More new information from the Nexvax trial from ImmusanT is here! Scientists found that nausea and vomiting indicate gluten exposure more reliably than other IBS type symptoms.
In the study, they looked at the 36 patients that received placebo during the trial. These patients were exposed to approximately 6g of vital wheat gluten or “sham” every two weeks. The patient recorded their symptoms based on the Celiac Disease Patient Reported Outcomes or CD PRO, adverse events, and blood tests. CD PRO rated symptoms based on a scale of 0 to 10.
CD PRO tracks symptoms like fatigue, nausea, diarrhea, and about 10 other symptoms.
Adverse Events are things like anaphalaxis, swelling, hives, or something really life threatening.
In the blood tests, they were looking for Interlueken-2 (IL-2) at baseline and after 4 hours. IL-2 is a signalling molecule to activate lymphocytes in the immune system. Lymphocytes are what is activated in the small intestine in celiac disease.
In this study, “sham” was low in FODMAPs.
Nausea and vomiting were the only common side effects with gluten only. When patients were given “sham”, nausea and vomiting were not common. With gluten, nausea started at about 1:34 after gluten consumption and vomiting typically started at about 1:51 after gluten.
Additionally, IL-2 increased 20 fold at 4 hours after gluten consumption over baseline. Ninety-seven percent of patients had significant increases in IL-2 at the 4 hour mark and it correlated with severity of nausea and vomiting.
Without nausea, it was also common for patients to experience tiredness and flatulence after gluten consumption. There was no other statistical difference in symptoms between gluten and sham.
According to the study conclusion, IBS-type symptoms without nausea are NOT an indication of gluten ingestion.
This study shows that nausea and vomiting are definitive indications of large amounts of gluten ingestion. Six grams of gluten is the equivalent of approximately 2 slices of bread and that is a massive amount of gluten. But smaller amounts of gluten ingestion would not create IBS type symptoms (diarrhea, constipation, bloating, and other gastrointestinal symptoms) either.
I know this will be controversial because one of the common symptoms of celiac disease is diarrhea. It is all over every web site you see regarding celiac symptoms. Maybe in untreated celiac disease diarrhea is a symptom. I did have uncontrolled diarrhea until and after I was diagnosed. So, that one might be IBS or something else. Heck, I don’t know – this has thrown me into disarray.
I’m not a thrower-upper. But when I did the Nexvax trial, I’ve never thrown up so much in my life after the initial gluten challenge. I also know when I received gluten during the trial and can endorse these results as exactly what happened to me. After about 2 hours I started to feel really, really bad and by 2 hours and 15 minutes in, I was throwing up.
This also confirms other studies that say symptoms take up to two hours to appear after gluten ingestion. I will find the study later, but it is another ImmusanT study.
Now, I think we should all take this information to heart. Know that the bloating and diarrhea may not be gluten and/or celiac related, but related to IBS.