Why is there no enzyme pill for gluten?

Beano is a product that uses an enzyme to break down complex carbohydrates to prevent the build up of gas.

Lactaid is a product that contains lactase, an enzyme for breaking down the sugar in milk.

Why is there no product that helps break down gluten? While gluten is a protein, those are broken down by a protease, which is to my understanding, an enzyme.

So, why can’t I buy some pills that will let me enjoy a nice bagel again?

Such enzymes exist, but they’ve not been shown to be of benefit.

Remember, celiac disease is an immune response to gluten. All it takes is a trace of gluten that escapes the enzyme to trigger antibodies against it (and also against the celiac person’s own gut lining).

I discount diagnoses such as “non-celiac gluten sensitivity syndrome” as gluten is probably not the specific trigger. The symptoms are not replicated on double-blind food challenge, suggesting a placebo or non-gluten-related physiologic effect.

Strange, since this is what I seem to suffer from. I am 98% sure that I do not have celiac but most wheat products cause me distress. If it is just in my head that means that there must be a way to get rid of it.

Neither the placebo effect nor the non-gluten-related physiologic effect constitutes the issue being in your head. The preponderance of evidence at the present time just points towards factors other than gluten as being causative rather than gluten. Hence its “syndrome” nature. More research will doubtless help clarify but it may take a while.

For example, my daughter suffered GI distress when she consumed dairy products. All signs pointed to lactose intolerance. But she was sensitive to casein (milk protein), not lactose, so no amount of lactaid or lactose free dairy products helped her. Superficially the two sensitivities looked the same, but the underlying mechanism was different.

Initially I thought that I was lactose intolerant. I did use Lactaid for a long while but it seems to only be effective part of the time. It wasn’t until I went on the low fodmap diet that I was really able to pinpoint wheat /gluten as the issue. Also it is pretty amazing how often dairy and wheat are consumed together.

I’m sure- especially as casein and dairy are common ingredients in breads and baked goods.

To the good doctor’s point, it may be wheat, but not gluten, even if that seems like the logical culprit. With my daughter it was dairy, but not lactose.

I think you have answered your own question. Low Fodmap has nothing to do with gluten. A useful by product of a lot of gluten free foods is that they are low in fodmaps, but it still isn’t the gluten. The Oligos aka fructans in the wheat are likely your problem, not the gluten.

Crap (no pun intended). I am diagnosed with fructose malabsorption (from a fructose hydrogen breath test) and somehow missed that wheat was high fructan - I have been mainly avoiding onions and high levels of garlic (and obviously high fructose foods). Symptoms are much better, but still occur. I will have to experiment with cutting down on wheat.

One thing that I don’t understand is why, if I have a problem digesting fructose, would fructans cause a problem - I thought humans in general cannot digest fructans? The only thing I could think of is that the human digestive system might knock a few fructose molecules loose from the fructan molecule on its way through - enough to cause me problems but not enough to be considered “digestion” of fructans.

Now I have to test to see if fructans are my issue. A lot of the fruit that I love is high in fructans. Time to do some shopping.

We don’t digest them. Which is the problem. Many of the fodmap components can cause water to be attracted into the colon, so if they are not otherwise digested we get problems.

If you havn’t seen it, have a look at the Monash University Fodmap site.

They have a (paid) app that is actually pretty useful.

I’m in much the same situation as you; avoiding onions and garlic, and as much as I love bread, I have to be very careful.

Like lactose, gut bacteria play a role in digesting fructans. So when they hit the colon the bacteria go at it, resulting in fructose production

I have the Monash University app on my phone. It really came in handy early on and I still consult it.

My understanding is that those of us with fructose malabsorption do not absorb fructose in the small intestines so it passes to the colon where the bacteria have a field day. But no human can digest fructans, so they all pass into the colon. Why is that more of a problem for us?

I have been using the Monash app for a number of years. Checking wheat just never occurred to me. Must have dozed off when the nutritionist went over that part - most emphasis was on onions and fruit.

I think the unfortunate answer is that nobody knows. The Monash work seems to have found that each person is different in their sensitivities. Whether this is down to different gut flora, differences/deficiencies in gut function, or phase of the moon is still unknown. But at least there is some understanding of how to approach the problem, and that is progress.

Speaking of syndromes, Irritable Bowel Syndrome may have dozens of triggers, including wheat and dairy. Maddeningly, there is no diagnostic testing for IBS except for cutting the suspected triggering food out of the diet. I’ve spent decades trying to figure out what foods to avoid. The relief is obvious once I hit on the right ones.

Healthline has a decent page on possible triggers. Few people will need to avoid everything on that list, so trial and error is an unfortunately necessity.