Q. I have been gluten-free for three years, although a biopsy came back negative at that time. I have experienced a night and day difference on the diet, and as a result, my partner and I work very hard to keep my diet extremely clean. However, I have noted that there are some things that I consider GF based on the listed ingredients and what the manufacturer tells me, that I get gastrointestinal symptoms from. Can you tell me if there is a way to narrow down what the culprit might be by how long it takes for me to have symptoms? In other words, if I go to a restaurant, and I eat something that has cross contamination from say a grill or utensils that are used in the kitchen, I know that within the hour. But there are times when I don’t exhibit any symptoms for 4 or 5 hours. I am wondering if this is because the ingredient I am responding to is such a trace ingredient, that I don’t feel it till the food is broken down to a certain level, way beyond the superficial. Is that a possibility, or am I way off base here?
A. We know that small fragments or peptides of glutens are directly injurious to the gut. These are independent from the celiac mechanism. It probably depends on the dose and variety of peptides that arrive in your gut. You’ll drive yourself crazy trying to figure it out, but it is likely that you will not undergo serious damage from this occasional exposure.
Health and happiness,
Dr. Jeffrey Aron
Gastroenterologist, San Francisco
(Dr. Aron is no longer taking questions.)
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