Elimination diet

[Svelte]

I've been gluten free for 2 months now and I seem to be having more abdominal pain problems than I did before I quit eating gluten.  I've been thorough avoiding gluten, but possibly I've had a few things with vinegar in them for example that I possibly could have reacted too.  It seems from what I've read on this forum that I quite possibly have more issue's like other food allergies.  So my plan is to start an elimination diet soon, which I'm not looking forward too.  I'm simply wondering how long on this diet before I should see some relief from my pain problems?  I would think this diet should sort out any diet issue's.  2 weeks?  1 week?  I'm becoming desperate for relief.

One possible source of gluten exposure would be from the painkillers I'm taking, like T1's, but the ingredients look good and mostly I'm taking Kratom for the pain anyways.  On the elimination diet I'm assuming I can still take painkillers?

Any advice for the diet also would be welcome.

Edited October 18, 2019 by Svelte
grammar

[cyclinglady]

Consider making sure that you are really gluten free by trialing the “Fasano” diet for a month or so.   Dr. Fasano is a leading celiac disease researcher and his team noticed that celiacs were being diagnosed with refractory celiac disease (not good) much too often.  They found that a chunk of people were still getting gluten into their diets despite their best efforts.  

https://res.mdpi.com/nutrients/nutrients-09-01129/article_deploy/nutrients-09-01129.pdf?filename=&attachment=1

In addition, avoid the common 8 allergens.

https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-food-allergies

Consider not consuming nightshades or corn either.  Some members report having issues with those.    Remember, many celiacs, due to the intestinal damage, do not release the necessary enzymes to digest things like lactose.  Avoidance usually helps.   Some members use digestive enzymes.  

Often intolerances can resolve with healing.  For example. I can eat corn tortillas but not whole corn when My celiac disease is flaring.  It is just too hard for me to digest.  

[GFinDC]

Some pain medications can cause stomach damage and pain.  Aspirin and Ibuprofen are two that can cause stomach pain if taken for prolonged periods.  You should take pain medications with food.

Have you seen the Newbie 101 thread  in the "Coping With Celiac" section?  It has some tips for starting the gluten-free diet.  Some people have cross contamination issues that cause problems.  Shared toasters or a gluten eating spouse for instance.

There is also the possibility of a stomach ulcer.  You didn't tell use where the pain is located so just guessing.  I don't know kratom is normally gluten-free or not.  You'd need to check with the maker to find out.

[cyclinglady]

Were you diagnosed with celiac disease?  I ask because your GI would have checked and biopsied your stomach as well as your small intestine.  GFinDC is right that prolonged use of aspirin and ibuprofen can cause gastric and intestinal damage.  I am not familiar with the other natural supplement you are taking, but it should be checked to insure it is gluten free.  

If your pain is strictly abdominal, consider getting off all pain meds.  It could be kind of a “chicken or an egg” thing.  

For me, I found that a super strict gluten-free diet that avoids processed foods and identifies additional  intolerances is best.  I think it expedites healing.  Certainly continuing an American Standard diet whether it is gluten-free or not, is not healthy based on our rising obesity and diabetes problems.   I sympathize with your pain.  Treating the source of it, is your best option.  I hope the gluten-free diet works for you.  

Oh, I also found that simple fasting (12 to 16 hours) can give your GI tract a needed break.  And DO NOT eat out until you are feeling better and have mastered the gluten-free diet. 

[Svelte]

Thanks for all of the advice.  I only had the blood test done for my diagnosis: Tissue Transglutaminase Ab IgA which I scored over 250.  Due to problems with the health of my father I was not around immediately after the test, and apparently they do something to check for gluten in the stool before and after a biopsy, so my normal confirmation for me was not an option here in Vancouver.  As I understand it, the blood test with the score I have is almost 100% accurate.  I guess I could go back and ask to have a biopsy done, but I didn't really see a benefit when I talk with my doctor yesterday.

