Why are many doctors (and nurses) unaware of this association? The answer is a sad reality, many doctors are unaware of the wide variety of symptoms associated with gluten intolerance and food allergies. In fact, many people with a gluten intolerance, including celiac disease (CD), dermatitis herpetiformis (DH) and non-celiac gluten intolerance remain undiagnosed. For example, with CD, over 90% of individuals remain undiagnosed. Likely, it is even higher in non-celiac gluten intolerance since it is more under-recognized by doctors than celiac disease. Unfortunately, many doctors are not very aware of the many elusive symptoms associated with gluten intolerance and as a result, only the symptoms (ie. possibly GERD, heartburn, indigestion) are diagnosed, not the underlying problem. Typically, it isn’t on the doctor’s radar so it often isn’t investigated as a cause.
Within the medical profession, gastric reflux is generally called gastroesophageal reflux disease (GERD), but many people just call it heartburn or indigestion. Gastric reflux (reflux of stomach contents) usually presents with burning pain that can radiate from the upper abdomen to the neck (sometimes it can be sharp and feel like pressure), nausea can be a problem and sometimes regurgitation of foods and vomiting can occur. If a gluten intolerance and allergies are the underlying cause and left undiagnosed, many complications can occur, such as inflammation in the esophagus (esophagitis), ulceration of the esophagus, blood loss, adenoiditis, build up of fluid in the sinus and middle ears of children (from irritated adenoids), aspiration pneumonia and pulmonary fibrosis (from aspiration of gastric contents). As well, sore throat, hoarseness, coughing, asthma like symptoms (irritated esophageal nerves can affect lung nerves), scarring and strictures of the esophagus, and cancer in the inflamed areas can occur (ie. Barrett’s esophagus). As you can see, for some, chronic heartburn can lead to many problems, some of which can be life threatening.
I had indigestion and heartburn for many years prior to my diagnosis. For me, the symptoms would flare up for a month or two and then disappear for a few months or more. During the flare ups, I would live fully stocked with an antacid. Once I was diagnosed with celiac disease and eating gluten-free, the gastric reflux went away and has never returned. I experienced permanent relief with a natural treatment which was wonderful since gastric reflux is usually treated with medication. A medication-free approach was very appealing!
I have met many patients who had heartburn while they were undiagnosed with a gluten intolerance and/or food allergies. Studies have also identified an association as well. Others had the same symptoms that were due to a food allergy (IgA, IgG, or IgE mediated) and experienced symptom relief once the offending foods were removed from their diet. Some patients may also have an infection (ie. H. Pylori) that requires treatment as well. With this in mind, I believe it is worthwhile to rule out a gluten intolerance by testing for celiac disease, dermatitis herpetiformis and non-celiac gluten intolerance. Other types of tests can investigate possible infections. Further testing for food allergies (IgE, IgA, and IgG mediated) can help to identify other food reactions. An allergist often only tests for IgE mediated allergies and offers an elimination diet. Naturopathic doctors will generally do blood tests for the other types of allergic reactions. Your physician, allergist or naturopathic doctor may recommend a food log along with an elimination diet if needed.
Some people on a paleolithic diet also experience relief from gastric reflux once they are eating a lectin-free. These people may have an underlying lectin intolerance, gluten intolerance or be allergic to a food that is naturally removed from the diet with eating paleolithic. Others, like myself, eat a paleolithic diet, but have additional allergies as well. My entire story with gluten-free and paleolithic living can be found in my book, “Gluten Toxicity”.
For a future study, I would like to see a large group of patients with gastric reflux, heartburn and indigestion tested for infections, gluten intolerance (celiac disease, dermatitis herpetiformis, and non-celiac gluten intolerance), a lectin intolerance, food allergies (IgA, IgG, and IgE antibody mediated) and investigated for other diseases. The results may help to shed some light onto the true underlying cause of gastric reflux.
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