her lunch. Being really creative with her foods and lunches will help her adjust and probably make her friends envious, (for a child someone being envious is a good thing), especially if the child has an illness. I have no children with this diagnosis but if I did every precaution would be taken at least until she's an adult to take care of herself. As you probably know, many restaurants offer gluten free meals (with possible cross contamination), but I wouldn't trust them, especially for your child. My fav food is ethnic, especially all types of Asian and I've learned how to prepare authentic Asian dishes myself. I like Italian, and with gluten free pastas I prepare my own.

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    Hi everyone. Regarding eating out and food choices: Whenever anyone has a diagnosis of an illness or disease, changes even drastic changes have to take place. Even with Celiac and gluten intolerance. After a year of knowing I am gluten intolerant and possibly have been for a long time, I finally came to the conclusion that I cant eat how I used to eat (restaurants, a glutinous dessert periodically). Because, even though I order from the "glutenfree menu" I cant count on my food not being contaminated. I told myself if I want to have a strong, happy productive life I must not eat gluten...ever. Its a hard pill to swallow, but I have no choice but to swallow it and live without putting myself in an early grave. I'm 53, I'm strong and vibrant, I have no major health problems except dealing with gluten intolerance. Our lives aren't over, and we should refuse to allow bad choices to end our lives early. We can do it, we can change! Gods health and healing, in Jesus name!

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    Thank you for such a wonderful article. I have searches the web for information like this. I appreciate the research and the time you took to put out the detail. I accidentally got gluten 2 days ago. I react with flew like symptoms, achy joints and tiredness for 2-3 days. This time I took Claritin and antihistamine and my reaction was not as bad as some past reactions. Your article helped. I agree with the response above. I think it is best to bring your own food with you and explain your allergy to the server. It is to risky to take the chance. I tried by ordering beans and tortilla's at a Mexican restaurant. I wanted to enjoy a special event and have just one night not worrying about food. So I ordered simple. I was two bites into the tortilla when I discovered it was flour. I cried!

    Hi Sharon, I wonder even taking an antihistamine to halt allergy symptoms of celiac or gluten intolerance, I don't think that halts any possible irritation or damage to any organs or does it?

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    This is good advice EXCEPT for one thing. When they deliver gluten-free food prepared improperly, ask to have the entire plate remade while you hold the one in error at your table. Explain that you do this to assist to prevent any mistakes in someone believing it should be delivered back to me for some mistaken reason. Do not touch the plate. Allow no one at the table to touch the plate. When the properly prepared plate is delivered, return the wrong one with grateful thanks. There is no need to make a fuss just hold the wrong one until the right one is delivered while explaining that your only goal is to help.

     

    This helps prevent the server from mistakenly removing the croutons and returning a dangerous plate to your table. If necessary, explain that another restaurant with a less experienced service staff accidentally did this and you help out in this way now.

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    On 10/1/2008 at 3:21 AM, Guest Sara said:

    Thanks for the smoothie idea, it definitely sounds like something worth trying!

     

    And just a note to Jen: It's a bit presumptuous of you to assume that those of us who suffer from severe intestinal pain and D as a result of being glutened somehow have it easier. It is literally the WORST pain I have ever felt, and it is most definitely not 'easily fixed with Imodium.' Just wanted to clear that up.

    I am 100% with Sara on this one, Jen.

    Literally the diarrhea attacks feel identical to child labor for me. The exact same. Also, I always have to have some sort of plastic cover in my car because there have been times I have been glutened and barey managed to get home or to a restroom quick enough. Not to mention, Imodium during severe attacks does next to nothing. Similar to how Zofran probably doesn’t work for you either during episodes of intense vomiting. 

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  • About Me

    An RN for 14 years, I have been following a strict gluten-free diet for six years of improving health! Now I help others as a Celiac Disease/Gluten Intolerance Educator. I work one on one with people on meal planning, shopping, cooking and dining out gluten-free. I will also work with children who have behavioral issues related to gluten or other food sensitivities.  My other websites are: www.WellBladder.com and www.neighborhoodnurse.net.

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