No doubt, we have all been in the position of having made a decision that cost us dearly. When you MUST be gluten free, however, one little misstep can cost you anywhere from a few days off work to an emergency room visit. Because of this, you want to recover as quickly as humanly possible, and get back to living life! Not to mention, the pain and agony of dealing with the aftermath of gluten poisoning is not something anyone wants to experience any longer than we have to.Some people cannot tolerate medications of any kind, so this list is a mixture of both types. I would do as many as I can.
This is your go-to kit. You can download and print off the checklist (pdf) here.
1. First Line of Defense
a. Activated charcoal is a reactive material that can bind to many things. It isn't very effective against alcohol, which is the only compound that shows any miscibility with gluten. It may be that gluten doesn't adsorb onto the carbon, but can be effective in the case of gluten poisoning, because it can trap excess gas that normally causes bloating and diarrhea in sensitive individuals.
b. Enzymes such as bromelain from pineapples (discussed more later) and papain from papaya can help to reduce gluten to its constituent amino acids. Papain is more effective in this case, as it is a non-specific protease, meaning it doesn't have certain cut sites, and can cut a protein at any sequence of amino acids. The more familiar trypsin and pepsin are other digestive enzymes that we make ourselves, but are not effective at removing the gluten threat.
In taking digestive enzymes, it's best to take them prior to eating foods that may have cross-contamination. However, after the fact, they may make digestion of other foods easier.
c. Lactase, especially if you are lactose intolerant, is important and can help relieve discomfort. When the small intestine is damaged, endogenous lactase can be lost, removing the ability of the gut to process lactase, leaving it to the gut flora, which release gas and contribute to the bloating effect.
2. Hydrate Mandate
If you need to filter your water, perhaps make sure to have several gallons on hand. Depending on how ill you are, you do not want to do this after you've been glutened, when you need it.
a. Water. Bottoms up! Water is the medium for all of life's processes. Nearly all of our biochemical processes take place because of water. In order to heal, you need this precious nutrient. Try boiling some water on the stove or in the microwave until coffee-hot, and adding a squeeze of lemon. If you don't like lemon, plain hot water is nice, too. Both are comforting and can aid in peristalsis to activated the bowels. The heat also serves to soothe. However, if you're having diarrhea, activating the normal bowel contractions isn't necessary. Eat or drink whatever offers you the most comfort, while still hydrating you.
b. You may want to occasionally supplement your water intake with something else, like the green tea mentioned above, a berry or vegetable smoothie.
c. You may also want to take in broth, which is not only hydrating, but can provide essential amino acids and other compounds.
d. You can make your own sports drink. Try this: 3 c orange juice + 1 lemon, squeezed + 1/2 teaspoon salt + 1/4 c raw sugar, honey, or other natural sweetener + enough water to make a gallon. This is a little diluted, so add more orange juice or lemon to suit your tastes. If you're on the run, add a few tablespoons orange juice to water and a pinch of salt and sugar or honey.
For very young toddlers, do not add honey. For children, dilute with 1 part electrolyte drink to 1 part water or 1 part drink to 3 parts water. You might also use diluted apple juice, instead.
3. Anti-Inflammatory Protocol
a. Anti-inflammatory drugs, only if approved or prescribed by your doctor, and are gluten free. This seems like a no-brainer, but sometimes, doctors don't check. In that case, you'll have to. The pharmacist often, can check their database to ensure the medication is gluten free.
Note: NSAIDs can cause gastrointestinal bleeding, which can be bad for a celiac disease patient, or someone else who has had GI bleeding in the past. It's almost a tautology, however, and so, it's between you and your doctor whether or not you want to have them as a break-through medication.
b. Pineapple juice contains the enzyme bromelain. It's a specific protease, meaning it cuts a protein only after or between certain sequences of amino acids. It may not help, too much, with breaking down gluten, but it is supposed to have anti-inflammatory properties. Perhaps, add it to your cocktail of efforts, especially in the case that you are unable to tolerate anti-inflammatory drugs. Consider buying a 64-ounce can, pouring into ice trays and freezing, then put the frozen cubes into a freezer bag.
c. Berry smoothie (non-dairy for now) is delicious and also helps with inflammation. You can eat plain berries, particularly blueberries, too, if you like. The compounds that give the berries their colors possess the anti-inflammatory properties in these nutritional powerhouses.
d. Ginger tea. You can make a tea with fresh ginger. Pinch off an inch or two of fresh ginger and steep it in hot water. Add a slice of lemon or other flavoring. Ginger is known for its antiemetic effect. It also is an anti-inflammatory food. Note: you can freeze ginger whole and unpeeled, so that it doesn't go to waste.
e. Green tea. It also has anti-inflammatory properties and can help gently ease edema. If you use caffeinated green tea, be sure to include plenty of plain water in your regimen or you may experience a backlash dehydration effect.
