Health Conditions / Digestive Health / Celiac Disease

Unfortunately, these grains and their derivatives can be found in what seems like everything, so it can be helpful to know exactly what foods to avoid. The good news is there are many gluten-free alternatives to the favorites on this list. According to the Celiac Disease Foundation, these are gluten heavy hitters:Breads, such as loaves, bagels, pita, and flour tortillasPastries, such as croissants, muffins, and donutsPasta, such as spaghetti, ravioli, and gnocchiNoodles, such as egg noodles, ramen, and chow meinBaked goods, such as cookies, cakes, and piesBreakfast foods, such as cereals, granola, and pancakesSnacks, such as candy bars, crackers, and pretzelsCondiments, such as dressings, sauces, and gravyEven foods that don’t naturally contain gluten, such as oats, can be risky if they’ve potentially been cross-contaminated. “Regular oats are highly contaminated with gluten from growing and processing, so one can only consume oats that are labeled gluten-free,” says Smith.Back to topWhat naturally gluten-free foods can you eat on a celiac disease diet?At first glance, a celiac disease diet can seem really restrictive (Really, no bread?!), but you might be surprised to learn just how many foods are naturally gluten-free. In fact, the Celiac Disease Foundation points out that people with celiac disease can still enjoy plenty of eats.While the main action item on this diet is to avoid gluten, it’s still equally important to eat a diverse range of foods to get all your essential nutrients, says Dr. Jossen. Let’s dive into what that might look like with these four naturally gluten-free food groups.Fruits and vegetablesIn general, the U.S. Dietary Guidelines for Americans recommend eating at least 2.5 cups of vegetables and 2 cups of fruit per day.2 Here’s the even better part: Not only are fruits and vegetables naturally gluten-free, but they are chock-full of important nutrients, so feel free to fill your plate with as many as possible. Throw some broccoli into your egg scramble, mix some cauliflower rice into your taco bowl, or roast some Brussels sprouts to have with your dinner for a little veggie boost.Meat, poultry, and seafoodWhen it comes to protein choices, meat, poultry, and seafood are all naturally gluten-free. These animal products are great sources of essential nutrients, especially protein and B vitamins. That being said, if you’re gluten-free and also vegetarian or vegan, you’ll want to fill your protein needs from plant-based sources like beans, tofu, legumes, nuts, and seeds instead.Milk, eggs, and dairyAccording to an older study published in the journal Digestion, lactose intolerance is often associated with celiac disease.3 However, not everyone with celiac disease is lactose intolerant, and milk, yogurt, and cheese are great sources of B vitamins, vitamin D, and calcium—especially if you’re on a gluten-free diet. If you can’t tolerate milk and dairy, still consider the humble egg. Not only are eggs naturally gluten-free, but they are a great source of protein.Legumes, beans, nuts, and seedsEven if you’re not vegetarian or vegan, diversifying where you get your starches from can help boost the nutrition of your meals. You may be surprised by how many gluten-free starches are out there, too. Choose gluten-free products made from a variety of grains when you can, this includes not just rice and corn but also quinoa, buckwheat, amaranth, and teff, Dr. Jossen says. Let’s not forget legumes, like black beans, chickpeas, and peas, all varieties of potatoes, and nutrient-rich nuts and seeds, either.

Digestive troubles, for many people, top the list of symptoms that are straight-up miserable to live with. After all, who wants to feel constantly gassy or bloated while running to the bathroom left and right? Not only can these symptoms feel uncomfortable (or even downright painful), they can seriously impact how you feel about yourself and the way you live your daily life. If you’re not sure what’s going on, don’t fret. Oftentimes, there is a simple explanation for gastrointestinal (GI) issues. But if they’re starting to feel constant, it’s worth exploring whether something more complicated could be lingering under the surface. Take this quiz to find out what might be causing your stomach problems, and when you should consider seeing a doctor about them—because you deserve to feel good in your body.

