Ask Dr. Chang – September 2023

This month’s “Ask the Expert” features Dr. Denis Chang from the Celiac Disease Program, Boston Children’s Hospital. Dr. Chang answers questions about how eating a little bit of gluten.

Read the answer below or watch Dr. Chang.

Question – My friends hang out at a lot of places that don’t have great gluten-free (GF) options. How much damage would it cause to my intestines if I ate gluten once a month? Would it matter if it was just a little bit vs. a whole meal of gluten?

Dr. Chang –
We know that celiac disease (CD) is a lifelong autoimmune condition where gluten ingestion can lead to damage or inflammation of the small intestine. While we know that a lot of people do a really great job being on a GF diet, we know that sometimes accidental or unintentional exposures to gluten can happen. When it does the body can recover and symptoms of present will get better.

However I’d be concerned if one of my patients asked me if it would be okay to have gluten once in a while. To start, I’d be worried that that once in a while would become twice in a month then three time in a month and maybe even more. We just don’t know what the long term implications are of intermittent gluten exposures in people with CD. We know that there are many complications associated with untreated CD. For those reasons, we recommend avoiding gluten at all times. Secondly, we also know that some people can have symptoms with gluten. This is especially true after being on a GF diet for a while as the body is healing. We know that the amount of gluten that they had can lead to the severity of the symptoms they experience. And so for all those reasons we recommend a strict GF diet.

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