Gluten is derived from the Latin word gluten which means glue. Gluten is a protein composite in wheat and other similar grains such as barley and rye. (1) It is also contained in food products as modified food starch, preservatives, and stabilizers made with wheat and as a protein filler. It can also be found in medicines, vitamins, and lip balms.
Gluten can cause constipation. Cessation or avoiding taking foods with gluten helps constipated patients caused by gluten to improve their condition. The effect of a gluten-free diet however seemed to be seen more immediately to those who are healthy individuals than those who have a particular disease.
Constipated patients with no diseases
a. Early gluten introduction caused functional constipation among infants
The connection between the timing of gluten introduction and food allergens early in life and functional constipation in childhood was published in a 2010 paper. Results of the study showed that early gluten introduction in the first year of life could cause functional constipation. Infants who were introduced to gluten more often before or at the age of six months had functional constipation. (2)
b. Healthy patient’s bowel habits had normalized after two to four months
An Iranian paper published in 2015 explored the effect of a gluten-free diet on a patient who had been suffering from constipation without any underlying cause. The male patient who was in his sixties visited an outpatient clinic because he was experiencing chronic constipation for too long. The patient would defecate less than three times a week, and his fecal texture would be typically lumpy and hard. When he’s not using laxatives, he would rarely defecate loose stools. His physical examination and diagnostic laboratory test results were all normal. His past medical history nor his family’s did not have any health problems. He also did not suffer from fatigue, malaise, loss of appetite, dyspepsia, abdominal pain, bloating, gastrointestinal bleeding, and GERD symptoms. To aid his constipation problems he had a dietary change and tried adopting a diet with high fiber and, a high amount of fruit. He consumed vegetables with olive oil and increased his daily water consumption. He also used osmotic agents and stimulant laxatives to find relief for his constipation, but his attempts were unsuccessful. He was not diagnosed to have gluten-related disorders which are celiac disease and wheat allergy, and since had no other abnormalities nor disorders, but only the long-standing constipation, a gluten-free diet was advised to him. He followed the instructions and adopted the diet. He had a positive response to a gluten-free diet. After two months he would defecate four times a week, and his stool texture had normal consistency. However, when he restarted a normal diet with gluten, he had constipation again. When his gluten-free diet was initiated again, his bowel habits had normalized after four months. (1)
Constipated patients with diseases
a. American patients with celiac disease resolve constipation problems after one to six months
215 celiac disease patients that were diagnosed between 1984 and 1998 and evaluated at the University of Iowa in the USA from 1990 through 1997 were followed up through telephone interview survey. Patients age were from 1 to 90 years old. They were provided with gluten-free dietary instructions, and efforts were made to ensure that they followed a strict gluten-free diet. The patients were seen routinely by a dietitian for at least one follow-up visit and were encouraged to join local or national support groups for celiac disease. Most of the patients denied consuming gluten more than once a month. Follow-up biopsy showed that all patients had substantial improvement except for one noncompliant patient, who had positive endomysial antibodies and villous atrophy and reported taking gluten-containing foods regularly. (3) A follow-up survey through telephone interviews was conducted with 215 patients by gastrointestinal nurses between 1997 and 1998. It was scheduled six months after their celiac disease diagnosis and the start of a gluten-free diet. Patients were asked about gastrointestinal symptoms, their perspective on how the gluten-free diet had affected their condition, and the status of the patient’s bowel movements regarding duration, frequency, severity, and features at diagnosis and six months after starting the gluten-free diet. Findings of the survey showed that though a gluten-free diet was not able to provide complete symptom resolution to all the patients, it demonstrated its efficacy in a large cohort of patients and yielded dramatic improvement. Most of the patients who had constipation symptoms had a resolution within six months of having a gluten-free diet. There was a notable decrease in their need for straining and laxatives, and their hemorrhoid problems were also reduced. Celiac patients who had diarrhea also had remarkable changes and improvement after a gluten-free diet. The prevalence and frequency of their diarrhea were reduced. Sixty-six percent of the patients who had diarrhea symptoms had complete resolution by six months. Most of the patients reported they had improvement within 31 days of following a gluten-free diet. (3)
Other discomforts
Moreover, after six months of consuming a gluten-free diet, 95% of the patients had substantial relief or complete resolution of abdominal pain. The improvement begins to usually show within days of the gluten-free diet introduction. Other documented effects of the diet were the reduction of postprandial pain, resolving nausea, and complete abdominal bloating relief. Moreover, those who have lactose intolerance were able to add lactose to their diet after starting a gluten-free diet. (3)
b. Ménière disease patient had her constipation, abdominal pain, and hemorrhoids remission after six months and maintained it for almost five years
A constipated 63-year-old female patient with right ear Ménière disease, osteoarthritis with mucous cysts, and Heberden’s nodes was the subject of a 2013 paper that presented the effect of gluten on Ménière disease symptoms. To treat her constipation, recurrent abdominal pain, and hemorrhoids, she underwent a total colonoscopy in 2006. However, the medical procedure did not yield positive results. Her healthcare providers thought that hypersensitivity had a possible role in gliadin which is a wheat grain protein. Hence she was instructed to follow a restrictive gluten-free diet and had to eliminate foods that contain wheat, rye, barley, oats, farro, kamut, and their derivatives. After six months of avoiding foods with gluten, her constipation has been resolved. (4)
Other discomforts
Moreover, her other disease’ symptoms were also reduced. Her arthritis progression and formation of mucous cysts and Heberden’s nodules stopped, she no longer had vertigo attacks, and her aural symptoms had remission. For almost five years the patient had good condition. However, her symptoms appeared again, one week after reintroducing gluten into her diet. (4)
Removing gluten from our diet without proper substitutions could result in nutritional deficiencies. To avoid gluten and wheat, we might resort to having low-fiber, high-fat types, which could also be harmful. (1) Hence, if fibrous foods such as wheats will be omitted from our diet, fibrous food such as vegetables and fruits should be taken to maintain the necessary nutrition. (1)Thus, a proper diet program must be developed to ensure that we can sustain the necessary nutrients in our bodies.
References:
- (1) Sadeghi A, Shahrokh Sh, Zali MR. An unusual cause of constipation in a patient without any underlying disorders. Gastroenterol Hepatol Bed Bench 2015;8(2):167-170).
- (2) Kiefte-de Jong, J. C., Escher, J. C., Arends, L. R., Jaddoe, V. W., Hofman, A., Raat, H., & Moll, H. A. (2010). Infant nutritional factors and functional constipation in childhood: the Generation R study. The American journal of gastroenterology, 105(4), 940–945. https://doi.org/10.1038/ajg.2010.96
- (3) Murray, J. A., Watson, T., Clearman, B., & Mitros, F. (2004). Effect of a gluten-free diet on gastrointestinal symptoms in celiac disease. The American journal of clinical nutrition, 79(4), 669–673. https://doi.org/10.1093/ajcn/79.4.669
- (4) Di Berardino, F., Filipponi, E., Alpini, D., O’Bryan, T., Soi, D., & Cesarani, A. (2013). Ménière disease and gluten sensitivity: recovery after a gluten-free diet. American journal of otolaryngology, 34(4), 355–356. https://doi.org/10.1016/j.amjoto.2012.12.019
📝 January 17, 2024
Oil Therapy 