Lea Ann Chen, MD, assistant professor of medicine and director of the Inflammatory Bowel Disease Translational Research at the Rutgers Robert Wood Johnson Medical School, tells SELF there are “many reasons” why EPI is underdiagnosed. “EPI symptoms are nonspecific and overlap with other more common GI diagnoses,” she explains. “Also, the tests to evaluate for EPI are very specific, so it is unlikely to be diagnosed incidentally.”That means your doctor would specifically need to suspect that you have EPI and order the appropriate tests to verify it versus accidentally stumbling upon a diagnosis while testing you for other conditions—and they likely would not do that specific testing unless you had one of the above conditions associated with a higher risk of EPI or red flag symptoms, like unexplained weight loss or nutrient deficiencies (which we’ll explain more in-depth below). “For patients whose EPI is mild or is not caused by chronic pancreatitis, the condition can be missed,” Dr. Chen says.Back to topWhat are the most common exocrine pancreatic insufficiency symptoms?Because the signs and symptoms of EPI can overlap with those of other GI conditions, you can imagine they’re not exactly fun to deal with. “If EPI is untreated, the symptoms can be extremely uncomfortable,” Mohamed Othman, MD, professor of medicine – gastroenterology at Baylor College of Medicine, tells SELF. However, there are a few tip-offs that you may be dealing with EPI symptoms compared to those of another health condition2.You have unexplained diarrhea after you eat.Diarrhea is a common issue that is usually caused by something you ate, a stomach bug, or a more serious condition like inflammatory bowel disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases. However, diarrhea is also an issue in people with untreated or under-treated EPI, Dr. Othman says, and there are a few reasons for this. One is that the food you’re eating doesn’t get properly absorbed in your gastrointestinal tract. This allows the bacteria that naturally hang out in your gut to ferment that undigested food, he says. At the same time, water collects around it which can make your stool more liquidy.There’s also this to consider: That undigested food can include fat, Amy Tyberg, MD, a professor of gastroenterology at Rutgers Robert Wood Johnson Medical School, tells SELF. “The fat subsequently stays in the GI tract and acts as a laxative as it travels through the intestines,” she says. Cue the constant diarrhea.Your poop looks “fatty.”EPI can also lead to fatty poops, which are literally bowel movements that have a higher fat content than usual. Medically known as steatorrhea4, these poops are often paler than usual, oily, and smellier than you might be used to, per the Cleveland Clinic. “It’s a result of the lack of absorption of fat in the intestines,” Philip Hart, MD, a gastroenterologist at The Ohio State University Wexner Medical Center, tells SELF.So, if your body has difficulty absorbing fat in your diet due to EPI, it simply comes out in your stool. Heads up: You might also see fat or oil droplets in your poop or an oily residue floating on top of the toilet water after you go, Dr. Othman says.You’re losing weight without trying.When your body can’t break down nutrients in the food you eat, you can’t properly absorb them—and that can cause you to lose weight without trying, Dr. Othman says. Diarrhea caused by EPI can also lead to weight loss if it’s constant.Your stomach hurts.This tends to be a more indirect symptom. EPI can cause excessive gas and bloating due to digestion issues, so your stomach may not feel great as a result. Your body’s difficulty absorbing fat can be a major reason for this symptom, Dr. Hart says.

