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Gluten free advice please

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My mother is gluten intolerant and vegetarian, and discovered the Deliciously Ella website when she had to cut gluten as well as meat from her diet. It's a little bit fad-diet-ish (in terms of all the health things talked about) but she swears by the recipes on there and the few I've tried (as someone who does eat both gluten and meat) tasted really nice :smile:
Reply 21
Original post by pineneedles
For IBS sufferers, gluten is often excluded in a trial as part of a low FODMAPS (fermentable oglio- di- mono- and poly- saccharides) diet. FODMAPS are carbohydrates which have been found in research to cause IBS symptoms in some sufferers.

Because IBS is psychologically driven, excluding certain foods from the diet is not the solution. Since it is the perception of certain foods rather than physical action of certain foods causing the symptoms, psychotherapy would treat the ultimate cause.

Obviously, all these "gluten/wheat/FODMAPS are evil" messages drive IBS symptoms.

Original post by pineneedles

This information is from an NHS leaflet.
"In the colon bacteria ferment FODMAPS, causing gas production and leading to bloating and wind. Diarrhoea may also occur as the fermentation causes an increase in the water in your stools, making them looser."
Wheat specifically contains oligosaccharides, a group of FODMAPS which can cause symptoms.

And the tide is turning against this thinking, with non-Coeliac gluten sensitivity being questioned as to whether this actually exists as a physical condition. Because people are increasingly being told and conditioned that they may get symptoms from certain foods, certain cohorts of people then expect they will get symptoms and start somatising them (or noticing things that they didn't used to)

Original post by pineneedles

I will say though that there is a world of difference between blindly following a diet because of some misconceived idea that it's definitely healthier because the low FODMAP diet itself isn't sustainable, and carefully monitoring your symptoms when following a diet to see if it's actually suitable for you.

As above.

Original post by pineneedles

As far as I'm aware, only coeliacs are eligible to receive gluten free foods on prescription. Considering the prices of gluten free foods, it may not be possible for every single person who has coeliac disease to afford enough food they can actually eat. Just think about the sheer amount of food that contains gluten.

What about people with egg allergies? Egg is in a lot of things.

Much of the problem of a person with Coeliac's Disease finding things to eat is that so much food for sale is so highly processed, with gluten containing ingredients finding their way into them. If somebody cooks from basic and raw ingredients, it isn't actually such an issue. Nobody needs to eat gluten containing products, so the state should not have to pay for people to eat gluten-free products.

Original post by pineneedles

Arguably, compliance with avoiding gluten would likely decrease if people don't receive enough financial support in regards to this, which simply costs the NHS more as they are forced to treat a higher number of people with subsequent complications such as malnutrition, osteoporosis, iron deficiency, infertility and miscarriage.

The vast majority of people with real Coeliac's Disease (i.e not all these people with "gluten intolerance/sensitivity") will avoid gluten irrespective of the cost, because the symptoms they get are so debilitating. This may not seem intuitive to the legions of "gluten intolerants" who 'feel a bit bloated' after eating bread (which is expected, bread is filling and supposed to make you feel full).
Original post by Rat_Bag
Because IBS is psychologically driven, excluding certain foods from the diet is not the solution. Since it is the perception of certain foods rather than physical action of certain foods causing the symptoms, psychotherapy would treat the ultimate cause.

Obviously, all these "gluten/wheat/FODMAPS are evil" messages drive IBS symptoms.



And the tide is turning against this thinking, with non-Coeliac gluten sensitivity being questioned as to whether this actually exists as a physical condition. Because people are increasingly being told and conditioned that they may get symptoms from certain foods, certain cohorts of people then expect they will get symptoms and start somatising them (or noticing things that they didn't used to)



As above.



What about people with egg allergies? Egg is in a lot of things.

Much of the problem of a person with Coeliac's Disease finding things to eat is that so much food for sale is so highly processed, with gluten containing ingredients finding their way into them. If somebody cooks from basic and raw ingredients, it isn't actually such an issue. Nobody needs to eat gluten containing products, so the state should not have to pay for people to eat gluten-free products.



