5 reasons why you still feel bloated after going gluten-free

Gluten is a protein found in wheat, rye, barley associated with bloating for people with celiac disease, non-celiac gluten sensitivity (NCGS)/gluten intolerance, or other gluten-related disorder.

Bloating, gas cramps, constipation, or pain persist for some people after going gluten-free. I can testify to that. Almost five years after being diagnosed with celiac disease, I went back to the doctor’s office to investigate the reasons behind feeling bloated and having frequent episodes of migraines. Why does that happen? * There are no simple explanations, and perhaps more than one may apply to each case. I strongly recommend you pay attention to some of the following possibilities and discuss them with your doctor.

1. You are eating too many processed gluten-free food

Processed gluten-free food can be higher in sugar, saturated fat, additives, and preservatives to mimic wheat protein functionality. The food industry wants to offer something similar in texture and taste to the conventional product. Those ingredients can make the food quite unhealthy for someone with poor digestive health.

Newly diagnosed people with a gluten-related disorder frequently feel lost and replace their regular food with gluten-free versions. Under inflammation, their bodies need real food to heal - nutrients such as specific vitamins and minerals that are often deficient. Their gut needs fiber, prebiotic and probiotic foods to ensure the balance in the microbiota. Adjusting diet and lifestyle changes is not an easy task and should be made with professional help. Ideally, you want to discuss your healing approach with a dietitian specialized in digestive wellness and with a deep understanding of your diagnosis.

2. You are exposed to gluten cross-contamination

Gluten-free for people with celiac disease or gluten sensitivity means more than having food made with ingredients free from gluten. The food must be free from cross-contamination or any minor contact with food containing gluten. Every country has its regulations for foods that carry the label “gluten-free,” “no gluten,” “free of gluten,” or “without gluten”. I know it can be quite confusing sometimes. In Europe and the United States, gluten-free food may contain a maximum of 20 parts per million (p.p.m.) of gluten. Considering one kilo of gluten-free flour, meaning 1.000.000 (1 million) milligrams (mg), it may contain less than 20 milligrams of gluten. That is more or less what the legislation stands for in terms of gluten in certified gluten-free products.

For most people, 20 p.p.m is considered safe, meaning that their immune system won’t react to such a small amount of gluten. Also, according to the FDA, it's the lowest that can be reliably detected in foods using scientifically validated analytical methods. However, it might be enough to trigger reactions to some. And if a diet is full of food with a bit of gluten, well, I don’t have to say that it accumulates and might be too much.

Frequent exposure to gluten can impede the healing process. Dr. Tom O’Bryan, who specialized in celiac disease and NCGS, preaches that each exposure to gluten maintains the antibodies activated for about three months. If it happens four times a year, it means that the body never gets a break.

In addition to the contamination coming from gluten-free products, there's restaurant food with probable gluten cross-contamination, plus any contamination at home, where other family members in a household might not follow a gluten-free diet and end up spreading gluten around the house.

3. Your gut might be leaky

Leaky gut is a condition in which the lining of the intestine becomes damaged. Food particles can cross the gut wall and flood the bloodstream.

Have you ever heard of leaky gut or gut permeability? I learned about the term almost five years after being diagnosed with celiac disease. As I said above, I was bloated and suffering from migraines after having cut gluten from my diet for years. The reason was a leaky gut. I was reacting to too many foods. That was the reason I went back to school to study Nutrition Coaching. Dealing with such a restrictive diet was making me sick. I needed reliable and constant support to change my eating habits and make my meals balanced and nutritious.

Gluten plays a role in the leaky gut because of the gliadin (part of the gluten protein). Gliadin triggers the release of zonulin, another protein. Zonulin then signals the tight junctions of our intestinal wall to open up, creating intestinal permeability. These were the findings of Dr. Alessio Fasano’s studies. He is a world-renowned celiac expert. As a result of a leaky gut, you have digestive symptoms because some pieces of food not recognized by your body crossed the gut barrier and activated the immune response. A gastroenterologist and a dietitian specialized in gluten-related disorders can help you heal your gut and improve health. A proper diet is helpful, but lifestyle also needs adjustments.

4. Food intolerance or allergy might be to blame

Intestinal villi damaged because of years of non-treatment can lead to another condition such as irritable bowel syndrome (IBS) or lactose intolerance due to lack of the enzyme lactase. Sometimes, going gluten-free is not enough. A proper diagnosis to eliminate other food allergies or intolerance are necessary to improve digestive wellness.

A gastroenterologist and a dietitian can help you identify which food makes you sick. Try to keep a food journal with notes of your symptoms and share it with your doctor or dietitian. It can guide them, help them consider necessary tests you need to go through. Changing eating habits and lifestyle sometimes is the only way to succeed.

5. Your body is dealing with molecular mimicry

Your body could be detecting other food as gluten. Proteins such as casein in milk have a similar molecular structure to gliadin (the wheat protein). They show certain amino acid sequence similarities, a process that is called molecular mimicry. Especially if you have an autoimmune disease, it could be triggering immune responses. In this case, your immune system may attack the protein in milk as it was gluten. By mistaking the food molecule with other invaders, it could be attacking your own body’s tissues, furthering the damage in your gut.

Knowing which food is causing the symptoms can be overwhelming. The good news is that there are lab tests that can help your doctor and dietitian identifying them.

*This article does not intend and should not be considered as medical advice. However, I recommend you discuss any symptoms with your doctor or any topic above if they make sense to you.