Pooping is a natural and essential bodily function. Everybody poops—no matter your location, socioeconomic status, or delicate sensibilities. Unfortunately, something that is supposed to be second nature can also sometimes be super difficult. So if you’ve ever found yourself straining to poop, you are definitely not alone.“Almost everyone experiences the feeling of having a hard time having a bowel movement,” Alex Sherman, MD, board-certified gastroenterologist at Vanguard Gastroenterology and a clinical professor at NYU Grossman School of Medicine, tells SELF.While that piece of information won’t exactly make you feel better when you’re stuck on the toilet, it should reassure you that straining to poop isn’t necessarily concerning. In fact, if it happens every once in a while, you’re likely okay and things can often be resolved with something as simple as increasing the fiber intake in your diet.But if you find yourself straining to poop frequently, that could potentially signal an underlying issue that needs your attention, Dr. Sherman says. Want to find out why it hurts to poop—and what to do about it? We turned to top docs for the answers to all your poop questions.First, let’s talk about why you’re straining to poop.“Someone sits down and they are trying to push, push, push—that’s really what straining is,” Felice Schnoll-Sussman, MD, professor of clinical medicine and director of the Jay Monahan Center for Gastrointestinal Health at Weill Cornell Medicine, tells SELF. People can strain to poop for all sorts of reasons, but constipation is really the main cause of this. By definition, constipation symptoms include passing hard, dry stools, having fewer than three bowel movements a week, or feeling like you haven’t really gotten everything out (if you know what we mean), according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).It’s important to understand that people poop at different frequencies, so pooping less than three times a week doesn’t always mean you’re constipated. For example, one person may poop twice a week for as long as they can remember and feel completely fine. “There is no rulebook for how often someone should go to the bathroom,” Dr. Schnoll-Sussman says. “The only time we are concerned is when there is a significant change for you.” If you’re frustrated because it feels impossible to poop and nothing comes out, then that’s also a problem. So, then, what causes constipation? A number of things, but dietary habits are a big contributor to this particular problem, Shilpa Ravella, MD, assistant professor of medicine at Columbia University Medical Center, tells SELF. “I see a lot of patients coming in who have way too little fiber in their diets. That can lead to hard stools and constipation that can cause people to strain a lot when they go to the bathroom,” Dr. Ravella says.That’s why constipation treatment typically includes eating more fiber-rich food, which adds weight to your stool and helps it stay soft, making it easier to pass. Drinking more fluids than you’re currently getting and increasing your physical activity can also help move stool through your digestive tract, according to Johns Hopkins Medicine.Some medications, including things like blood pressure drugs, opioids, antacids, and antidepressants, can also cause constipation, according to Dr. Ravella. And finally, constipation can be a symptom of certain medical conditions like irritable bowel syndrome (IBS) and celiac disease.Your body mechanics might also explain why you’re straining to poop. There are two sphincter muscles in the rectum (the inner and the outer sphincter) that assist with bowel movements.1 The inner sphincter is controlled involuntarily, meaning your brain tells that muscle it’s time to relax (so you can poop) when your rectum is full. Your outer sphincter is a muscle that you knowingly control. And some people may not have good control over the outer sphincter, so they tense their muscles, holding poop in when they should really be relaxing that muscle to let poop out.2 This can make you feel like you’ve never really emptied everything in your bowels.

Real talk: Everybody farts, including supermodels, politicians, actors—everybody. While it can be embarrassing and awkward to let one rip in front of a crowd, that doesn’t mean it’s not perfectly normal (same goes for burping).Still, if you’re suddenly letting flatulence fly like it’s your job, you might take a beat to wonder, “Why do I have so much gas?” Also, if you’re farting that much, you might be a little uncomfortable, too, whether you’re also dealing with bloating or just feeling anxious about the idea of accidentally clearing a room in public.Again, farting is a fact of life, but it’s not typical to desperately hold back your gas to the point of constant discomfort. Not sure if you should be concerned? Here are the most common excessive gas causes, and how to get some relief already.What causes gas in the first place?Gas forms in your digestive tract for two reasons: from the air that you swallow and from the breakdown of undigested food by the trillions of bacteria that live in your large intestine, according to the U.S. National Library of Medicine. “We all have bacteria in our gut, which produces gas—and it has to go somewhere,” Sophie Balzora, MD, gastroenterologist and assistant professor of medicine at NYU Langone Medical Center, tells SELF.Whether you fart or burp, gas comes out of your body in one form or another. In fact, we all pass gas an average of up to 20 times each day, according to the Mayo Clinic. In most cases, the gas you expel from your body is odorless, a mix of carbon dioxide, nitrogen, hydrogen, and sometimes methane. Sometimes, however, the bacteria we mentioned release gases