The happy wheat-free intestine

Happy bowels are central to overall health, aren’t they?

Eliminate the gliadin protein of wheat and it can no longer trigger activation of inflammatory T-lymphocytes in the intestinal lining. Eliminate the lectin of wheat, wheat germ agglutinin, and this direct intestinal toxin can no longer destroy intestinal villi, increase intestinal permeability to foreign substances, and enter the bloodstream itself (and generate wheat germ agglutinin antibodies). (Interestingly, in experimental models, administration of wheat lectin alone is sufficient to generate celiac disease-like destructive changes.)

The majority of people who eliminate wheat therefore experience relief from symptoms of acid reflux and heartburn, relief from the gas, cramps, and diarrhea of irritable bowel syndrome, and marked reduction–occasionally cure–of ulcerative colitis and Crohn’s disease.

But not everybody.

What about the relatively smaller number of people who eliminate wheat and feel a bit better . . . but don’t return to normal, happy intestinal health? Putting aside the odd possibility that an entirely separate condition is simultaneously present, such as gallstones or duodenal ulcer, why would someone experience, say, 70% relief from acid reflux or irritable bowel symptoms, but not 100%?

Here are some possibilities:

–Wheat-eaters have different bowel flora (bacteria) compared to non-wheat consumers. When a wheat-consuming individual does away with all wheat, there is a necessary shift in the numbers and species of bowel bacteria. (Dysbiosis, or bacterial overgrowth, i.e., marked increases in the numbers of bacteria, a shift in composition away from normal and favoring some uncommon species, and greater numbers ascending higher in the intestinal tract into the ileum, jejunum, and duodenum, is common in wheat-eating individuals.) But, for unclear reasons, some people struggle with the shift back to a more normal bacterial profile. After eliminating wheat, they may be left (most typically) with constipation or excessive gas.

Some people therefore experience a smoother transition in bowel habits by supplementing with a probiotic preparation, e.g., 50 billion CFUs, preferably containing species of Bifidobacteria and Lactobacillus. Most people experience relief within days to weeks to initiating a probiotic regimen. (Incidentally, yogurt preparations do not work for this purpose, no matter how long you consume them.)

–Impaired pancreatic enzyme release–The pancreas produces enzymes required for digestion. Also for unclear reasons, some people develop less than optimal release of pancreatic enzymes and, while enjoying partial relief with wheat elimination, are left with some residual cramping, gas, and diarrhea. Some people describe (and this can be assessed formally) remnants of partially-digested food in their bowel movements (e.g., meat fragments, oil droplets). Perhaps it’s from low-grade repetitive pancreatic injury/inflammation from gliadin/lectin. Or maybe it’s from glucotoxicity and lipotoxicity from the metabolic derangements so common in the wheat-eating individual (e.g., high blood sugar, high triglycerides, postprandial lipoproteins). Or maybe it’s from the small intestinal lymphocytic infiltration or villous atrophy (destruction of the intestinal lining) of the wheat-eater.

While this is an undoubted oversimplification, some of these people simply respond to a several month course of pancreatic enzymes, especially one that contains the fat-digesting enzyme, lipase.

The wheat eliminating experience for us non-celiac people is growing rapidly and widely. Should you be among those who struggle with full recovery of bowel health after elimination of all things wheat, please speak up and report your experience!

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Comments & Feedback...

  1. LauraAnn

    Dr. Davis –
    Perhaps you can offer me an answer that my doctor is currently unable to explain. I had my gallbladder removed six months ago, and felt so much better. Then, about one month ago I began experiencing such intense abdominal pain that my doctor thought I might have appendicitis. She prescribed a CT Scan which showed that I had very swollen GI tract and attributed my gastroenteritis to a virus – the catch all. I never really recovered from the pain I was experiencing in my abdomen – I felt bloated, swollen, achy, and tired. I thought maybe this could be that the “virus” hadn’t gone away… or perhaps it was something else perhaps a gluten intolerance or food allergy. However, I continued eating gluten so that my doctor could run a celiac panel on my blood work for my annual physical. Once I gave my blood I immediate quit eating wheat. I have felt much better ever since, but still have some cramping and pain occasionally. I have only been entirely off wheat/gluten for 10 days now.

    The blood work from my physical showed that #1 I am negative for celiac, #2 – my triglycerides are off the chart high – 270 (my doc said this was a lab error), and #3 – my amylase is elevated, but not my lipase (doc said this was possibly due to my birth control). I am concerned that the combination of such elevated triglycerides and high amylase is a very bad sign pointing right to my pancreas. Can you offer any insight? Do you think that with more time on my GF diet the levels will fall? My doctor only advice to me was it was a lab error and birth control… I take my health seriously and don’t want to dismiss potentially serious warning signs.

    I am two chapters into Wheat Belly and am enjoying the articles on your blog and comments by your readers so much! I can’t wait to fully embrace all that the Wheat-free lifestyle has to offer.

