​​A gluten-free diet may be a fashionable way to stay healthy or even maybe lose weight, but for some people – those with gluten intolerance – it is the only way to control their bodies’ allergic reaction to gluten.

​Dietitians do not know the exact cause of gluten intolerance but it is often hereditary. People with gluten intolerance need to give their diet a complete overhaul and eliminate gl​uten from their diet.

Gluten is a protein found in wheat, barley, oats and rye, and is commonly used as a stabiliser, thickener and emulsifier in processed foods.

What you need to know about gluten intolerance

Gluten intolerance is a digestive disorder resulting in a person reacting aversely to foods containing gluten. 

Most people who suffer from gluten sensitivity experience symptoms such as diarrhoea, bloating and gas, explains dietitians from Dietetic & Food Services at Changi General Hospital (CGH), a member of the SingHealth​ group.​

8 diet tips to manage gluten intolerance

  1. Avoid all products containing wheat, rye and barley (e.g. breads, pastas).

  2. Avoid baked foods (e.g. pies, cakes, cookies).

  3. Read food labels carefully and avoid foods with dextrin, emulsifiers, stabilisers, corn starch, malt and modified wheat starch.

  4. Check all seasonings, thickeners and marinades for gluten-containing additives.

  5. Avoid processed foods and meats (e.g. luncheon meats, salad dressings, vegetarian mock meats, soup stocks).

  6. Eat more whole grains – rice, white rice, millet, buckwheat, beans, seeds and nuts.

  7. Increase your daily intake of fruits and vegetables.

  8. Choose fresh meats, fish, poultry, eggs, and dairy products.

Making the switch to a gluten-free diet may be difficult initially as there seems to be a long list of foods to avoid. But there are now many gluten-free alternatives for pastas and noodles, such as soba, buckwheat and kelp noodles. There are also gluten-free flours made from potatoes, tapioca and arrowroot.

Symptoms of gluten intolerance

Gluten intolerance symptoms vary from mild to serious. They include:

  1. Diarrhoea

  2. Abdominal pain

  3. Bloating and gas

  4. Weight loss

  5. Stomach upset

  6. Nausea and vomiting

  7. Fatigue and weakness

Some symptoms such as abdominal pain, gas and bloating may be caused by digestive problems and not due to gluten intolerance, so it is important to get this condition properly diagnosed.

Diagnosis and treatment for gluten intolerance

There is no cure for gluten intolerance. A gluten-free diet is the only effective treatment.

Go for a blood test to determine if you are really allergic to gluten before going on a gluten-free diet. Consult a dietitian who will carry out a nutritional assessment and then devise a proper meal plan suitable for you.

Gluten intolerance vs celiac (coeliac) disease

Gluten intolerance is due to sensitivity while celiac (coeliac) disease is an autoimmune disorder.

For persons with celiac (coeliac) disease, consuming gluten damages their intestinal lining, which generates an immune response that could cause inflammatory reactions in other parts of the body. Celiac (coeliac) disease is the most severe form of gluten intolerance.

Gluten sensitivity has been recognised as being less severe than celiac (coeliac) disease. People with gluten sensitivity do not test positive for celiac (coeliac) disease based on blood testing, and do not have damage to their small intestines found in those with celiac (coeliac) disease.

Symptoms of celiac (coeliac) disease

Those suffering from untreated celiac (coeliac) disease may suffer from malnutrition and small bowel ulcers. They also have a higher risk of developing gastrointestinal cancers.

Signs of celiac (coeliac) dsease include:

  • Chronic diarrhoea or constipation

  • Gas

  • Pale, foul-smelling stools

  • Recurring weight loss

  • Anaemia (usually from iron deficiency)

  • Abdominal pain

  • Early osteoporosis or fractures

  • Joint pain

  • Painful, itchy skin rash

These may suggest complications of the disease.

Ref. I23 (ed)

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Irritable Bowel Syndrome (IBS): How to Manage

Food Allergies in Children: How to Manage

Lactose Intolerance in Children: Tips to Manage

Intolerance to Food Additives: What to Look Out For