that include sulfur, which is the culprit behind the unpleasant odor associated with passing gas, according to Johns Hopkins Medicine.Occasional gas is perfectly healthy. Excessive gas, however, can cause discomfort to the point of bloating and abdominal pain, and it can actually be a symptom of a more serious condition.Back to topWhy do I have so much gas?There’s a pretty wide range of excessive gas causes, and some are more easily remedied than others. Here are the most common ones to be aware of:1. You’re eating a lot of fiber-rich food.Usually, the food you’re eating can be to blame for any excessive gas you’re dealing with. A food that causes gas in one person may not in another, but there are some common culprits. “The classic food groups are high-fiber foods such as whole wheat and grains, fresh fruits and cruciferous vegetables (such as broccoli, cabbage, Brussels sprouts, kale, etc.),” Felice Schnoll-Sussman MD, gastroenterologist and director of the Jay Monahan Center for Gastrointestinal Health at NewYork-Presbyterian and Weill Cornell Medicine, tells SELF.Fiber is usually recommended to combat constipation, but it can lead to excessive gas if it’s eaten in excess. This is because fiber isn’t fully digested by the small intestine, and the bacteria required to ferment or break down fiber-rich foods in the large intestine produce gas as a by-product, per Johns Hopkins Medicine.So, as with all good things, moderation is key. “Fiber must be slowly incorporated into the diet,” Dr. Schnoll-Sussman explains. “If you binge on kale for its obvious nutritional value, you will most likely feel it with gas and bloating.”Another tip? Make sure you’re drinking enough water, as fiber promotes healthy bowel movements best when there’s an adequate amount of water in your body.2. You have a sneaky food sensitivity.“Many people as they get older have difficulty digesting milk products,” Dr. Schnoll-Sussman says. So even if you’re not full-on intolerant, your body’s level of lactase (the enzyme that breaks down lactose) may be lower than it used to be, making dairy a problem food. “Someone who is very lactose intolerant may experience bloating, cramps, and flatulence as soon as they ingest milk or other dairy products.” But your level of gassiness will vary depending on how sensitive you are.

If you have heartburn here and there, you probably don’t have a huge issue on your hands. Most people can manage the discomfort with over-the-counter antacids, which help neutralize stomach acid, after a particularly triggering meal (thanks, greasy pizza!). But “heartburn that is so severe it keeps you up at night for more than one to two weeks warrants investigation with a gastroenterologist, Dr. Shukla says.Constant heartburn is a sign of uncontrolled acid reflux, or gastroesophageal reflux disease (GERD)—a condition that impacts roughly 20% of people in the U.S., per the NIDDK. Getting a proper diagnosis is crucial if you deal with heartburn or other symptoms—like difficulty swallowing, regurgitation, or unexplained coughing—more than twice a week, as untreated reflux can lead to complications over time, like inflammation or narrowing of the esophagus, which can possibly cause ulcers or problems with swallowing, respectively.To complicate things further, heartburn can feel similar to cardiac chest pain, which can signal a heart attack, Dr. Chen points out. “If you are unsure, please call your doctor for advice on next steps,” she says. If you feel other possible signs of a heart attack—like unexplained shortness of breath, pain in your back, neck, jaw, or either arm, or sudden sweating—it’s best to seek immediate medical attention.Back to top4. You’re having an oddly difficult time swallowing.You may not think of issues with your throat as a “digestive” symptom, but think about it: Your entire digestion process starts in your mouth!Having a sore throat that makes it uncomfortable to swallow is very different from actually feeling like you can’t swallow well. Dysphagia is the medical name for this phenomenon, and it goes beyond not feeling like you can get food down easily. You may cough a lot after eating, hear gurgling sounds from your throat while eating, clear your throat a lot, chew very slowly, or feel chest discomfort after swallowing, per the U.S. National Library of Medicine.“Any type of swallowing difficulty should prompt a visit to the doctor,” Dr. Chen says. (If you know the issue is caused by an object stuck in your esophagus or you’re having trouble swallowing even saliva, she recommends heading to the emergency room.)With that said, if you’re having a difficult time swallowing, there could be an underlying issue to address. As we mentioned, it could be caused by uncontrolled acid reflux, but dysphagia can also be rooted in stress or anxiety, a brain or nerve condition, or direct issues with your tongue, throat, or esophagus, so it’s not something to ignore if it’s interfering with your day-to-day life. In some cases, trouble swallowing can point to esophageal cancer, but Dr. Shukla says this is a less likely explanation.Back to top5. Your stomach pain is borderline agonizing.Severe abdominal pain is different from the stomach ache you experience after eating too much. Instead, you may be experiencing intense cramping that won’t let up or sharp, stabbing pain that forces you to lay down. “If the abdominal pain is severe and persists, it needs to be evaluated,” Dr. Chen says.If you’re really uncomfortable but it’s not so bad that it’s disrupting your daily life, make an appointment with your primary care doctor if you have one, Dr. Chen says. But if you’re doubled over in pain and can’t imagine going on with your day in that state, it’s best to head to the emergency room.