The vast majority of people with real Coeliac's Disease (i.e not all these people with "gluten intolerance/sensitivity":wink: will avoid gluten irrespective of the cost, because the symptoms they get are so debilitating. This may not seem intuitive to the legions of "gluten intolerants" who 'feel a bit bloated' after eating bread (which is expected, bread is filling and supposed to make you feel full).


So if people only got symptoms from foods they believed were causing those symptoms, the only reason their condition would improve when they stopped eating those foods would be through a sort of placebo effect, right?

Statistically, though I don't know how up to date this is, around 70 % of people felt their symptoms improve after going through all of the phases of the low FODMAP diet, eliminating those foods they thought were causing their issues and reintroducing the rest (statistic from researchers at King's college, in London I'm trying to find the exact study)

Does it seem realistic that this statistic could be caused by the placebo effect, considering how sketchy placebo can be?

In addition to this, because the FODMAP diet excludes so many groups of food, it is necessary to only eliminate the foods which have actually been found to cause symptoms. If patients are told that a wide range of foods could be causing their condition, surely would they not feel it necessary to eliminate everything, considering the psychological effect you say this has?

I'm probably biased here, however, as I've been on a gluten free diet, and a low FODMAP diet for several months, and I've found that they weren't helpful for me. I told the dietician this and I stopped the diet fairly immediately, with no concerns whatsoever. I don't exclude anything from my diet now, and I sure don't worry about what I'm eating.
I'm not suggesting everyone would react in the same way as I did, I just think that if what you were saying was completely accurate, for a person with anxiety such as I, I would be susceptible to the psychological effects of being told to avoid certain foods. This also applies to most people with IBS, as they have a tendency to have mental health problems, because of the psychological link you mentioned.

I think you made a good point about receiving gluten free foods on prescription. I hadn't thought about it that way before, but I've been thinking about it and I thought that the increase the popularity of a gluten free diet as a fad is hopefully widening the market for such foods, which may help with the price and availability to a certain degree. As the NHS are placing cuts on GF prescriptions, this may force some people to look to the shops for their foods, enhancing this effect. Eventually there may not be a problem with this.
Though, there are downsides to this of course, such as the preparation of gluten-free foods becoming careless as people begin to assume it's for non-coeliacs.
Apologies for bumping an old thread

Original post by pineneedles
For IBS sufferers, gluten is often excluded in a trial as part of a low FODMAPS (fermentable oglio- di- mono- and poly- saccharides) diet. FODMAPS are carbohydrates which have been found in research to cause IBS symptoms in some sufferers.


Gluten exclusion from the diet is not part of the FODMAP diet. Gluten is a protein. The FODMAP diet is about excluding fermentable carbohydrates. Gluten avoidance is only recommended for people with with coeliacs disease. However, coincidentally, many foods that contain gluten, such as wheat, barley and rye, also are high source of fructans. Fructans are a short chain oligosaccharide that is often avoided on the low fodmap diet.

It is therefore hypothesised that those with 'gluten sensitivity' are actually most likely having issues with the fructans, but aren't aware that the fructans in wheat, barley etc.. can be an issue for some people.

Original post by Rat_Bag
Because IBS is psychologically driven, excluding certain foods from the diet is not the solution. Since it is the perception of certain foods rather than physical action of certain foods causing the symptoms, psychotherapy would treat the ultimate cause.


Whilst there does appear to be a brain-gut axis relationship with IBS, and thus psychological and anxiety related issues might have some correlation with IBS (which can be helped with Cognitive Behaviour Therapy and such), it would be incorrect to label IBS as only being psychologically driven. There does seem to be evidence pointing to IBS also being influenced by a dysbiosis of the microbiome.

