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I treated a Case of Constipation with Gluten and Dairy Free Indian Diet

Rachel Hemraj,
Rachel Hemraj,
Diet Therapy
New Delhi, Delhi, India
 10 years exp 
July 14, 2019
7 YearsFemaleAsian

Medical Condition:

Constipation, Irritable Bowel Syndrome (IBS)

Therapies:

Diet Therapy

Medical History:

7 year old girl had been suffering from severe constipation for one and a half years. Despite all the diagnostics, medication and high fiber high fluid diet, the girl didn’t show any long term relief from constipation. We recommended tests for food allergies and found that the girl was allergic to gluten. 



Case Management:

Recommended gluten free diet after the girl was tested positive for gluten allergy. Within a week, the girl started getting regular bowel movements. Gluten free diet was recommended for few months with slowly introducing other food items for which the girl had tested positive. It was observed that the girl had problem with foods that contain gluten and nothing else. She started normal bowel movements. However,  after 3 years, we have started introducing limited foods that contain gluten. She has fully recovered and has no problems with constipation.




What exactly is Gluten? 

Lot of clients ask me about Gluten. Gluten is categorized as a group of proteins, composed of glutelin and prolamins present in the starch containing endosperms of a number of food grains. Gluten is found in the highest density in wheat; making up for 75% to 80% of the total protein content and is a fixture in Barley, Rye, Oats and other cereal grains. Gluten is known for its elasticity, and is the primary component in wheat dough that gives wheat products its chewy consistency. Gluten is a common component in a wide range of foods. And, one can be quite sure that gluten consumption is a given when eating foods made from a number of cereal grains. 


Is there a correlation between Gluten and digestion?

The widespread consumption of gluten through a number of cereal grains, brings up the subject of gluten intolerance and constipation, which is a prevalent digestive health issue for many individuals.  Gluten free constipation is possible, even the absence of gluten in one’s daily diet does not guarantee a cure from constipation. However, for many individuals, gluten is the primary cause for constipation, and can also be linked to IBS or Irritable Bowel Syndrome, which is defined by the prevalence of irregular bowel movements in many individuals. 

To shed light on the correlation between gluten and IBS or constipation, various studies have been conducted. These studies show that people with Non-Celiac Gluten Sensitivity and Gluten sensitivity are more often than not benefited by gluten exclusion in a daily diet. Records indicate that many individuals exhibit symptoms of Celiac disease without testing positive for Celiac. It is also noted that the exclusion of gluten from the diet for these people, often provides relief. In 2016, researchers from Columbia University Medical Center even released a report indicating the damage intestinal cells of those with NSGC, even in the absence of positive testing for Celiac disease1


Gluten and Dairy Free Indian Diet and its Benefits:

Bearing all of the above in mind, and the prevalence of IBS and constipation in the general Indian population, it becomes necessary to explore the benefits of a gluten free diet of Indian food. Gluten free Indian foods effectively exclude cereal grains that trigger symptoms of gluten sensitivity in both those with Celiac disease and those experiencing Non-Celiac Gluten Sensitivity symptoms. Furthermore, to combat a combination of constipation and IBS, I recommend a gluten and dairy free Indian diet for this particular case as we found that the client had gluten intolerance. . In my experience as a dietitian,  the dietary recommendations have proven to be effective in combating gluten sensitivity and often rely on the consumption of substitutes for gluten rich cereals. I recommend quinoa, buckwheat, sorghum, millet, amaranth and corn. These cereals effectively make up for the need for dietary fibers without triggering gluten sensitivity. 

In conclusion, one must make efforts to substitute the everyday consumption gluten rich cereal grains with gluten-free cereal grains. For example; chapati (wheat bread) and a vegetable curry is a staple breakfast diet for many individuals in India. This can be effectively replaced by a breakfast meal comprised of ‘makki ki roti’ or corn bread with a vegetable curry of chickpeas and potatoes. The emphasis is on exploring dietary options that eliminate gluten consumption. 


What are some of the common popular India dishes that are gluten free?

Dosa: South India crepe made with rice and lentils

Poha: Popular breakfast dish made with rice flakes, onions and spices



Reference:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403030/


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