Gluten-Free After Bariatric Surgery – A Good Idea?
As general surgeons, we see a wide range of concerns stemming from the intestines – small (also called the small bowel) and large (known as the colon). The intestinal tract is essential for our overall health because it can become diseased, and the microbiome or intestinal flora (normal bacteria) can regulate everything from insulin secretion and gluten tolerance to weight loss and maintenance. Of course, what we eat, and drink makes a significant difference in our overall intestinal health, so it stands to reason that we should discuss whether a gluten-free diet makes sense.
Celiac disease is an autoimmune reaction to gluten. About 1 to 2% of Americans suffer from celiac, and their response to foods containing gluten can be significant. These reactions can run the gamut but are typically punctuated by fatigue, pain, other physical responses, and even joint inflammation. For these patients, it makes sense to go gluten-free as the alternative is not acceptable.
A somewhat more significant (up to 6%) portion of Americans has what is known as gluten sensitivity. Foods containing gluten can trigger minor symptoms as compared to those with celiac disease. Patients may feel bloated, tired, and achy. Speaking to an allergist can help tremendously in understanding what foods or combinations of foods are creating these symptoms, and patients can get a suitable roadmap for eliminating them from their diet. Interestingly, some patients find that they can consume glutenous foods overseas without discomfort. Many theories surround this, but we have yet to fully understand why this is the case.
Those Who Can Tolerate Gluten
For those who can tolerate and enjoy gluten, there is no reason to avoid these foods altogether. This is not to say that quitting gluten has no benefits. Many will swear that, despite not having a sensitivity or celiac, dumping gluten allowed them to lose weight and feel better. This is less likely due to eliminating gluten and more likely because they reduced carbs overall, including those bad carbs often found in processed foods containing gluten.
Of course, there are also downsides to eliminating gluten from your diet. Many beneficial foods, including whole grains, contain gluten and can be very good for your digestive health. Indeed, by eliminating gluten, some patients do not receive sufficient fiber, vitamins, and nutrients, which can lead to several digestive and systemic concerns. However, increasing your fruit and vegetable intake can offset this.
Some gluten-containing products may also stimulate the gut microbiome and increase the function of probiotics. Going gluten-free may eliminate this possible benefit.
The Bottom Line
While following a gluten-free trend when you do not have a sensitivity or celiac may seem appealing, it’s unlikely to significantly affect your overall intestinal health. If gluten-free is a way to improve your carbohydrate intake temporarily and the first step in a long-term lifestyle change, there’s nothing wrong with trying it for a while. Just ensure you receive the appropriate nutritional intake to keep your health top-notch over the long term.
More important is to take a close look at the foods you are eating and try to avoid highly processed items in favor of whole fruits and vegetables as well as lean meats. Also, be sure that you are hydrating appropriately. Combining a better diet and hydration often makes bariatric patients feel better and more energetic. This can all be achieved without eliminating gluten. With that said, if you do consume gluten products, be sure to avoid those that are low in essential nutrients, like white bread. While they are undoubtedly tasty, they do not contribute significantly to your nutrition and don’t help you stay full throughout the day.
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