How Long Should I Give Up Gluten For?
When you don't feel well, you generally want to do whatever it takes to get better in a hurry. Sometimes, that general "not well" feeling drags on for days, weeks, even years. In fact, it can take up to 7 years to be properly diagnosed with Celiac Disease.
So why wait? Some people are anxious to get going and feel better. They've heard of gluten intolerance, and they know that there's a huge health movement that involves abandoning gluten in their diet altogether. So, frustrated with their symptoms, they dive in head first. They go gluten free and wonder how quickly they will (or won't) see the effect.
This seems like a great idea. What you eat is your choice, it isn't mandated by a doctor. By simply going gluten free, you can skip that pesky trip to the doctor's office. You can save two or three copayments worth of visits, avoid expensive testing and skip right to the diagnosis, right?
Celiac Disease can only be properly diagnosed while an individual is still consuming gluten. What's more, getting an accurate diagnosis is important. Gluten isn't just found in bread and pasta. People with Celiac Disease can't simply control their diet by following their symptomatic response. To put it simply, a person with a mild gluten intolerance can eat the sliced cheese off of crackers on an hors d'oevre tray. A person with Celiac Disease can't, even if they don't seem to have any negative response.
What is Gluten, Anyway?
Gluten is a protein found in all varieties of wheat, rye and barley. Some people believe it is an unhealthy addition to any diet. Whether or not that is true, people with a medical condition called Celiac Disease need to avoid all traces of gluten.
Gluten can be found in pastries, pastas, soy sauce and even tea bags! A person with Celiac Disease or gluten intolerance needs to read all labels and carefully avoid cross contamination of their food with gluten containing crumbs.
Whoa, Slow Down. Why Can't I Eat Gluten if it Doesn't Hurt?
Celiac Disease is an autoimmune condition that causes actual, physical damage to your digestive tract. Inside your digestive tract are teensy tiny little finger-like tentacles called 'villi'. These villi are an important part of the digestive process. They contain some enzymes that help with digestion, and they help to move food waste along smoothly and appropriately, while absorbing nutrients.
When a person has Celiac Disease, the body's immune system mounts an attack against these little villi. The result is that the tips of the villi are damaged and blunted. The digestive tract smooths out. This causes malnutrition, and can lead to more serious disorders such as osteoporosis and even cancer. Some people with Celiac Disease even suffer from neurological problems such as peripheral neuropathy.
When we think of food intolerances, we tend to think of immediate results. But with Celiac Disease, the damage can come quietly. You don't know it's there until the symptoms start occurring, and by the time you get a diagnosis it's too late. The damage is done.
What Do You Mean, 'The Damage Is Done?' Why Bother Giving Up Gluten, Then?
Don't give up hope. The body is a miraculous entity. As soon as you stop eating gluten, the body begins to repair itself. It stops making antibodies, because it stops perceiving an attack by gluten molecules. (You aren't ingesting them, it stops fighting them)
This creates a few problems, though. The biggest problem is that it makes diagnosis tricky. With any other food intolerance, a doctor will tell you try an elimination diet. But with Celiac Disease, an elimination diet makes diagnosis tricky if not impossible.
The other problem is that even minute amounts of gluten can cause symptoms. A single bread crumb that falls into an entire pot of soup can contaminate it enough for the single serving of Celiac's soup to trigger the immune process, with or without symptoms. A person with Celiac Disease might think that they're doing a great job avoiding gluten and take a few risks, like picking the croutons off of their salad. As long as they don't have symptoms, they think they're fine. But tests can later show that the damage was building up.
If you have been diagnosed with full fledged Celiac Disease, you know not to take any risks. And you know to get tested periodically to see if there is any hidden gluten in your diet that's triggering an autoimmune response. You know to ask more questions at parties and restaurants. And the best part? Your doctor will be able and willing to write a letter of explanation for any event that you might be required to attend that involves food. (Things like jury duty or work retreats or amusement parks that don't like you to bring your own food in)
What Does Testing Involve?
Testing for Celiac Disease begins with a simple blood test. It's not very invasive. Just a few vials. You'll have the results in about a week, sometimes two.
Some doctors feel this is enough of a diagnostic tool. Others will insist on a biopsy. The biopsy is much less scary than it sounds. It simply involves going to sleep, and receiving an endoscopy (a tube down your throat) The doctor will take several biopsies of your intestine, and examine the lining for flattened villi.
Retests generally just include blood tests.
If medical doctors and biopsies are not in your budget right now, there is also a lab called 'Enterolab' that does stool testing. The stool testing is believed to be highly accurate, but the doctor who runs the lab hasn't finished all the long term double blind studies needed to be accepted by the general medical community. However, the stool test may be all you need to know the difference between giving up gluten and giving up gluten completely.
My Tests Were Negative, Now What?
Sometimes, despite all the testing you undergo, the tests are still negative or inconclusive. Once you've given it your best shot, there's no reason not to go gluten free just to see what happens. Keep a careful food diary, logging what you eat and when as well as the symptoms you hope to treat. This diary is indispensable, since your memory can be faulty.
If your problem is run of the mill food intolerances, you should see an improvement within just a week or two of giving up gluten. Many people with Celiac Disease see improvement in the same time frame. Others feel worse before they feel better, but start feeling better within a month.
If for some reason you decide to go gluten free without a test, remember that you might have Celiac Disease, and that once your body has healed it can take a long time for the damage to work up to the point that a test will be accurate again. And there does come a time when some damage can be irreversible. It saves a lot of time and energy to just get tested, even if it might seem like it costs more up front.
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