Gluten Sensitivity: Are You Sensitive to Gluten or FODMAPs?

There’s a growing recognition that people who don’t have celiac disease can still be sensitive to gluten. People who are gluten sensitive may find they have more energy and experience fewer digestive issues when they eliminate gluten from their diet even if they don’t have celiac disease. But what if you purge gluten from your diet and STILL have symptoms? Some experts now believe some people who think they’re gluten sensitive actually have problems digesting foods that contain FODMAPS.

FODMAPs and How They Differ from Gluten

What the heck are FODMAPs anyway? FODMAP is an acronym for fermentable oligo-, di- and mono-saccharides and polyols. These are compounds also found in wheat and other gluten-containing grains. Let’s break it down a little further. FODMAPS include oligosaccharides like fructans found in wheat, onions, artichokes, and garlic and galactans abundant in beans, lentils and Brussels sprouts, to name a few. It also includes the disaccharide lactose in dairy products. Fructose falls under the monosaccharide category and is found in a wide variety of fruits and products that contain high fructose corn syrup. Polyols include sugar alcohol like sorbitol, maltitol, mannitol and xylitol that are added to some sugar-free foods as sweeteners.

In some cases, FODMAPS coexist with gluten. But FODMAPS are also found in foods that don’t contain gluten, as you can see from the list above. This list isn’t exhaustive. FODMAPS are found in other foods as well. There are lists available online. Unfortunately, they’re in a lot of foods, even healthy ones.

Why might FODMAPS be a problem? While most of us can tolerate some foods high in FODMAPs, a portion of the population has a very low tolerance for them and can’t absorb them. If they aren’t absorbed, they hang around in your intestinal tract where bacteria break them down and form gases. In addition, they draw water into your intestinal tract. This can lead to loose stools. People who have irritable bowel syndrome often improve when they remove foods high in FODMAP from their diet.

With FODMAPS being in many foods that contain gluten, some people may mistakenly believe they’re gluten sensitive because they have intestinal symptoms may actually be reacting to FODMAPS. So getting rid of gluten may not solve the problem.

In one study, researchers gave participants who believed they were sensitive to gluten a diet low in FODMAP’s for 14 days and their symptoms improved significantly. Then they re-challenged some of the participants a diet high in gluten, low in gluten or gluten-free without awareness of who was getting the diets containing gluten. Only 8% of the participants experienced a recurrence of their symptoms. More research is needed but this suggests that some people who think their gluten sensitive may be reacting to FODMAPs in foods that contain gluten – not the gluten itself.

What Should You Do if You Think You Could Be Sensitive to FODMAPs?

The best way to find out if you’re FODMAP sensitive is to eliminate all foods with FODMAPs from your diet for four to six weeks and see if your symptoms get better. You may discover you’re not gluten sensitive after all and FODMAPs are the problem. Plus, you may find that only certain FODMAP foods are a problem for you. If your symptoms improve after four to six weeks, gradually add a limited number of FODMAP foods back into your diet and monitor your symptoms. As long as you’re symptom-free, keep slowly adding healthy FODMAP foods back in your diet. Once you add something that causes digestive issues, you know to avoid that food.

The worst culprits are likely to be polyol sweeteners like xylitol, sorbitol and maltitol, wheat and high-fructose corn syrup in processed foods. High fructose corn syrup is a concentrated source of fructose. You may be able to tolerate small amounts of fruit with natural fructose without symptoms. Keep as many healthy, whole foods like Brussels sprouts and broccoli that contain FODMAPS in your diet as long as you’re able to tolerate them without symptoms. Many FODMAP foods are high in fiber and some, like broccoli and Brussels sprouts, are rich in anti-cancer chemicals. They’re ones you want to hang on to if at all possible.

The Bottom Line?

If you think you’re sensitive to gluten, you might be. But make sure you’re not actually reacting to the FODMAPs in grains and other gluten-containing foods instead. The best way to find out is to eliminate FODMAP foods from your diet and see if your symptoms improve.

References:

Holistic Primary Care. Winter 2013. Vol. 14. No. 4.

Medscape Family Medicine. “Evidence-based Dietary Management of Functional Gastrointestinal Symptoms: The FODMAP Approach”

Today’s Dietitian. Vol. 14 No. 3 P. 36

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