Does that mean you need to eat a low-fat diet to feel your best? Not necessarily, but if you notice that your IBS symptoms get worse on days when you eat particularly rich and fatty meals—especially creamy dishes, cured meats, fried foods, or fast food like pizza—then that’s something worth paying attention to.If fat seems to be your culprit, your doctor or dietitian may recommend following an elimination plan to identify specific fatty food triggers, and then assess your fat intake to see what kind of adjustments can be made based on your personal needs.Gluten-free dietGluten is a protein found in wheat, barley, and rye. If you have celiac disease, eating gluten sets off a wonky immune response that triggers lots of inflammation, leading to some really severe symptoms that can cause intestinal damage. Many people with IBS report experiencing symptoms after eating foods that contain gluten, even if they don’t have a wheat allergy or celiac disease, research shows. Experts refer to this as “non-celiac gluten sensitivity.”“While it is not necessary to avoid gluten if you are not diagnosed with celiac disease, some individuals with IBS feel relief when avoiding gluten,” Henigan confirms. One possible reason for this? These individuals may actually be responding to the elimination of FODMAPs, as many foods that contain gluten also contain FODMAPs. For others with IBS, eating foods that contain gluten is no big deal and a welcome part of their diet.If you’re unsure about gluten, check in with your doctor, who can run the appropriate tests to determine whether or not you have celiac disease or a wheat allergy. If you’re cleared of both and still suspect gluten may be doing more harm than good when it comes to your bowel habits, you can work with your doctor or dietitian to develop an elimination diet for gluten specifically. You may find that only certain foods that contain gluten—but also contain, say, tons of fiber—may be the culprit, so you may not need to avoid all gluten completely. Once you ID your specific triggers, you can create a balanced plan that works for your needs.Lactose-free dietHultin says that if you feel bloated or gassy (or other annoying GI symptoms) after eating lactose, then you might want to check in with your doctor about getting tested for lactose intolerance. “The symptoms of lactose intolerance are very similar to the symptoms of IBS, so it is important to rule the former out,” she says.If you have IBS and you’re lactose intolerant, then steering clear of cow’s milk products may help you prevent a flare-up. “People with lactose intolerance need to avoid foods that contain lactose, including cow’s milk, cheese, yogurt, sour cream, ice cream, buttermilk, cream cheese, butter, and prepared foods that could have these ingredients in them,” Hultin says.Instead, according to the Mayo Clinic, you may want to switch to dairy products that are lower in lactose if you can tolerate them, like ricotta cheese or kefir, as well as plant-based milks and yogurts.Is your diet the only IBS trigger you should be aware of?IBS is a complex condition, so it’s important to remember that while food is a big piece of the puzzle, it’s not the only thing that could be triggering your symptoms. For example, going through a heavy period of stress, taking certain medications like NSAIDs, not getting enough exercise, and not getting enough sleep can all contribute to an IBS flare-up, depending on the person, per the NIDDK.That’s why it’s so important to work closely with your doctor if your digestive symptoms are starting to take an overwhelming toll on your life. They can prescribe certain medications that help relieve your specific IBS symptoms and help guide you on the best lifestyle changes you’ll need to make to feel more in control of your condition.Sources:1. World Journal of Gastroenterology, Diet in Irritable Bowel Syndrome: What to Recommend, Not What to Forbid to Patients2. Journal of Nurse Practitioners, Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management3. Nutrients, Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis4. Advances in Nutrition, Low-Residue and Low-Fiber Diets in Gastrointestinal Disease Management5. BMJ Clinical Research, Soluble or Insoluble Fibre In Irritable Bowel Syndrome In Primary Care? Randomized Placebo-Controlled TrialRelated: