It seems fiber is important, especially for those suffering from Celiac disease. Who knew? A study published in Clinical Gastroenterology published in March 2018 determined that increased fiber intake helped with ongoing Celiac symptoms among sero-negative and those with healed small intestine mucosa.
The study looked at 47 confirmed Celiac patients – twenty two were not suffering from ongoing Celiac symptoms and 25 had ongoing symptoms. Both groups had healed intestinal mucosa and negative blood tests for Celiac disease. They also tested a whole bunch of other technical biomarkers such as ” CD3+ and γδ+ intraepithelial lymphocytes (IELs), CD25+ and FOXP3+ regulatory T cells, and CD117+ mast cells, and the expression of tight junction proteins claudin-3 and occludin, heat shock protein 60, interleukin 15, and Toll-like receptor 2 and 4 were evaluated in duodenal biopsies.” I have no idea what these are or why they are important, but they looked at them. My guess is it is related to the autoimmune process and/or inflammatory processes.
The asymptomatic patients ate more fiber and had a larger number of CD3 intraephithelial lymphocytes (IELs). According to the study, “There may be a correlation between the number of CD3 IELs and intestinal inflammation.”
What to do?
The big take away for me on this is that we should eat more fiber. The gluten free diet is notoriously low in fiber. A couple of sources for fiber is beans, greens, coconut, corn, broccoli, sweet potatoes, and rice.
Beans can cause unfortunate gas and bloating and can be mistaken for Celiac symptoms. Soaking beans overnight before cooking and Bean-O are good ways to counteract the gassiness. I find I can eat beans one day, but struggle if I try to eat them two days in a row. Leafy greens, again two days in a row throws my body into a fit. Maybe alternating days of beans and greens might help!
Also, there is no shame in a gluten free fiber supplement. I find psyllium husk fiber supplements to be exceptionally hard on my system. I use flax seeds when I need to. Here is a great article on how to choose a good fiber supplement for yourself.
Anyway, if you are experiencing ongoing Celiac symptoms, try a fiber supplement for a few weeks. Many people will tell you to eliminate diary, all grains, or a low FODMAP diet. This might be simpler and easier to implement than any of those and might provide relief. I would say this is worth a try!!
Update 5/11
I’ve been experiencing ongoing terrible diarrhea. It affects me everyday. Sometimes it is better and other times it is worse, but it is always my friend. I’ve taken fiber supplements on and off. Sometimes they help and other times they don’t for me. I would say that for the most part the supplements are good.
I’ve added a prescription pancreatic insufficiency enzyme in conjunction with the fiber to help resolve the diarrhea. I’ve had very good luck with that combination.
I still stand by the recommendation for additional fiber in the celiac diet.
Chia seeds are also a great source of fiber!
This information is extremely helpful! I’m curious, though: I don’t have a Celiac diagnosis yet, but I’m unsure where to go to begin the process. The UC center I usually get my physicals at has an allergy care center (https://rockymountainurgentcare.com/allergy-care-center/) — would that be an appropriate place to begin? I’m just getting my foot in the door with this, so any info helps!
Celiac isn’t an allergy, so the allergy clinic isn’t quite the tight place to start. Your General Practitioner can run a celiac panel, including a genetic screening. Of any of the tests, other than the genetic screen, are positive, then you should be referred to a gastroenterologist for review of the tests and an upper endoscopy to confirm test results. A genetic screening can rule out celiac but cannot confirm active celiac disease. Many, many people carry the genetic markers but never actually acquire the disease. I hope that helps.