Originally posted by Dr. Davis on 2014-04-26
on the Wheat Belly Blog, sourced from and currently found at: Infinite Health Blog.
PCM forum Index of WB Blog articles.

Gastrointestinal Recovery After The Wheat Battle Is Won

Josie posted this comment that addresses the issue of bowel health recovery post-grain removal.

“I have been wheat-free for almost a year now and I no longer fall asleep during the day, and my mental fog has disappeared. My wheat-free life is great!

However, I am experiencing major digestion problems. I went to see a dietitian and explained to her I do not eat wheat and try not to eat grains. She emphasized that I need fiber in my diet and based on my current food intake I was not receiving an adequate amount, which was most likely the cause of my digestion problems.

She respects that I do not eat wheat, but is encouraging me to eat rice, oats, oat bran and flax seeds. I am extremely hesitant on eating these things because I value my health and want to do what’s right based on what I know. I ate oatmeal earlier and I felt so scared and was upset afterward because I know they aren’t healthy.

What can I do to get my digestion back on track? How can I get rid of these digestion problems without having to eat grains? My mental health is suffering because of it and I feel torn between needing the fiber and having a desire to be healthy.”

Remove modern wheat from your diet and you have removed the great disrupter of gastrointestinal health. The gastrointestinal disruptive effects of wheat include:

• Gliadin–The peptides that derive from gliadin digestion are directly toxic to enterocytes (intestinal cells), whether or not you have celiac disease. An interleukin-driven inflammatory mechanism has been documented.
   
• Gliadin also induces autoimmunity. Wheat-induced autoimmune diseases of the gastrointestinal tract most commonly involve stomach parietal cells that produce stomach acid, the biliary tree and liver, the small intestine (Crohn’s disease) or the colon (ulcerative colitis). Vitamin B12 absorption is also impaired due to its complex absorptive mechanism distorted by gliadin’s effects on the stomach and small intestine.
   
• Wheat germ agglutinin (WGA)–WGA is a direct bowel toxin, causing “denuding” of intestinal villi responsible for nutrient absorption. It is also a potent blocker of any glycoprotein receptor lining the gastrointestinal tract, particularly the cholecystokinin (CCK) receptor responsible for triggering bile release from the gallbladder and enzyme release from the pancreas. When WGA blocks the receptor for CCK, digestion is impaired, bile stasis develops that leads to gallstones, dysbiosis results because of incomplete digestion of foods. When dysbiosis develops (VERY common), bowel health is further impaired, autoimmunity facilitated, metabolic distortions magnified.
   
• Phytates–Phytates block iron, zinc, and magnesium absorption. Absorption is impaired by as much as 90%. This is a big part of the reason for grain product fortification.

Remove wheat and the damage recedes over time. BUT you can still be left with residual inflammation, impaired stomach acid production (hypochlorhydria), partial healing of small and large intestines, dysbiosis, and nutrient deficiencies.

For this reason, just removing wheat is only the start; all these other factors may need to be addressed. While many people heal perfectly well over time, someone like Josie may not.

Among the most helpful and effective strategies to consider in your wheat removal efforts are:

• Consider removing ALL other grains, especially rye and barley that share similar gliadin structures; corn and oats that also share somewhat similar gliadin-like proteins; rice due to a small quantity of wheat germ agglutinin (i.e., a rice lectin with a structure identical to that found in wheat).
   
• Take a high-potency probiotic for at least several weeks, longer if an autoimmune condition is present. 30-50 billion CFUs per day has been working very well for us, especially brands with a wide variety of Lactobacillus and Bidifobacteria species, such as VSL3, Renew Life, and Garden of Life brands.
   
• Bowel flora are like a garden: probiotics are the seeds, prebiotics are the water and fertilizer. If all you do is plant seeds, they may sprout but not flourish, and may even die. So you must nourish your plants. Likewise, you must nourish the bowel flora reinoculated by your probiotic. Lactobacillus and Bifidobacteria love fibers that are indigestible, what I call “leftovers,” what some call “resistant starches.” Easy ways to obtain such fibers: one green unripe banana per day in a smoothie, one peeled raw white potato in a smoothie, 4 teaspoons of inulin in anything, small servings (¼-½ cup) of legumes, chickpeas, hummus. It is best to start with smaller quantities, then build up over several weeks to avoid abdominal pain and bloating. I believe this issue is Josie’s #1 problem. Note that relief from symptoms requires several weeks to develop, not after your first green banana.
   
• Consider hypochlorhydria — Because the stomach’s parietal cells may not recover, you may be left with inadequate stomach acid. The telltale sign of this is heartburn symptoms unresponsive to acid-suppressing medication. This responds to supplemental hydrochloric acid as betaine HCL or apple cider vinegar, but is best managed under the watchful eye of someone with experience with this situation.
   
• Consider pancreatic enzyme supplementation — Since, for unclear reasons, full restoration of the CCK receptor sensitivity may not occur. The lipases and proteases, in particular, are helpful here. (We require less amylase and other carbohydrate-digesting enzymes since we don’t eat grain amylopectin or sugars.)

Rarely does someone need to supplement fibers with this lifestyle, as replacing the lost calories of grains with foods such as nuts, seeds, mushrooms, avocados, and vegetables easily matches or exceeds the fiber intake of a grain-based diet. If you must, psyllium, chia, and flaxseed are fairly benign fiber sources.

My new book, Wheat Belly Total Health, is my answer to questions such as Josie’s: the additional steps to take to maximize health in the aftermath of wheat removal.

Total Health is scheduled for release September, 2014. It will discuss how to tip the scales in favor of full remission from autoimmune diseases, ulcerative colitis, Crohn’s, diabetes, hypertension, “high cholesterol,” skin rashes, and other conditions. Yes, national advice to consume more “healthy whole grains” ruins health; you may need some help beyond their removal to fully recover.