4. Eating Is a Chore
a. Eat whatever feels good or tastes good or seems palatable.
b In some cases where eating is the last thing on your mind, juicing might be your best option. Here's a suggested starting place:
2 large or 3 medium carrots
1" piece of fresh ginger
1-2 stalks celery (good for potassium)
1 apple
Ninja or Juicer it. If you don't have a proper juicer, you can use a coffee filter and funnel to strain the pulp out of the juice. Don't just sip and swallow. You want to allow the juice to sit in your mouth for a period of time and "chew" it. This allows your digestive process to begin to work on the compounds in the juice.
c. BRAT diet is a diet developed to aid in eating when one has a GI disturbance. B- bananas, R- rice, A-applesauce, T- toast. Well, if you do toast, it would have to be GF, of course, but there is nothing saying you need to eat it. Only eat what you are pretty sure will sit well.
5. Repair
a. Take an anti-histamine. Histamine is also part of the immune system's response, helping to combat invaders, even parts of the body that it doesn't recognize as "self." If you take an anti-histamine, you can bring a wayward immune response under control, and maybe even stop it. Inflammation is induced by histamine, so if you stop this cascade, you can actually help to stop the effects of gluten.
b. Take an Epsom salt bath to help relieve edema. Swelling is part of the inflammatory process, and as you may or may not be aware, inflammation can cause collateral damage. Reducing swelling can help the body get back to normal.
c. Continue to allow your body to rest, as you digest compounds you take in. There is no need to jump right back into eating steak. Ease back into heartier foods and grains, especially.
d. Take a probiotic. When there is bacterial, viral, or auto-immune damage to the intestine, there can be an imbalance in the normal gut flora, there. This can lead to bacterial or yeast (Candida) overgrowth and infection. Taking a probiotic can help to restore the balance to the biota in the intestine. We need these bacteria, because they help break down some of our food, and can even produce vitamins, for us. Vitamin K is an example of such a commensal bacterial function.
d. If you haven't been, now might be a good time to start taking a supplement. You may lose some minerals and vitamins during your illness stint. Taking a supplement can help with that,especially if your small intestine was healthy and fully functional right before this bout.
e. Restoring essential amino acids can help replenish your ability to make proteins, particularly those involved in repairing the body after an attack. Antibodies are proteins, and are in high demand during an autoimmune or other attack where the immune system is involved. There are 9 amino acids humans cannot make, but lysine is the only one to show any clinical effect, and only in the case of cold sores. It is also the one that is most often lacking in natural sources.
Supplementing most of the other 9 amino acids is not recommended, due to adverse effects.
Tyrosine is also supplemented in certain cases, in place of tryptophan, but that recommendation should come from a doctor. All of the amino acids are safe at food levels. You can most effectively accomplish replenishment with a bone broth, egg, some vegetables, or meats. The only reason one might need to supplement is if you are subject to developing cold sores. If you are unable to eat sufficiently, don't worry about supplementation and call your doctor.
The paradox of autoimmunity is that, while we want to heal and protect ourselves from invading substances and pathogens, having a strong immune system is, in the case of a flare up, counterproductive. In Celiac Disease, we are fortunate, because in the absence of gluten, our immune systems benefit us. If you suffer other autoimmune disorders, consult your doctor about foods to avoid.
f. Sleep, if you can. If you have sick days, this may be the time to use them. Missing one day of work can help prevent mistakes and speed your healing.
6. Prevent
Learn from this situation, and resolve not to allow yourself to get into it again. This is often easier said than done.
Maybe you risked eating out, because you were on the go. It might be better to have a few restaurants around town that you can go to. Meet with the manager and find out their practices for dealing with customers with special requests. See if they are able to cater to your needs. Once you establish this rapport, you will have a safe place you can go in the heat of a busy day.
Alternatively, keep gluten free snacks in your purse or attache case. Along with that, maybe keep a stash of papain-containing supplements on-hand, and take religiously, when you are having to rush through meals. This is the beginning of your "I've Been Glutened!" Care Kit.
Get well soon!
