Introduction:
Fructan and gluten are carbohydrates that lead to gastrointestinal problems like bloating and gassiness in certain people and should be restricted in them. Due to all the attention given to gluten sensitivity on social media and other public platforms, there is a common misconception that all gastrointestinal issues are caused by gluten consumption.
What Are Fructan and Gluten?
Fructans are short-chained carbohydrates and are often referred to as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). Fructans are found in wheat, rye, barley, garlic, onion, chickpeas, raisins, etc. People who are sensitive to fructans can have digestive system disturbances, especially those with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).
Gluten is a protein that is usually found in grains like wheat, barley, and rye. It acts as a binder allowing its stretchy and sticky nature to hold the particles together. Without gluten, the particles would fall apart and not form a dough when kneaded. Gluten can also act as a prebiotic. Some people’s immune system reacts in a little different way, considering it as a toxic substance. This is the cause of celiac disease.
What Is the Difference Between Gluten and Fructan Intolerance?
In people having gluten intolerance, even a small amount of gluten in their diet can trigger symptoms like diarrhea, bloating, fatigue, seizures, etc. Humans do not have enzymes to digest fructans. Hence, they are fermented in the gastrointestinal tract. The bacteria in the gut feed on these fructans and produce by-products, which can cause symptoms like bloating, nausea, abdominal cramps, etc.
A hydrogen breath test can help to identify fructan intolerance. The patient is asked to eat a portion of food with fixed fructan content. Their fructan intolerance limit can be determined by the amount of hydrogen they exhale post-fructan digestion.
What Are the Dangers of Going Gluten-Free?
Many people discontinue gluten intake in all possible forms thinking all their gastrointestinal woes are because of gluten sensitivity. This can be more harmful than beneficial and can give rise to several health issues like nutritional deficiencies. It can cause deficiencies of iron, folate, phosphorus, thiamine, calcium, etc., in the body. Research shows that people who follow a gluten-free diet have a higher risk of developing type 2 diabetes later in life.
What Are the Symptoms of Fructan Intolerance?
Symptoms associated with fructan intolerance can be:
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Gas.
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Abdominal pain.
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Constipation.
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Diarrhea.
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Nausea.
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Flatulence.
These symptoms can be associated with gluten intolerance, IBS (irritable bowel syndrome), and many similar conditions.
What Are the Conditions That Gluten and Fructan Consumption Trigger?
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Irritable Bowel Syndrome (IBS): IBS can be a collective compilation of symptoms, including a tight stomach. The other symptoms can include stomach cramps, abdominal pain, constipation, gassiness, diarrhea, etc. IBS can usually be managed by changes in lifestyle, though severe cases might require medication. These are disorders caused by gut and brain miscommunication, which means the issues with how the gut and brain work together. In people with irritable bowel syndrome, the colon contracts more than in normal people. These contractions can lead to cramps and pain. People with IBS also tend to have a low pain threshold (ability to bear pain). Some factors like stress, medication, and emotions can trigger irritable bowel syndrome. A diet rich in fiber has been found to improve the condition. Avoiding or limiting caffeine can also help to reduce the severity of the condition.
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Non-celiac Gluten Sensitivity: Non-celiac gluten sensitivity is the term used to describe people who show symptoms like vomiting, diarrhea, etc. when they consume food containing wheat but do not actually have celiac disease. It is also called gluten intolerance. A recent study shows that only about sixteen percent of people who thought they were gluten sensitive are gluten intolerant. It is most common among gluten-related disorders. Since no proper biomarker is available, the condition can be confirmed only by ruling out other gluten-related disorders like celiac sprue and gluten intolerance.
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Celiac Disease: It is also called celiac sprue or gluten-sensitive enteropathy. It causes the immune system to attack the small intestine during gluten consumption. The small intestine is prevented from working properly. It is an inherited autoimmune disorder. The gluten in the diet triggers the immune system to produce antibodies against it. The antibodies destroy the lining of the small intestine and impair its function to absorb nutrients properly. This results in malabsorption.
In children, it can cause stunted growth and development. About fifteen percent of the people suffering from celiac disease have a chronic skin condition as its side effect. It is commonly called celiac rash or gluten rash. It is medically termed dermatitis herpetiformis and is clinically seen as itchy rashes that look like a clump of blisters. It is commonly seen in the elbows, knees, buttocks, or scalp.
There is no cure for celiac disease, but the symptoms can be managed by following a gluten-free diet. Celiac disease and gluten sensitivity or gluten intolerance show similar symptoms but are two different conditions. Celiac disease is autoimmune and produces an antibody against gluten, which is absent in gluten intolerance. The symptoms of celiac disease are due to the antibodies produced. Avoiding gluten completely might be difficult initially, especially in finding the right alternatives. But continuing a diet with gluten can cause more harm than good; it can affect the nervous and skeletal systems of a celiac sprue patient.
Conclusion:
Self-diagnosis of gluten sensitivity and following a gluten-free diet has gained prominence, probably due to the immense media attention it receives. Nonceliac gluten sensitivity is a condition in which gastrointestinal and other external symptoms are seen in a person who consumes gluten. There are no reliable biomarkers, and the clinical presentation can be very similar to irritable bowel syndrome. Hence, there can be a diagnostic problem.
Food intolerance is another confusing diagnosis. It is always advisable to seek medical help before confirming a diagnosis to prevent further complications. For example, a completely gluten-free diet can cause other serious health issues.
