Gluten reaction - What happens and what to do if a coeliac eats gluten?

Coeliac disease is an autoimmune condition related to the ingestion of gluten, which is a protein found in the cereals wheat, barley and rye. When a coeliac patient consumes gluten, the immune system identifies gliadin, a substance contained within gluten, as a foreign invader and produces antibodies to fight against it.  

Unfortunately, healthy cells from our digestive tract get damaged in the process, particularly the villi, small finger-like protuberances that line the small intestine and which play a key role in absorbing nutrients from food. Over time, the villi become seriously impaired and a person will stop absorbing the necessary amounts of some nutrients, leading to potentially very serious health problems. This is why it is very important to get a diagnosis if you think you may have coeliac disease. 

The symptoms triggered by the autoimmune reaction that causes coeliac disease are many, and vary widely from person to person. When someone is diagnosed as having coeliac disease and makes a complete switch to a gluten free diet, most symptoms tend to disappear within weeks or months. 

When that person who is following a gluten free diet eats gluten again, symptoms can be expected to return, even if the amount of gluten was small. Some of the most common symptoms are diarrhoea or constipation, abdominal bloating and cramping, stomach ache, fatigue, joint pain, anxiety, depression and brain fog. It is not usual for a coeliac patient’s skin to break out in hives as the condition is not an allergy, but some people with coeliac disease develop a skin rash called dermatitis herpetiformis, and this could return or worsen in cases of one-off or accidental gluten ingestion.  

How long does a gluten reaction last?

There is no hard and fast rule on how long the symptoms from your reaction to eating gluten will last. But the most likely scenario is that the worst discomfort will subside after a few days, but it may take weeks before all symptoms have disappeared without trace.  

First and foremost, don’t feel guilty or bad about it. According to a recent study from the Celiac Disease Foundation, 74% of all patients reported accidental exposure to gluten in the past 30 days. It is something that is extremely hard to avoid, although you can learn from each experience and try to make it less likely to happen again. It is important not to add emotional pain to the physical symptoms you will be suffering, so having someone you can talk to about the matter can be helpful.  

Regarding the physical symptoms, here we will see that there are some things you can do to mitigate them. You may also want to see your doctor, who can monitor your progress and give you specific recommendations for the symptoms you are showing. 

Once you realise that you have accidentally ingested gluten, there are certain steps you should take immediately to start the healing process to recover as quickly as possible.  

• Drink plenty of water. Staying hydrated is very important, especially if you experience diarrhoea, and extra fluids will help flush your system as well. In addition to drinking regular water, try coconut water or bone broth for electrolytes. 
• Get some rest. Your body will need time to heal, so make sure you get plenty of rest. If you try to keep working or going to class while experiencing physical side effects, you could make things worse for yourself. If you can’t take a break entirely, do your best to at least take it easy. 
• Take activated charcoal. If you’re experiencing a lot of gas and bloating, taking activated charcoal may help. The charcoal binds to toxins and helps to eliminate gas and bloating – just be sure to increase your water intake when using them to avoid constipation. 
• Heal your gut. Taking probiotics will help to re-establish the balance of healthy bacteria in your gut and L-glutamine is an amino acid that is beneficial for gut repair. You can also take supplements to decrease inflammation such as omega-3 fatty acids, ginger and turmeric. 

After taking the steps described above for a few days, you should start to feel better. You can also try adding some light exercise after a couple of days to help with the mental side effects such as anxiety and depression. Other activities that you know help you to relax and feel better will also help, be it meditation, walks in a favourite nature spot, reading, soaking in a hot bath or whatever works for you.  

It is important to take things slowly with your gut and eat plain food for a while for easy digestion.   

What should you do to avoid another accidental ingestion in the future? Here are some simple steps to start implementing now, if you haven’t already: 

• Always check food labels. First look for the label “gluten free”. On other products, have your checklist of ingredients that could contain gluten, such as wheat starch or malt. Here is our guide to help you understand what to look for on a label. 
• Keep a gluten free kitchen. You may need to keep separate utensils and cookware to avoid cross-contamination at home. 
• Label everything. If some of your family members or flatmates don’t follow a gluten free diet, make sure everything is labelled so they know what they can and cannot touch. Items such as toasters, cutting boards, pots/pans, and other kitchen utensils need to be kept separate at all times. 
• Be proactive. When you go out to eat, be proactive about choosing a restaurant that offers gluten free options and follows precautions against cross-contamination. 
• Speak up. In addition to finding a restaurant with gluten free options, talk to the waiting staff and the manager about how to avoid cross-contamination. 

Coeliac disease is by no means easy to live with but, by following a gluten free diet you can repair your gut from the damage and experience relief from symptoms. There is always the possibility that you might accidentally ingest some gluten, but the more you educate yourself and the more careful you are, the less likely it is to happen.