Studies have been done and have shown that many IBS sufferers do find the symptoms improve on a low FODMAP diet. It works on the same principle as lactose intolerance. The short chain carbohydrates that are not digested and absorbed in our small intestines work their work through our digestive system to the colon. At the beginning of the colon is the caecum where our gut bacteria are based. The bacteria then starts to ferment these short chain carbohydrates and lactose sugars, and in the process produce gasses. These gases are the bloating and flatulence that come with IBS and lactose intolerance. The breaking down of these sugars produces more small solutes, which results in more water entering the colon through osmosis. This is what is referred to as osmotic diarrhoea, which is another typical symptom of IBS-D and lactose intolerance.

I've attached some journal articles on the FODMAP diet if you are interested.

Original post by Rat_Bag
Obviously, all these "gluten/wheat/FODMAPS are evil" messages drive IBS symptoms.


FODMAP's are not evil. FODMAP's are actually beneficial for humans. These short-chain carbohydrates that the human body cannot digest are fermented by the commensal bacteria in our gut and they produce beneficial Short Chain Fatty Acids such as butyrate which are important for colon health. The low FODMAP diet is based on studies which have shown that by reducing the FODMAP's in our diet, many IBS sufferers find their symptoms improve. But the low FODMAP diet does not recommend the diet be followed for a long period of time. Instead, it encourages the elimination of, and then the slow reintroduction of each individual FODMAP, but to a bearable and controllable level.




Original post by Rat_Bag
And the tide is turning against this thinking, with non-Coeliac gluten sensitivity being questioned as to whether this actually exists as a physical condition. Because people are increasingly being told and conditioned that they may get symptoms from certain foods, certain cohorts of people then expect they will get symptoms and start somatising them (or noticing things that they didn't used to)


It is actually hypothesised that those who believe themselves to be suffering from non-coeliac gluten sensitivity possibly have IBS. Foods that contain gluten such as wheat, rye and barley also contain large amounts of certain FODMAP's such as fructans. Their avoidance of gluten containing foods would actually be half-assed attempt at a low FODMAP diet without realising, and might explain why they experience some partial relief while following such a diet.
(edited 8 years ago)
Original post by The Epicurean
Apologies for bumping an old thread



Gluten exclusion from the diet is not part of the FODMAP diet. Gluten is a protein. The FODMAP diet is about excluding fermentable carbohydrates. Gluten avoidance is only recommended for people with with coeliacs disease. However, coincidentally, many foods that contain gluten, such as wheat, barley and rye, also are high source of fructans. Fructans are a short chain oligosaccharide that is often avoided on the low fodmap diet.

It is therefore hypothesised that those with 'gluten sensitivity' are actually most likely having issues with the fructans, but aren't aware that the fructans in wheat, barley etc.. can be an issue for some people.



Whilst there does appear to be a brain-gut axis relationship with IBS, and thus psychological and anxiety related issues might have some correlation with IBS (which can be helped with Cognitive Behaviour Therapy and such), it would be incorrect to label IBS as only being psychologically driven. There does seem to be evidence pointing to IBS also being influenced by a dysbiosis of the microbiome.

Studies have been done and have shown that many IBS sufferers do find the symptoms improve on a low FODMAP diet. It works on the same principle as lactose intolerance. The short chain carbohydrates that are not digested and absorbed in our small intestines work their work through our digestive system to the colon. At the beginning of the colon is the caecum where our gut bacteria are based. The bacteria then starts to ferment these short chain carbohydrates and lactose sugars, and in the process produce gasses. These gases are the bloating and flatulence that come with IBS and lactose intolerance. The breaking down of these sugars produces more small solutes, which results in more water entering the colon through osmosis. This is what is referred to as osmotic diarrhoea, which is another typical symptom of IBS-D and lactose intolerance.

I've attached some journal articles on the FODMAP diet if you are interested.



FODMAP's are not evil. FODMAP's are actually beneficial for humans. These short-chain carbohydrates that the human body cannot digest are fermented by the commensal bacteria in our gut and they produce beneficial Short Chain Fatty Acids such as butyrate which are important for colon health. The low FODMAP diet is based on studies which have shown that by reducing the FODMAP's in our diet, many IBS sufferers find their symptoms improve. But the low FODMAP diet does not recommend the diet be followed for a long period of time. Instead, it encourages the elimination of, and then the slow reintroduction of each individual FODMAP, but to a bearable and controllable level.






