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Wheat and Digestive Symptoms: Is It Gluten or Something Else?

by Valerie Polley | Sep 9, 2024 | 0 comments

In recent years, gluten-related disorders have gained significant attention, leading to a surge in people following gluten-free diets and new gluten-free products on store shelves. This has been driven by the increasing number of people experiencing digestive problems after consuming wheat, a primary source of gluten. However, there is widespread confusion surrounding whether these symptoms are truly due to gluten or related to other components in wheat.

In this blog post, we’ll explore the complex relationship between wheat, gluten, and other potential triggers of digestive upset, such as FODMAPs. By the end, you’ll have a clear understanding of the different causes of digestive symptoms related to eating wheat.

Understanding Wheat and Gluten

Wheat is a staple grain in many cuisines worldwide and is found in foods like bread, pasta, and cereals. It contains several proteins, with gluten being the most notable. Gluten is made up of two proteins: gliadin and glutenin. These proteins help dough rise, maintain its shape, and provide elasticity to wheat-based foods. Gluten is also found in rye, barley, and triticale.

In people with certain conditions, gluten can trigger various digestive symptoms, including gas, bloating, diarrhea, constipation, and abdominal pain. However, gluten is not the only component in wheat that may cause these symptoms. This has led to a growing interest in understanding other factors that might be at play.

Gluten-Related Disorders

Two of the most common gluten-related disorders are celiac disease and non-celiac gluten sensitivity.

Celiac Disease

Celiac disease is a well-known autoimmune disorder in which eating gluten damages the small intestine. It’s estimated that about 1% of people worldwide have celiac disease. When someone with celiac disease eats gluten, their immune system mounts an attack on the villi, which are small, finger-like projections that line the small intestine and are essential for nutrient absorption.

Symptoms of celiac disease vary widely, ranging from digestive issues like diarrhea and bloating to non-GI symptoms like anemia, fatigue, skin rash, and joint pain. In fact, there are over 250 known symptoms of celiac disease! The only effective treatment for celiac disease is a strict, lifelong gluten-free diet, which allows the intestines to heal and symptoms to improve.

Diagnosing celiac disease typically involves blood tests to look for specific antibodies, followed by a biopsy (taking a small sample of tissue) of the small intestine to confirm that the villi have been damaged. Early diagnosis and treatment are important for preventing long-term complications like osteoporosis.

Non-Celiac Gluten Sensitivity

Not everyone who experiences symptoms after eating gluten has celiac disease. Non-celiac gluten sensitivity (NCGS) is a condition where people experience similar symptoms but lack the autoimmune response and intestinal damage seen in celiac disease. NCGS is thought to be more common than celiac disease, but its exact prevalence remains unclear due to the lack of a definitive diagnostic test.

Symptoms of NCGS include bloating, abdominal pain, fatigue, and headaches, which typically improve after eliminating gluten from the diet. However, unlike celiac disease, NCGS does not require a lifelong gluten-free diet. Some people with NCGS may tolerate small amounts of gluten or certain gluten-containing grains better than others.

If you suspect you have NCGS, it’s important to work with a healthcare provider to rule out celiac disease and wheat allergy before attempting a gluten-free diet. This is because the tests to diagnose celiac disease do not work if you’re not currently eating gluten.

Beyond Gluten: Other Wheat Components and Digestive Symptoms

Some people who struggle with wheat may have other conditions that don’t necessarily involve gluten, such as wheat allergy or irritable bowel syndrome.

Wheat Allergy

Wheat allergy is another condition distinct from celiac disease and NCGS. It’s an allergic reaction to some of the proteins found in wheat. Wheat allergy is more common in children but can also affect some adults. The immune system in a person with wheat allergy mistakenly sees wheat proteins as harmful, which triggers an allergic reaction.

Wheat allergy symptoms can range from mild, such as hives and nasal congestion, to severe, including anaphylaxis – a potentially life-threatening reaction requiring immediate medical attention. Wheat allergy is diagnosed through skin prick tests, blood tests, or an oral food challenge conducted by an allergist.

Managing a wheat allergy involves avoiding all forms of wheat and carrying emergency medication like an EpiPen. Unlike celiac disease, wheat allergy does not necessarily require the elimination of gluten from non-wheat sources, such as barley or rye.

FODMAPs

FODMAPs are short-chain carbohydrates that are poorly absorbed by the human gut. This leads to fermentation by the gut bacteria and digestive symptoms like gas, bloating, and changes in bowel movements. Fructans, a type of FODMAP, are found in wheat and are believed to contribute to digestive discomfort in some people, especially those with irritable bowel syndrome (IBS).

When fructans reach the large intestine undigested, they are fermented by bacteria, producing gas and drawing water into the gut. This leads to bloating, pain, and changes in bowel movements. This explains why some people who believe they are sensitive to gluten may actually be reacting to the fructans in wheat.

One way of managing fructan intolerance is the low-FODMAP diet. The low-FODMAP diet involves temporarily eliminating high-FODMAP foods, such as wheat, then systematically reintroducing them to identify specific triggers. It should only be followed under the guidance of a dietitian to ensure nutritional adequacy.

Interestingly, some people with IBS can tolerate sourdough bread made with wheat flour because the fermentation process reduces the amount of fructans present in the bread. During sourdough fermentation, the naturally occurring bacteria and yeast break down complex carbohydrates like fructans into simpler compounds. This reduction in FODMAPs makes sourdough bread easier to digest. However, tolerance can vary from person to person, so it’s important to monitor symptoms when trying sourdough bread if you have IBS.

Tips for Identifying the Culprit

If you suspect that wheat or gluten might be contributing to your digestive symptoms, consider the following strategies:

  • Keep a food diary and symptom tracker: Keep a detailed record of what you eat and how you feel afterward. This can help you identify patterns and potential food triggers.
  • Try an elimination diet: An elimination diet involves removing the foods you suspect are causing your symptoms, such as gluten or high-FODMAP foods, from your diet for a period of time and then gradually reintroducing them. This can help pinpoint foods that are causing symptoms. It’s best to work with a healthcare provider while undertaking an elimination diet to ensure you’re still getting the nutrients you need. Also, it’s important not to eliminate gluten until celiac disease has been ruled out.
  • Work with a registered dietitian: Consulting with a registered dietitian who specializes in digestive disorders can help you identify triggers and ensure your diet remains balanced and nutritionally adequate.

Final Thoughts

Navigating the complexities of wheat and digestive symptoms can be challenging. While gluten is a well-known culprit, it’s important to consider other components of wheat, such as fructans, that might be contributing to your digestive problems. A personalized approach guided by a registered dietitian is key to effectively managing these symptoms.

For more in-depth information, practical guidance, and a personalized approach to gut health, consider booking an appointment with our dietitian at Blue Tree Nutrition.

Our gut microbiome (the community of trillions of microbes that live in our gut) plays a key role in maintaining metabolic and immune health. Gut dysbiosis occurs when the composition and diversity of our gut microbiome shift. This could include overgrowth of harmful bacteria or a decrease in beneficial bacteria. Gut dysbiosis has been linked to a wide range of negative health outcomes, including increased levels of inflammation and changes in metabolism.

Many people switch to non-nutritive sweeteners like sucralose, aspartame, and stevia for health reasons, and for decades, we've believed that they pass through our bodies without affecting us. But emerging research shows that these compounds interact directly with our gut microbiome and may have potential negative effects on our health. 

This article will review what we currently know about the relationship between non-nutritive sweeteners (including artificial sweeteners and calorie-free natural sweeteners) and the gut microbiome, plus practical advice for navigating sweeteners.

Sucralose

Sucralose (Splenda) is an artificial sweetener commonly used in baked goods, gums, and sugar-free beverages and is approximately 600 times sweeter than sucrose (table sugar). However, recent research has linked it to adverse health effects such as systemic inflammation, metabolic disease, and gut dysbiosis. For example, a 2022 study found that sucralose consumption increased harmful bacteria and reduced beneficial bacteria, which was associated with changes in insulin and glucose levels.

Additionally, a 2025 randomized controlled trial examining the effects of replacing added sugars with sucralose found that people with type 2 diabetes who consumed sucralose experienced reductions in both alpha diversity (the number and types of species present in a single person) and beta diversity (differences in microbial composition between people). Interestingly, the people with overweight and obesity without type 2 diabetes did not experience the same changes.

Overall, animal studies and limited human studies suggest that sucralose may trigger intestinal inflammation, likely through its effects on the gut microbiome. However, since most of the evidence we have comes from test tube or animal studies, these results should be interpreted cautiously.

