We've all been there, the stomach pains start, you run for the nearest toilet and straight off the bat you are wondering whether that cafe you stopped for lunch at really was gluten free or the 100% gluten free snack you ate earlier was hiding something. I think it is the first thing we do when we fall ill. If I'm honest, I don't, the pain I get when I've ate gluten is so different from any other pain I don't have to make assumptions I know if it is gluten and I know a lot of others will too, but still I see so many people saying "oh it must have contained gluten" (even my parents are guilty of that, I only have to say I have stomach ache and they are rechecking ingredients automatically assuming gluten even when I say it isn't) when they are sure everything they have eaten was fine, so how can it be gluten?

Let's say for this one you've been out for lunch, the cafe seemed clued up and said they would prepare your food separate and that the chips were done in a separate fryer. You eat your ham sandwich with a side of fries and take off, driving home you begin to feel nauseous and the cramps start. We all know what is now running thorough your head. "It's been 30 minutes since I ate, is that enough time for a gluten reaction? What if she just SAID it was all separate? Maybe it was a conspiracy and they didn't believe it was going to make me ill? I'm going to complain to management as soon as I can get off the toilet long enough!"

Lets look into this a little shall we. Unless you get a specific pain like me how do you know it is gluten? If you've got the pain you ONLY get with gluten then you can probably 99% say it was but how do you know it was the cafe? 15 minutes to 24 hours is the average range for a response to trigger, could it actually be something from yesterday and it's coincidence the pain has started now, well that's something you might not ever figure out, it could be either, but if you can trace back everything you have ingested since yesterday lunch you might be able to nail down the culprit.

Now what about the other side, you don't get a specific pain or symptom, you just have to make a mad dash to the toilet, you get stomach cramps, nausea and a killer headache, now there is no saying you haven't been glutened by that cafe, but the symptoms are so generalised, are you just "jumping on the gluten bandwagon" as I once got accused? There is no way of knowing for sure if you have accidentally ingested gluten and that is the culprit but that is what we will automatically assume. Until we get a device available on the market which can check IgA levels on the fly (which is currently being worked on I believe, works in a similar way to blood sugar monitors) so we can see if an immune response has been triggered we can only work out logically if we may of may not have been glutened. If it's not gluten what else could have triggered the symptoms? Let's take a look.

Most obvious one that jumps to mind is a stomach bug. All kinds of viruses are forever floating around, and anyone with an auto immune disease is already at a higher risk of contracting one. And lets face it bugs are so easy to catch, a child only has a cough a few feet away from you and that's it, you just know you are going to be ill in a few days. But on a serious note, the time we usually begin to feel the first effects of a stomach bug is just after eating, when your stomach isn't sure whether it want's to hang on to the food you just gobbled down. You get pain when you stomach is trying and failing to hold onto it's contents, you're trying to figure which end it is going to come out of first and bam you have to run to the toilet. We know you're still blaming that lunch time meal, but is is just a bug? Some last only a matter of hours after all and you could be feeling much better before you have chance to say "I must have been glutened". If it is a bug you may find paracetamol will help relieve symptoms, if it was gluten then paracetamol usually won't touch it.

So, what about if you are 100% sure everything you have eaten recently was gluten free. Maybe it was a 100% GF cafe or you made lunch yourself with 100% gluten free ingredients, but you've had a "reaction". You know you haven't had anything you can't but still gluten is the cause somehow. The amount of times I see or get asked "is xxx and yyy ok, as I feel ill after eating them but I thought they were gluten free", I'd be rich if I got £1 for each time someone asked it, after all we have been so used to gluten making us ill, it's impossible not to jump to the gluten conclusion.

Again a stomach bug like we mentioned above would be the fist thing to consider but there are other options when we know for sure no gluten has been ingested. Go to a doctors and the first thing they will suggest is IBS, I know many of you were misdiagnosed as having IBS before being diagnosed Coeliac, but that doesn't mean you can't still have it. I do, I get random flares up of it when I am least expecting it. If this is the case you may find over the counter drugs such as Buscopan help, or stronger medication such as Omeprazole. Neither help me, but I do find Peppermint Oil, either on prescription or from Holland and Barratt can work wonders and ironically also helps relieve my gluten pains if I've been the victim of gluten.

The final more obvious reason we can think of is another intolerance or allergy, it could be just one small ingredient but your body may not like it, some Coeliacs struggle with vinegar (even vinegar which doesn't contain barley at all (less than 20ppm is in balsamic so is fine for Coeliacs usually)). Xanthan gum or psyllium husk are other popular irritants too and are in a lot of gluten free bread. Dairy, a lot of Coeliacs become lactose intolerant at least temporarily at the very beginning of diagnosis. If you find you are feeling ill a lot it might be worth checking the foods you have eating to see if there is any common ingredient. Strangely a lot of Coeliacs will find they are intolerant to multiple food items, not always common ones either. Also consider oily foods and/or acidic food, a lot of people, Coeliac or not, find they irritate their stomachs in large quantities.

Before automatically assuming gluten consider if it could be something else, we all make slip ups now and then so there is no saying you weren't glutened, but it is always worth considering the other options before 100% blaming gluten. The one's we have mentioned are just the first ones that come to mind, there are of course many other reasons you could be feeling ill and if symptoms persist always seek professional medical attention.