    Thank you for your time, Dr. Davis!

    Love,
    Laura

    • Dr. Davis

      Oh, boy, Laura. I don’t think you need advice . . . you need a new doctor!

      First of all, to subject you to consuming wheat and gluten to prove or disprove celiac disease is nonsense.

      Second, the vast majority of people who have adverse reactions to modern wheat have negative blood tests to gluten.

      Third, the high triglycerides are a result of the poisoning to your liver from wheat. (Tell your doctor that it is due to the de novo lipogenesis from the conversion of amylopectin A branching glucose polymer to triglyceride-containing lipoproteins.)

      I think you have to recover from the intestinal poisoning you’ve suffered at the advice of your doctor.

  2. Melissa

    It has been about a week since I started read Wheat Belly. I picked up the book because I have a stubborn condition in which there is fluid stuck in my inner ear. After taking 2 courses of antibiotics I gave up on doctors advice and began researching myself. I read that it could be a food allergy and decided to start by eliminating wheat. While I’m still struggling with my ear, I am quite pleased with the results of avoiding wheat. I feel my belly has deflated and I’m sleeping very well.

    I am commenting on this post because I do have loose bowels and I have to go multiple times in the morning. It could be due to the antibiotics I was taking. I have been eating a good bit of yogurt but it doesn’t seem to help. I suppose I might should simply allow time for my body to come to a balance of flora again. But I wonder if the pancreatic enzymes or the probiotic will help. …Probably want to choose one or the other.

    • Dr. Davis

      I’d bet on the probiotics, Melissa.

      Yogurt is far too weak. I use a 50 billion CFU preparation, e.g., Renew Life, that works quite well, with many, many times more beneficial bacteria.

      • Melissa

        Thank you.

        You know you are giving out free medical advice here…. But more than that, I think you are a true ‘healer’ and those are few and far between. I’m so glad you are sharing your gift.

  3. Brenda

    I read your book Wheat Belly and have been gluten free since January. I was diagnosed with IBS a year ago after having symptoms following my bowel and bladder mesh surgery. Prior to that I never had digestive problems. This week I was tested for Celiac and gluten sensitivity and all tests were negative. I also did a 3 day course of Xifaxan in case bacteria was the cause because of surgery. There was no change. Even though there is no evidence according to the testing, I do want to remain gluten free not only because of IBS, but for all the other problems I now believe it can cause . I believe my IBS problems are because of the surgery since I never had the problem before, but I don’t know why that would happen. Thank you so much for your book and for having this website. We need a place to go for support.

    • Dr. Davis

      Wouldn’t it be great, Brenda, if we could find a gastroenterologist or other GI health expert to weigh in on these bowel issues?

      I have yet to stumble on one, however. He/she will declare themselves eventually!

  4. With digestive enzymes which we DO recommend to our patients, we do however suggest caution as overuse can lead to irritable bowel or leaky gut.

  5. Wildrose

    I just recently read your book and I’ve been almost wheat free for about 2 months. Strangely, I’ve just developed diarrhea in the past week. Could I be eating too many nuts, maybe? I do overdo it a bit on them. And I also brought a new dog into the house who was suffering from diarrhea. He’s better, though, and I’m not! I don’t feel ill in any other way.

    • Dr. Davis

      Humans do get diarrhea, Wildrose, for reasons other than wheat or wheat elimination.

      However, should this continue, consider a high-potency probiotic on the small chance this is a late wheat-related phenomenon, i.e., a delayed shift towards health bowel flora.

  6. Kari

    My husband read wheat bell lost his tummy and exema. I didn’t totaly listen to him about the book and am now reading it myself. I’ve had colitis on and off for 20 years. Ive been wheat/ gluten free for three weeks. When will I know if it can fix the colitis? Could it fix my depression problems also?

    • Dr. Davis

      Colitis, if it is going to respond, Kari, can take longer than, say, relief from lesser conditions such as acid reflux.

      However, I believe that you should have a sense of whether there’s going to be a response within 4 weeks.

      I’ve witnessed improvements in depression in many people, many detailed in these blog pages.

      • Kari

        Thank you do much for writing this book!!!!!!!! It has had a taken my childs exema away, and is hopefully soon going to take away my sisters IBS and my colitis. This book has been the answer to my prayers. Thank you!!!!