It is actually hypothesised that those who believe themselves to be suffering from non-coeliac gluten sensitivity possibly have IBS. Foods that contain gluten such as wheat, rye and barley also contain large amounts of certain FODMAP's such as fructans. Their avoidance of gluten containing foods would actually be half-assed attempt at a low FODMAP diet without realising, and might explain why they experience some partial relief while following such a diet.


Good information, thank you.
I think I got my wires crossed, I was following a gluten free diet at the same time as a low FODMAP diet, so I thought they were part of the same diet.
Original post by The Epicurean
Apologies for bumping an old thread



Gluten exclusion from the diet is not part of the FODMAP diet. Gluten is a protein. The FODMAP diet is about excluding fermentable carbohydrates. Gluten avoidance is only recommended for people with with coeliacs disease. However, coincidentally, many foods that contain gluten, such as wheat, barley and rye, also are high source of fructans. Fructans are a short chain oligosaccharide that is often avoided on the low fodmap diet.

It is therefore hypothesised that those with 'gluten sensitivity' are actually most likely having issues with the fructans, but aren't aware that the fructans in wheat, barley etc.. can be an issue for some people.



Whilst there does appear to be a brain-gut axis relationship with IBS, and thus psychological and anxiety related issues might have some correlation with IBS (which can be helped with Cognitive Behaviour Therapy and such), it would be incorrect to label IBS as only being psychologically driven. There does seem to be evidence pointing to IBS also being influenced by a dysbiosis of the microbiome.

Studies have been done and have shown that many IBS sufferers do find the symptoms improve on a low FODMAP diet. It works on the same principle as lactose intolerance. The short chain carbohydrates that are not digested and absorbed in our small intestines work their work through our digestive system to the colon. At the beginning of the colon is the caecum where our gut bacteria are based. The bacteria then starts to ferment these short chain carbohydrates and lactose sugars, and in the process produce gasses. These gases are the bloating and flatulence that come with IBS and lactose intolerance. The breaking down of these sugars produces more small solutes, which results in more water entering the colon through osmosis. This is what is referred to as osmotic diarrhoea, which is another typical symptom of IBS-D and lactose intolerance.

I've attached some journal articles on the FODMAP diet if you are interested.



FODMAP's are not evil. FODMAP's are actually beneficial for humans. These short-chain carbohydrates that the human body cannot digest are fermented by the commensal bacteria in our gut and they produce beneficial Short Chain Fatty Acids such as butyrate which are important for colon health. The low FODMAP diet is based on studies which have shown that by reducing the FODMAP's in our diet, many IBS sufferers find their symptoms improve. But the low FODMAP diet does not recommend the diet be followed for a long period of time. Instead, it encourages the elimination of, and then the slow reintroduction of each individual FODMAP, but to a bearable and controllable level.






It is actually hypothesised that those who believe themselves to be suffering from non-coeliac gluten sensitivity possibly have IBS. Foods that contain gluten such as wheat, rye and barley also contain large amounts of certain FODMAP's such as fructans. Their avoidance of gluten containing foods would actually be half-assed attempt at a low FODMAP diet without realising, and might explain why they experience some partial relief while following such a diet.


From an Ibs sufferer, this is a great post.


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Original post by pineneedles
Good information, thank you.
I think I got my wires crossed, I was following a gluten free diet at the same time as a low FODMAP diet, so I thought they were part of the same diet.


The foods avoided, such as wheat, rye etc... are the same, so it is very similar, so it is an easy mistake :yep:

Original post by myblueheaven339
From an Ibs sufferer, this is a great post.


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Thanks, although it was a bit of a rushed post :tongue: Fellow IBS sufferer myself here, so I know how confusing and frustrating it can all be.

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