How Long After Eating Gluten Do Symptoms Start

Overview

Gluten is a protein found in grains like wheat, rye, and barley. It helps bind the food together, giving dough its stretchy quality. Gluten has received a negative reputation in recent years, with some people opting to eat gluten-free diets as they believe it is healthier. 

However, gluten is only proven to have a consequence for those with an intolerance to the protein that results from a condition known as coeliac disease. Some people not diagnosed with coeliac disease can experience similar symptoms upon eating gluten, as non-coeliac gluten sensitivity, or gluten intolerance is becoming more and more common. However, evidence for this condition is lacking. 

Either way, gluten can cause uncomfortable symptoms such as poor digestion for some people, and if the underlying problem remains undiagnosed for too long it can lead to more severe health consequences. 

Coeliac disease is an autoimmune condition that leads to the body attacking its own tissues when gluten is consumed. Its cause is unknown, but a combination of genetics and environmental factors is suspected. Individuals with other medical conditions, such as type 1 diabetes, inflammatory bowel disease, and Down’s syndrome are the most at risk of developing the disease. 

Coeliac disease is diagnosed through blood tests and a biopsy of the small intestine, which involves taking a small sample of the lining of the gut to examine it. Patients are also requested to eat gluten-containing foods during the diagnosis period to make sure that gluten is what triggers the symptoms. Coeliac disease is a chronic condition, and there is no cure available for it. Individuals living with coeliac disease have to eat a gluten-free diet to ensure that they are free of pain and other symptoms affecting their quality of life. 

How quickly do symptoms start

When ingested, gluten is broken down into another protein called gliadin. Normally, gliadin is absorbed successfully; however, in coeliac disease, the body mistakes these proteins for harmful ones and produces antibodies against them. This process causes inflammation and uncomfortable digestive symptoms. It also causes damage in the small intestine. This leads to malabsorption, with fewer nutrients being absorbed and utilised by the body.¹

It can take one to two days for gluten to be broken down and removed from the body.² The onset of symptoms of coeliac disease varies and can depend on how quickly gluten reaches the small intestine, referred to as ‘transit time’. Symptoms can appear within two hours of ingesting gluten, although some may experience a delayed response of up to 12 hours before symptoms appear.³ The more serious, long-term complications of coeliac disease may take years to develop. 

Symptoms of gluten exposure

When gluten is eaten, uncomfortable digestive symptoms can appear. These include

• Diarrhoea or constipation
• Steatorrhoea - when excess fat is deposited in your stools, causing them to be foul smelling, greasy, and difficult to flush. 
• Abdominal pain 
• Indigestion 
• Vomiting 

Other symptoms include: 

• Weight loss
• Itchy rash across the elbows, knees, and buttocks - also known as dermatitis herpetiformis 
• Fatigue - often from anaemia caused by deficiencies in iron, B12, or folate. 
• Delayed periods, infertility, and increased complications in pregnancy.  
• Peripheral neuropathy - a tingling or numbness in your hands and feet 
• Ataxia - problems with coordination, balance, and speech 
• Oedema - a swelling of the limbs. 
• Ulcers around your mouth 
• Chronic headaches 
• Osteoporosis 

In the long term, people with coeliac disease are at an increased risk of certain cancers, such as lymphomas or small bowel cancer. If left undiagnosed in childhood, it can lead to delayed development and stunted growth.^1,4

How to get relief from the symptoms of gluten exposure

The best way to manage coeliac disease is to avoid eating food containing gluten. Even a small amount of gluten can trigger symptoms, so removing any potentially harmful food groups is the only way. This may feel challenging at first, so constructing a diet plan with a doctor or nutritionist can help navigate the best way to lead a gluten-free life. Gluten is not essential in your diet, and even common gluten-containing foods, such as bread, flour, and pasta, now have readily available gluten-free versions.⁵

When diagnosed with coeliac disease, it is recommended to take supplements for the first few months to ensure that you are receiving enough vitamins and minerals while adapting to your new gluten-free diet, especially due to the increased likelihood of already having a deficiency from malabsorption. 

It is also recommended that people with coeliac disease receive an annual flu shot and other vaccinations. This is because the spleen, an organ that helps fight against infection and cells in the blood, does not function as efficiently, leaving the individual more vulnerable. This is not the case for all individuals with coeliac disease. 

Rarely, removing gluten from the diet does not work to remove the symptoms. This is known as refractory coeliac disease, and its cause is unknown. There are also no treatment guidelines, as there is limited data on this condition. Possible options include treatment with steroids or even surgery.⁶

Accidental gluten exposure can be horrible, and often people will have to endure the symptoms until the gluten has fully left their bodies. Sadly, there is no remedy to treat gluten exposure in coeliac disease, but there are a few recommendations that can help the process. 

• Rest up - although eating gluten can be stressful, try to sleep or rest as much as possible
• Drink plenty of water- staying hydrated can help to flush out toxins, which will help the  symptoms improve
• Take pain relief - over-the-counter paracetamol or ibuprofen will help with headaches, abdominal pain, and joint swelling
• Take probiotics - there is a theory suggesting that normal intestinal bacteria may play some role in coeliac disease. Probiotics have been suggested as a potential treatment strategy; however, further research is needed⁷
• Fasting - some studies have shown that fasting improves the regenerative ability of cells⁸
• Exercise - after a few days, light exercise is a good way to aid recovery and improve your overall mood 
• Supplementary digestive enzymes - these products claim to help break down gluten, although Coeliac UK claims that evidence of their effectiveness is lacking

Summary

Although unpleasant at the time, symptoms of gluten exposure will pass with no lasting damage. Sticking to a gluten-free diet is the best way to try and ensure that you do not accidentally consume gluten. If you are struggling to understand what foods to eat, speak to a healthcare provider. There are also plenty of organisations and charities, such as Coeliac UK, and the Celiac Disease Foundation, offering advice and support to those affected by the condition.