Aspartame

Aspartame is another commonly used artificial sweetener that is about 200 times as sweet as sucrose. While it does contain some calories, because you don't need much of it to reach the same sweetness levels as sucrose, these calories are negligible.

Like sucralose, most of the research into the gut effects of aspartame has been done in animals. However, we do have some very small human studies. A 2022 randomized controlled trial (RCT) involving 20 healthy adults found that participants taking aspartame showed changes in both probiotic (beneficial) and pathogenic (harmful) bacteria, but the changes were specific to each individual. 

Why the differences? It's likely due to the "responder vs. non-responder" phenomenon. We all have differences in our "baseline" microbiome. While certain bacterial species are common in healthy populations, our microbiome is as unique as a fingerprint. Whether an artificial sweetener has positive or negative effects on our microbiome may depend on which species are already present in our gut, as well as on our habitual diet. This difference in responses makes it very challenging to draw firm conclusions about whether artificial sweeteners are harmful.

Stevia

Many people choose stevia because it's a "natural" zero-calorie sweetener. Studies have shown mixed results regarding the effects of stevia on the gut microbiome. For example, while some in vitro (test tube) and in vivo (animal) studies have reported potentially harmful effects of stevia on the gut microbiome, others have found no impact, and some even reported beneficial effects through inhibition of inflammatory pathways.

Additionally, a 2024 human study found that stevia had no significant effect on the gut microbiome. This highlights the importance of not forming conclusions based solely on test tube and animal studies. Overall, it appears that stevia is a potentially less-harmful alternative to artificial sweeteners like sucralose and aspartame.

Practical Advice for Navigating Sweeteners

Since the research on artificial sweeteners is still evolving, the decision to include or avoid them comes down to personal preference. Here are some tips for including them in your diet in moderation:

  • Try gradually reducing the amount you use: If you typically use two packets of sweetener in your coffee or tea, try gradually reducing to one packet. Our taste buds are highly adaptable, and you may find that one packet is sweet enough once you get used to it.
  • Check your labels: Low- or no-calorie sweeteners (such as sucralose, aspartame, and sugar alcohols like erythritol) are often hidden in low-sugar foods like protein bars, yogurt, and diet sodas. Awareness is the first step to reducing your intake.
  • Rotate your sources: If you do use artificial sweeteners, try switching up the types you use. Since different sweeteners may affect your gut microbiome in different ways, this may reduce the concentrated impact on your gut.
  • Switch to stevia: While animal and test-tube studies show mixed findings, human research indicates that stevia has a limited effect on the gut microbiome, making it a better choice for people seeking to support their gut health.

Another way to support your gut if you regularly use artificial sweeteners is to rebuild gut diversity with fiber and fermented foods, while focusing on whole-food sweeteners.

  • High fiber prebiotic foods (like legumes, whole grains, garlic, onions, asparagus, and under-ripe bananas) act as "fuel" for your healthy gut microbes. Aim to include a variety of these foods in your diet to support the microbes already in your gut.
  • Add fermented foods, like unpasteurized sauerkraut and kimchi, kefir, or kombucha, to your diet. Some fermented foods contain live, beneficial bacterial cultures, while others are rich in "postbiotics" (beneficial compounds like short-chain fatty acids, which are produced when bacteria break down prebiotics).
  • Try using whole-food sweeteners instead of artificial ones. For example, sweeten plain yogurt with vanilla extract and berries or add dates to smoothies or homemade energy bites.

Final Thoughts

Emerging research suggests that certain low- or no-calorie sweeteners, including sucralose and aspartame, may affect the gut microbiome, whereas stevia appears to have a less negative effect. While individual responses can vary with a person's unique baseline microbiome, certain artificial sweeteners may increase inflammation or reduce gut microbiome diversity.

If you need personalized support navigating sweeteners or supporting your gut health, Blue Tree Nutrition can help. Click here to get in touch!

 

 

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Hello, I am

Valerie

My name is Valerie Polley. I am a Indianapolis-based registered dietitian and owner of Blue Tree Nutrition. I consult with clients both local and far away.
I have a bachelor’s degree in nutrition from Purdue University and I have been practicing for 20 years.
I thoroughly enjoy helping clients through their gut health journey. I see a range of GI issues including, but not limited to celiac disease, IBS and SIBO. I also specialize in the FODMAP elimination diet.

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