My doctor thinks that it's likely my pain medications causing my pain, Kratom (kratom is a herb you make tea from, but has opioid properties) and Tylenol with codeine that I've been taking for years.  So the plan is to get off the pain medication and see if that helps things.  I thought it also might be a “chicken or an egg” thing, but the pain seems real to me, but it also makes no sense.  I've got about 6 different locations in my abdomen and the pain seems to rotate through them on a daily or semi daily basis; mostly in my lower left quadrant, but also around my stomach on the left side.  So I consider this a realistic possibility that the pain meds have rewired my brain or something even though I don't consider the doses I take as particularly high.

I suspect that there is another issue, but I'm thinking another food allergy is the most likely, so I think it will be to my long term benefit to also do the elimination diet and figure out once and for all if there are more allergens.  I'm just trying to knock down one problem at a time and see what is left.  I don't seem to have any indicators of anything serious other than my half a dozen pains that come and go.

[cyclinglady]

It certainly sounds like you have celiac disease with such a high TTG result.  What I was trying to convey is that not all things are due to celiac disease.  About five years after my diagnosis, I had stomach pain that would not resolve.  How was I getting gluten into my diet (my DGP IgA was off the charts at the time)?  I trialed the Fasano diet and I knew my intolerances.    I had a repeat endoscopy.  Gastric biopsies revealed autoimmune gastritis which was not there five years earlier.  My small intestine had completely healed yet my celiac antibodies were high.  I realized that not everything is due to celiac disease and that the celiac blood tests were designed to diagnose but not check for dietary compliance.   However, they are the only non-evasive “tool in the tool box.”

So, you are still new to the diet.  It could could be gluten or you have some unidentified intolerances/mild allergies or the medications/supplements you are taking.  

[Svelte]

Yeah, I'm pretty new to this stuff.  2 years ago I was blaming all of my problems on a hernia I had, so I my success rate as a doctor is pretty low ?.  Things seem to be getting worse and accelerating, so something should show up soon.  Hopefully it is just the pain meds and or some flaws in my diet.  Another month should give me some more info.  I'm going to try that diet you attached, that should make sure I am not getting any gluten in my diet.  For example I had been planning on using frozen fruit and vegetables, but apparently that's not good enough.  I've had so many problems in my abdomen for so many years, I'm not sure what normal even feels like anymore.  These forums have been very useful to me and I can see that this might be a lot more complicated than I thought.  

[Awol cast iron stomach]

Yes sometimes during healing the immune system is super sensitive and fired up. I had 13 intolerances at one time down to 3 besides gluten.

My immune system didn't like corn/ corn dervatives, cow milk, xathum gum things I often ate with gluten or tried when I went first tried gluten-free diet before diagnosis.

Nowadays even with diligence and strict gluten-free no eating out  the GI/immune system is still in charge. I have discovered while a new autoimmune disease did not show I get symptoms of other AI without being diagnosed.

I have to be careful with my protein and electrolytes daily also aware of vitamins B's, D, magnesium.

My nervous system has been through a lot going misdiagnosed too long. Lately, I discovered with busy work schedule and activity level at work I have to be careful with getting enough protein at breakfast and electrolytes throughout the day. ( At my job I am active sit, walk, stand, and minimal time or place for snacking) otherwise my GI and nervous system can struggle with almost "POTS like"  symptoms of hypotension, blood pooling in abdominal/legs, bloating, flushing, and difficulty with temperature regulation.

So sometimes the healing even after our food intolerances are apparent can reveal to us new challenges our celiac masked that take a bit to discover, and address particularly, in my case if they are subclinical under the (lab testing range) yet very real symptoms.

Best wishes on your intolerances and subsequent healing journey.

 

[Whitepaw]

If your pain moves around, it may be gas. Consider activated charcoal or gas-tax. You might look at FODMAP lists to see if foods you can't tolerate fall into any of those categories.  Same with nightshades and corn, as previously mentioned. A food diary, even for a few days to a week, may help you pinpoint offenders. You can look up meds ingredients here: 

https://dailymed.nlm.nih.gov/dailymed/