Gluten sensitivity or FODMAP diet causing "Irritable Bowel Syndroms" ?

"Are you having wheat products or barley or Rye products ? Is it gluten free ? "

Wait, I am not going to talk about the products you eat but the protein it consist.  Because of the chewiness of this gluten, the Thai restaurants has started to serve so called "Wheat meat" . Yes, this surely has gluten in it.

Gluten sensitivity symptoms: Does it exist ?   (credit)

These all products of wheat, barley or rye has a protein called Gluten .This gluten generally helps in making a shape or acts as a glue that holds the food together. But, it can also be found in other types of food which you can't expect. These remain in hidden or found in unexpected ways.Now, this gluten is composed of compound glutelins and prolamins along with the starch. For the nourishment of the plant, it need this gluten. It is elastic so it make the final  food product chewiness. According to the type of product like wheat, barley or rye, it has definite names for prolamins and glutelins like secalins, gliadins, hordeins.  [1]

Celiac disease  (credit)

People suffering from the coeliac disease has some intense reaction with the gluten. The small intestinal cells are destroyed. Human Leucocyte Antigen- DQ ( HLA-DQ) complex has a leading role in autoimmune reactions in damaging this cells. This causes nutritional absorption problems.When these patient consume gluten, the intestinal walls are inflammed and sometimes rupture due to immune reactions. Better these patients are supposed to be away from gluten. [2]

I am not talking about the gluten that our ancestors used. I am talking about new breed of gluten that our body is highly sensitive to called as "Non- celiac gluten sensitivity "

Gluten has become a villain in the past several weeks. Has it become a scapegoat or villain  ? 

From the past years, people thought of having gluten intolerance had symptoms like bloating and flatulence, tiredness and irritability associated with join paint and some kind of inflammation.  Child born with ADHD or autism, cases of hypothyroidism were the clear sign of gluten sensitivity.Considering, the gluten puts a hole in you gut and starts going outside the gut producing inflammation. Not only this, acting on the thyroid tissue has cause Hashimotos' thyroidits, Alzheimer disease was formulated in the past years.

From this cases, around more than 40% of people in US has started consuming gluten free diet. It was all the placebo kind of diets 

Hey Wait ! I am on bread, pizza and burger diet . Do I develop this symptoms ?

Yes, if you happen to eat a lot .

 But not cause of gluten ! It is because of so called " FODMAP ! 

All gluten diets has FODMAP's composition(credit)

What on earth is FODMAP ? 

FODMAPs are the short chain of carbohydrates which are not absorbed through intestine. Acronym is: 

F- Fermentable which means broken down by bacterias 

O- Oligosaccharides ; Oligo means "few" and Saccharide means "sugar"

D- Disaccharides ; meaning two 

M- Monosaccharides ; meaning single or one. 

A- And

P-Polyols which are sugar alcohols.   [3]

Simple, FODMAP is group of certain carbohydrates like Fructose, lactose, sorbitol, fructans or things like that.  FODMAP are not absorbed through the small intestine as these are present in many food and human diets.  These gets fermented in the large intestine and bowel . Due to high osmotic nature , it absorbs water and produces gas. Intolerance to this FODMAP has symptoms so called "clinical diagnosis" like : Stomach ache, constipation, bloating and flatulence(fermentation by bacteria) ; "Irritable Bowel Syndrome". 

Pathology of FODMAPS in food causing symptoms   (credit)

So you if you are having with your problems regarding you gut and neither you have coeliac disease, then you have you answer. It's not about the action of gluten. It's all about the FODMAP's you intake along with the diet. 

Pretty nasty huh ? 

When there is certain sensitivity to gluten b the intestine, then the antibodies are produced. These antibodies come in the blood and hence produce some immune reactions. When the patients related with above symptoms  and think of gluten sensitivity, have you blood tested. 

If it is due to gluten intolerance, then antibodies are seen in the blood but if it is neither of the gluten sensitivity then no anti-bodies are found against gluten. 

Treatment : 

For the patients having the symptoms of FODMAP diet, start of low FODMAP diet is useful. Not only for the patients with Irritable Bowel Syndrome, but other conditions such as Functional Gastrointestinal Disorder, Rhumatoid arthritis, Fibromyalgia , low FODMAP diet are useful. FODMAPS are existed in dairy products, fruits and vegetable. When you go on a this diet plan, it corrects the imbalance of the bacteria in the gut thus giving some time in healing. 

In the Elimination phase carrying about 3-8 weeks,  there is pretty much all of the FODMAP diet cancelled. This phase can adjust the body and reset for the diet you consume. Problem arises when there is a hydrogen breath and difficult to identify which specific FODMAP has caused if it occurs in less than 3 weeks. 

In the Rechallenge phase, there is introduction of specific kind of each FODMAP food. doing this can give a certain result which has caused this symptoms. It starts from fructose introducing for 1 week and the other sugars at the interval of 1 week. 

Last is the Elimination or the exclusion phase, where the diet that has triggered and caused the symptoms is eliminated and the other FODMAP diet is introduced. If fructose has caused then fructose is eliminated and other diets rather than fructose is supplied. 

Conclusively, Gluten free foods are lower in FODMAP's and Low FODMAP's diet is for temporary use only for the treatment cases. It is highly restricted for several weeks but can improve symptoms about 50% within a week. 

Reference : 

(1) https://www.dietvsdisease.org/diy-low-fodmap-diet/

(2) https://theceliacscene.com/fodmap-malabsorption-gluten-free-diet/

(3)https://www.sciencealert.com/non-coeliac-gluten-sensitivity-caused-by-fodmap-carbohydrate-fructans

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