Unknot Your Insides

Photography by: Hector Sanchez

1. Know the symptoms The signs of celiac and gluten intolerance are identical, and vary in severity by person. Watch for: frequent abdominal pain; bloating; bone pain; constipation; diarrhea; fatigue; low moods (even depression, say some naturopaths); muscle cramps; weight loss.

2. Get tested If you suffer from digestive conditions or have a family history of such complaints, consider taking a simple blood test to help determine whether you’re producing auto-antibodies— proteins generated by your immune system that attack normal cells—to gluten. To make sure you’re getting the right diagnosis, get tested before you start eliminating gluten from your diet.
CELIAC DISEASE. If the test turns up the relevant auto-antibodies, doctors will perform an endoscopy to determine whether your immune cells are attacking your villi— the tiny, fingerlike protrusions that line the small intestine and help digest food. When the villi are damaged, you lose the ability to absorb nutrients and open the door to other diseases. By eliminating gluten you allow the villi to repair themselves.
GLUTEN INTOLERANCE. If your autoantibodies are moderately elevated but tests determine you don’t have celiac, you may be gluten intolerant, which means your body can’t break down gluten. Unlike with celiac disease, you won’t experience malabsorption of nutrients or serious side effects like anemia and osteoporosis.

3. Change your diet If diagnosed with celiac disease, cut out all sources of gluten. For gluten intolerance, you might eat an 80 to 90 percent gluten-free diet, depending on your symptoms. Once you eliminate—or reduce—gluten, your digestive issues should clear up. “It may take weeks or up to a year, depending on age and overall health,” says Daniel Leffler, M.D., director of clinical research at the Celiac Center of Beth Israel Deaconess Medical Center in Boston.
AVOID: Any form of wheat (durum, graham, kamut, semolina, or spelt), rye, barley, or triticale (a cross between wheat and rye). Always check the label of any food product (including sauces), cosmetics, and supplements you purchase.
ENJOY: Rice, corn, soy, potato, tapioca, beans, quinoa, millet, buckwheat, arrowroot, amaranth, and nut flours.
RESOURCES: For additional help figuring out what you can and can’t eat, check out the Celiac Disease Foundation (celiac.org), Gluten Intolerance Group of North America (gluten.net), American Celiac Disease Alliance (americanceliac.org), or celiac.com.