One of the most common symptoms of gluten intolerance and celiac disease is constipation. Before we address constipation directly, you need to understand why celiac disease causes you to become constipated. You also should understand why exactly it isn’t good for you to be constipated (besides that it can be unpleasant).
In celiac disease (sometimes spelled coeliac disease), gluten catalyzes your immune system to produce certain unusual antibodies. These antibodies then attack the lining of your small intestine. This lining absorbs nutrients and vitamins from food as it is digested and passes through your bowel.
The lining of your small intestine contains villi, which are like little fingers reaching out from the walls of your bowel. They’re so tiny they can only be seen under a microscope. They densely populate the lining of your small bowel so that they create a large surface area over which digesting food moves. As food moves across this surface area the villi help grab and absorb vitamins and minerals into your blood stream.
When the antibodies created by gluten attack these villi, the villi slowly wear down over time, often eventually being completely destroyed.
As the villi are reduced or destroyed, the food slides through your gut less digested and with far fewer of the nutrients absorbed.
The further the food proceeds, the more the small intestine expects the food to be digested and the nutrients absorbed. When the parts of your bowel expecting the food to be digested into a certain state tries to process this food, this later area of your small intestines instead either pass it completely without further digesting or just absorbs what little it can — often only the moisture and water.
This leads to dark, firm stools and eventually to constipation.
Constipation isn’t just gut pain, fewer bowel movements or the many other related symptoms. It is a dysfunction in your body’s ability to digest nutrients and eliminate toxins.
Not unlike bad traffic, celiac disease constipation represents slow transit time and thus leads to back-ups. When your colon becomes backed up, then eventually your small intestine will become backed-up. This then leads to delayed gastric emptying in your stomach. (Now you may understand why some people experience reflux and heartburn when they are constipated.)
This gastric delay reduces absorption of nutrients at all points in the digestive system. This keeps toxins your body normally eliminates in your system for a longer period, taxing your immune system even further as some of these toxins may be reabsorbed.
So how do you address celiac disease constipation?
The most important step is to completely eliminate gluten from your diet. This means no more wheat, rye or barley or foods that might contain ingredients derived from wheat, rye or barley. You should also avoid oats. While oats aren’t inherently bad for celiac disease, they are commonly farmed and processed with gluten-containing grains. Please see my gluten free pantry to help you get started.
However, this is a long-term solution, and even after remaining strictly gluten-free for a long time, you still may suffer some permanent celiac disease symptoms from going undiagnosed for many years. So how do we more rapidly address constipation?
My favorite approach to celiac disease constipation, and one which has helped many people, involves the following constipation treatment:
- Every morning before you eat anything else, drink a tall glass of warm water with a natural fiber supplement, such as one which uses psyllium. You can take it either as a powder mixed in with the water or a pill, whichever you prefer.
- With this fiber or right after consuming it, I strongly suggest a supplement (or more than one supplement if you can’t find a single one with these in it) containing slippery elm bark, flax seed and L-Glutamine (often listed as just glutamine).
- At any point in the day, take a probiotic supplement which comes in an enteric covered capsule or pearl. A quality probiotic contains multiple strains of friendly bacteria (such as lactobacillus acidophilus, which is used in most yogurts). The enteric coating protects the friendly bacteria from your stomach so that it is not killed too early in your digestive tract. This helps it reach and flourish within your small intestine. I really like Nature’s Way Reuteri pearls.
- Take a flax oil supplement in the later part of the day. This is different than taking a ground seed or a supplement with flax in it. You need the lubricating quality of a flax oil supplement.
- Be sure to drink plenty of water throughout the day — soda-pop, coffee and alcoholic beverages do NOT count. You REALLY need to increase your water intake if you’re constipated.
- You knew this one was coming: you really need to get regular exercise every single day. This can mean different things to different people so I won’t go into detail here, but at least try to get in a well-paced walk every single day.
If you do these every day for a week to two weeks, you should start to experience a significant improvement in your regularity and comfort. Constipation from Celiac Disease can be tough, so I urge you to remain discipline and motivated.
While this list may appear intimidating at first, with some focus and a positive attitude you can make these points part of your daily routine. And before you know it — as long you’re being smart and disciplined with your gluten-free diet — you’ll find yourself eliminating celiac disease constipation and enjoying both the greater comfort of regularity and the benefits of greater nutritional absorption.
Thank you for reading and I really hope this helps. Please visit Celiac Disease Symptoms regularly as I add and refine my website during the coming months.