  7. Rae

    In response to: “Should you be among those who struggle with full recovery of bowel health after elimination of all things wheat, please speak up and report your experience! “, I’d like to share my experience and ask for your input. After experiencing 4 bouts of diarrhea over a 3 month period I went to my PCP, had blood and stool labs (all normal), told to avoid gluten and dairy, and was then referred to gastroenterologist. I had an endoscopy and colonoscopy with biopsies and was diagnosed with Microscopic (collagenous) colitis but not Celiac. I began treatment with budesonide (corticosteroid) 9 mgs. a day and liquid imodium (1/4 tsp. 4 x a day) which I have done for 12 weeks. I am still having trouble with my stools, bloating and cramping though not diarrhea as bad as before. I am also fatigued and unable to participate in the many outdoor activities that I am used to because of the abdominal pain and fatigue. A week ago I had a follow-up and because I am still having symptoms, I was prescribed Xifaxan (antibiotic) 550 mgs 2 x a day for 10 days. I was told that if I am not improved within 3 weeks that a more aggressive immune suppressant (Imuran) will be required. I was also advised to follow the FODMAP diet plan and have an appointment scheduled with a dietician in the gastroenterology clinic. I have been following the gluten free diet for 4 months, with the exception of the period of time between first seeing the GI and the testing, when I was told to eat it for the Celiac testing. I had a lot of digestive trouble with it during that time. I have gained 15 pounds since starting the steroid treatment. I have missed a lot of work due to the diarrhea, pain and fatigue. I also take 100 mcg synthroid daily for hypothyroid. Two years ago I developed scalp psoriasis and am being treated with prescription shampoo for that. Since eliminating gluten in my diet my scalp condition has improved. I want to stop taking the steroid but the GI says the diarrhea will likely return if I do. I am hoping the antibiotic will help. I’d like to be able to rely on dietary modifications for treatment of the microscopic colitis and wonder if the continued symptoms are from the side effects of the steroid.

  8. James

    Since eliminating wheat from my diet 4/9/12, I have lost 17 pounds, found relief from itchy fore arms and realized better intestinal regularity. No more wheat for me. Thank you Dr. Davis.

  9. James

    I have been wondering if you are the same Dr. Davis that published diet reports in 2005 advocating the Atkins diet. At that time my weight was 272 (5’10”) after living on hospital food that I ate while my ladyfriend was hospitalized (I bought her food from restaurants), as a result of following the reports advice I lost 70 pounds.
    Unfortunately I fell off the plan and gained 20 back, but I am back on track now. Thank you for all of your help.

    • Dr. Davis

      While I do indeed advocate limiting carbohydrate exposure, I don’t believe that was me.

  10. Trina Guggerty

    I literally stumbled across your book, Wheat Belly, about a month ago and I found the information fascinating. I had no idea how bad wheat was….the only people I know who are gluten-free have celliac disease. I decided to experiment and go wheat free for a couple of weeks to see if I could tell a difference in the way I felt…energy levels, etc. Well, the surprising thing for me was how the pounds fell off. I had been trying to lose 5/6 lbs for several years and when I cut out all sugars I thought I’d lose the lbs. Not. So I figured it was my age…64….and the theory that your brain holds on to a weight-set number. Boy, have I ever disproved that theory. What started as an experiment is now my permanent lifestyle….I will never go back to eating Frankenwheat again.

    My husband watched the pounds dropping off and decided he would try it also. Unfortunately he has not lost any weight but after only 3 weeks I’m telling him to be patient. What has changed – drastically – is his bowel movements. From having one every other day or so he now has to eliminate 3-4 times a day. Sometimes the urge is accompanied by stomach cramps. He eats a Greek yogurt everyday and adds a teaspoon of Benefiber. He is eating more fruit (but not overmuch), eating more salads and continues to eat meat and veggies. Can you tell me why his frequency has changed so much? And will it slow down as he continues on?

    Thank you for your help.

  11. Debora Sadler

    Hi,could someone explain to me Pancreatic Enzymes are they available through health food or chemists or is it a prescription medication. Also in what quantities should it be taken. I am sugar/wheat/gluten sensitive i also suffer from Fibromyalgia and chronic constipation. I have the Wheat Belly Book have found it to be a great tool in discovering all the hidden Wheat that i didn’t know about. Love this site Thank you so much for a wonderful tool.

    • Dr. Davis

      I am going to refer your question to my friend and nutrition educator, Kathy Howitt.

      You can buy them at health food stores, but Kathy will know more about dosing.

  12. M Goodspeed

    Does anyone know if there’s a connection between lymphocytic colitis and wheat consumption? I have had on and off bouts with diarrea over the past few years but did not know until today what was the cause. I am wondering if a wheat free/gluten free diet would help with this condition? I have been prescribed a two month dose of steroids, but think that somehow my diet must be partially to blame. Does anyone have any info on this?

  13. Gilgia

    Hello you all,
    I have stopped eating gluten 7 months ago and felt a real turnaround for a short while. No more diarrhea!
    Then it started up again and now I go between bouts of diarrhea and constipation. I have been taking a quality probiotic for years and yet no improvement. I cannot figure out is it what I eat or what I don’t eat, is it my gut bacteria or the lack thereof, is it stress, is it an autoimmune problem, an ulcer? I am so tired of it all. I have had this for years.
    Thanks for any insight.

    • Dr. Davis

      Yes: Wheat is the most powerful cause for increased small intestinal permeability through its gliadin protein.