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Alyssa Simpson RD, CDE, CLT
Alyssa Simpson

RD, CDE, CLT​

My Gluten-Free Diet Isn’t Working. How Do I Get Rid of My Stomach Issues?

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Gluten Cross-Reactivity

Food issues can be frustrating. If you’ve been following along this month, we’ve been talking all about the gluten-free diet. We’ve covered…

Gluten-free basics

How to avoid cross-contamination and hidden gluten

Tips on combining the gluten-free diet with the low FODMAP diet for IBS patients

My best resources and tips to go gluten-free with as much ease as possible

But what if you’ve tried all of this, and you still don’t feel well?

Take a deep breath. I know it’s frustrating. Healing is hard. Sometimes it seems like it would be so much easier to just take a pill and mask your symptoms. But addressing the root cause of your issues and improving your health from the inside out has the long-term rewards you’re looking for.

But that doesn’t make it easy.

If the gluten-free diet hasn’t helped the way you thought it would, there are other possibilities. Let’s take a look at what might still be bothering you — and what you can do about it.

Gluten Cross-Reactivity

Gluten cross-reactivity isn’t as complicated as it sounds.

Let’s break it down a bit…

If you’ve got celiac disease, you have an autoimmune disease. Here’s how that happened:

You likely developed leaky gut. This is where the lining of your small intestines became permeable, allowing protein particles to leak out into your bloodstream before they were fully digested.

Because your immune system is good at its job, it detected these protein particles and created antibodies to get rid of them.

But these antibodies got confused. And instead of just attacking the unwanted protein molecules, they also started attacking the cells of your small intestine.

Well, the confusion doesn’t always stop there. Even though your body is reacting to gluten, there are other proteins that have similar structures. And if you eat these proteins, your antibodies may also confuse them with gluten. Then you can end up with symptoms like headaches, digestive issues, rashes, brain fog, joint pain and swelling, or fatigue — the same symptoms you get when you eat gluten.

So even if you are totally avoiding gluten, but you feel like you did when you weren’t, it’s not your imagination. You may be having a cross-reaction to some other protein.

The most common proteins for gluten cross-reactivity are dairy products, corn, oats, rice, millet, and yeast.

In my practice, I find that many of my patients who don’t tolerate gluten also react to casein, the protein found in dairy. This is different from lactose intolerance. Lactose is a carbohydrate (specifically a sugar), not a protein.

So if you are sensitive to gluten and think you might be experiencing a gluten-like reaction to another food, giving up dairy is a good place to start.

Non-Gluten Food Sensitivities

While gluten may be an issue for you, it may not be your only food issue. I know… that’s not what you want to hear. Giving up gluten is hard enough without having to worry about other foods along with it.

But if you’re ready to get rid of those troublesome symptoms and going gluten-free doesn’t do the trick, it might be time for some food sensitivity testing. Our bodies can react to just about any food. To learn more about food sensitivities, check out this article: Is Food Making You Sick? How to Tell the Difference Between a Food Intolerance, Allergy, and Sensitivity.

How do I figure out which foods I’m sensitive to?

There are a few different approaches to figuring out food sensitivities. A common method is to go on an elimination diet. But there are many types of elimination diets, some of which have a number of downsides.

In a typical elimination diet you give up the foods that might be problematic for you. But this approach is based on guesswork. Unless you already know which foods are safe to start with, you may still be eating foods that are actually bothering you.

So even with a strict elimination diet, food sensitivities can be missed. Maybe you’re sensitive to a food you didn’t eliminate. Or maybe your reaction took longer and you didn’t connect it to the actual culprit.

You’re never eating just one thing. So it’s hard to pinpoint which foods are causing you problems, even with an elimination diet.

In my practice I use the MRT food sensitivity test. You can learn more about that here: Will Food Sensitivity Testing Help You Feel Better? Let’s Cut Through The Confusion. This test is the most reliable on the market. And it will let you and your practitioner know EXACTLY which foods you have issues with. The MRT test is one that must be done through a practitioner. If you feel like you need food sensitivity testing, reach out and I can help you.

Once we know for sure which foods you react to, I can design a dietary protocol that will eliminate your symptoms.

Some of my patients are nervous about food sensitivity testing because they aren’t sure they really want to know. Giving up favorite foods is hard. But food sensitivities aren’t necessarily permanent. With a good protocol and gut healing, oftentimes you can bring these problematic foods back into your diet over time — without the nasty symptoms.

Maybe You’re Sensitive to FODMAPs

FODMAPs are specific, difficult-to-digest carbohydrates that are found in a variety of foods including some grains, dairy, certain fruits & veggies, and some legumes.

If you’re sensitive to FODMAPs, these foods can cause unpleasant digestive symptoms.

But be careful, going on a low FODMAP diet isn’t like giving up gluten. You don’t want to give up all FODMAP foods forever. Without these foods, you can end up with nutritional deficiencies. If you think FODMAPs are a problem for you, it’s important to work with an experienced practitioner who can guide you through the three-step process of this therapeutic diet.

To learn more about going low FODMAP while staying gluten-free, check out this article: Help! What to do if I Need to Eat Gluten Free and Low FODMAP?.

Microbiome Imbalance

We each have a whole world of organisms living inside our bodies. Don’t panic! They belong there. Your microbiome is an important part of your overall health. You can learn more microbiome specifics here: How Does Stress Cause Digestive Problems? Let’s Dig Deep into the Microbiome.

But sometimes things can get out of balance. And if your microbiome is out of balance, you can develop problems like SIBO.

SIBO stands for small intestine bacterial overgrowth.

Your microbiome exists primarily in your large intestine, or colon. You do have beneficial bacteria other places like your skin, but most of it lives in your gut.

Sometimes this bacteria can migrate up into the small intestine where it doesn’t belong. And while a little bit isn’t usually a big deal, it can get out of control. Learn more about what happens when you develop SIBO here: How do I Know if I have SIBO? Painful Signs to Watch Out For.

Lab testing is the only reliable way to figure out if you have an imbalance in your microbiome. You can try adding probiotics, but if you have an overgrowth, this isn’t always the right course of action. If you want to know what’s going on, it’s important to work with a practitioner who offers microbiome and SIBO testing.

Physiological GI Problems

I’m a big believer in diet and lifestyle changes, obv. As a dietitian nutritionist, I work with clients to change their diets and tweak their lifestyles. We start with lab testing, symptom analysis, food journaling, and more. My goal is always to get to the root cause and deal with your symptoms from the ground up — so to speak.

But sometimes there are issues going on that therapeutic diets and supplements just can’t fix. And if this is where you find yourself, it’s okay. That’s what doctors are for.

If your problems persist or your dietitian refers you to a GI doctor, it doesn’t mean you failed on your quest for natural health. It just means you need some extra care. And there’s nothing wrong with that.

A GI doctor can do a more in-depth evaluation to find out if there is a physiological problem that is causing your symptoms. And when you get to the bottom of what’s really going on, you can deal with it directly.

And I will still be here to support you. Even if you discover you have a condition that requires a medical intervention, diet and lifestyle will still make a huge difference in your outcomes.

If you’ve tried going gluten-free and you’re not seeing the relief you need, let me know. I offer a consultation where we can talk through your concerns and discuss a plan to find your root cause and help you make the dietary changes that will get you feeling better!

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