Day 18 - Trouble Shooting

Welcome to Day 18! Today we are going to talk about what to do when you aren't feeling better on a gluten free diet. It common when you're diagnosed as an adult to have a more difficult road to recovery then if you're a child. Around 20% of people continue to get symptoms on a gluten free diet. Why? there are a few reasons and i'll talk about them today.

Today we'll talk about:
1. What's normal and what's not when it comes to celiac disease healing
2. When should you start feeling better
3. What to do when you aren't making a full recovery
4. Conditions associated with celiac disease
5. How to know whether or not your gluten free diet is working

If you're just starting a gluten free diet or have been on it for a short time you're probably wondering how long it will take to feel better, when you should feel better and what symptoms take the longest to go away.

What's to be expected after my celiac disease diagnosis?
If you have had celiac disease for a long time before it was discovered and you've been very ill it will take you longer to recover then someone who has only had the condition for a short time with minimal symptoms. Some symptoms you have should start to improve like your energy levels, your general sense of feeling well and some gastrointestinal symptoms. Some people see results in days others months. It is important to be noticing improvement even if it is gradual.

Is there any way I can monitor my condition?
There are no rules regarding tests when it comes to monitoring celiac disease. You doctor may run repeat blood tests testing your (TTG) IgA antibodies. This can be used to monitor if your gut is healing and these levels should start falling after you implement a gluten free diet. Your doctor also may run a repeat small intestinal biopsy to monitor your condition. This usually only happens if you have continual symptoms or new or unexplained symptoms.

How do you know whether or not the gluten free diet is working?
You may be worried that the gluten free diet you're on isn't working. This is a common concern as many on a gluten free diet have continual symptoms. You'll know if the gluten free diet is working if your blood test numbers are going down, your symptoms are disappearing and you're

I’ve been on a gluten-free diet for a while and I don’t feel better. Why?
Most often the reason patients don’t feel better is because they have not completely removed gluten from their diet. Once hidden sources of gluten are removed from the diet, you will often start to feel better. Other reasons for experiencing symptoms while on a GFD include: having a separate condition, such as irritable bowel syndrome (IBS), refractory celiac disease, lactose intolerance, fructose malabsorption, small intestine bacterial overgrowth, or microscopic colitis.

Why is fructose sometimes a problem for people with celiac disease? What does the low fructose diet involve? What are FODMAPs?
Some people with celiac disease discover that although they are following the gluten-free diet carefully, they have symptoms of burping, bloating, gas, cramping and loose stools and/or constipation. If gluten exposure is not the concern, you may consider lactose intolerance or other poorly digested carbohydrates, such as fructose. Fructose is found naturally in some fruits and vegetables (pears, apples, asparagus, watermelon, mango, and sugar snap peas), honey, high fructose corn syrup, sweetened drinks, sweets and candy. Other examples of poorly absorbed carbohydrates are fructans (wheat, rye, garlic, onions), galactans (cabbage, legumes such as lentils and soybeans), lactose (milk, milk products) and polyol sweeteners that include naturally occurring sorbitol (peaches, plums, nectarines, cherries, apricots), xylitol, mannitol (cauliflower, mushrooms) and isomalt (an ingredient in sugar-free products). These polyol sweeteners are also commonly found in sugar-free products. Together, all of these poorly absorbed carbohydrates are called FODMAPs (fermentable oligo/di/polysaccharides and polyols).