Should you cut out bread to stop bloating?

Is eating bread giving you bloating and other digestive symptoms? If so, you could be "sensitive" to wheat. Cutting out bread or changing the type you eat may help.

What's with wheat?

There are three key health problems caused by wheat.

• Wheat allergy: reactions usually begin within minutes and include itching, rash, tongue or lip swelling and wheezing. See your GP for referral to an NHS allergy clinic.
• Coeliac disease: also known as gluten intolerance, is a common digestive condition where your intestine can't absorb gluten found in wheat, barley, oats and rye. See your GP for a blood test.
• Wheat sensitivity: symptoms like bloating, cramps, diarrhoea and sickness come on quite slowly, usually hours after eating wheat. There is no diagnostic test.

More and more of us claim to suffer from a wheat allergy, so we shun bread and other wheat-based foods like pasta and cereals.

Genuine food allergy is, in fact, rarely to blame, say experts. But wheat sensitivity (also known as wheat intolerance) or simply trouble digesting wheat is increasingly common.

Bread-related gut symptoms

"Probably one-third of patients in my allergy clinic complain of digestive symptoms such as bloating, diarrhoea, vomiting and stomach pain after eating bread," says Isabel Skypala PhD, specialist allergy dietitian at the Royal Brompton and Harefield NHS Foundation Trust.

She says allergy is unlikely to be the culprit, but bread-related symptoms are real and wheat could be to blame.

"Some people find certain foods are simply hard to digest and wheat appears to be one of those," she explains.

Read more about food intolerance.

The health problems caused by wheat

There are three key health problems caused by wheat:

• Wheat allergy – reactions usually begin within minutes and include itching, sneezing and wheezing. See your GP for referral to an NHS allergy clinic.
• Coeliac disease – is a condition where the intestine lining can't absorb and is damaged by gluten-containing foods including wheat, barley, oats and rye. See your GP for a blood test.
• Wheat sensitivity – symptoms like bloating, cramps, diarrhoea and sickness come on quite slowly, usually hours after eating wheat. There’s no diagnostic test.

What to do if wheat triggers digestive symptoms

If your symptoms are severe and long-lasting, especially if you have blood in your stools (poo), vomiting or painful stomach cramps, see your doctor to rule out a medical condition.

If you have bloating or other minor symptoms after eating bread, Dr Skypala recommends that you try an elimination diet. This is where you completely cut out wheat from your diet for four weeks, then bring it back in gradually to see if symptoms reappear.

"When you bring wheat-based foods back in, I recommend trying Weetabix or pasta first for a few days before starting on bread. It’s better to start with wheat in a more pure form, as bread has so many other ingredients," Dr Skypala says.

Is it wheat intolerance or sensitivity?

If your symptoms return, it confirms you’re sensitive to wheat and will also show you which foods are especially troublesome. Some people may only have problems with pasta, for example, while others are fine until they eat bread.

If you are sensitive to wheat, or you have trouble digesting it, the main way to relieve your symptoms is to embark on a wheat-free or partially wheat-free diet.

Foods that contain wheat

• Bread
• Pasta
• Cereals
• Couscous
• Cakes and pastries
• Biscuits
• Doughnuts
• Hydrolysed vegetable protein (HVP)
• Beer
• Soy sauce

Wheat-free foods

These foods are a great alternative to wheat-based ones:

• Porridge, Rice Krispies and corn flakes
• Buckwheat pasta
• Quinoa

The main sources of wheat

• Bread
• Pasta
• Cereals
• Couscous
• Cakes and pastries
• Biscuits
• Doughnuts
• Hydrolysed vegetable protein (HVP)
• Beer
• Soy sauce

These wheat-free foods are a great alternative:

• Porridge, rice crispies and cornflakes
• Buckwheat pasta
• Quinoa
• Popcorn

How to go on a wheat-free diet

Cutting out bread and other foods containing wheat shouldn’t harm your health, if you do it properly.

Wheat is one of our staple foods and lots of wheat products, such as breakfast cereals, are fortified with vitamins and minerals.

In the past, there was a danger of running short of essential nutrients like B vitamins and iron if you cut out wheat. But nowadays there’s a good range of widely available wheat-free alternatives that won’t compromise a balanced diet.

Read more about vitamins and minerals.

"There are great wheat substitutes that you can buy off the supermarket shelf now. Go for gluten-free bread and try other types of grains, such as quinoa, corn and rice," says Dr Skypala. "Just make sure you substitute other equally nutritious foods for the wheat-based ones you’re cutting out."

Be sure to cut out all wheat from your diet. Some sources of wheat are obvious, such as bread, but others are less so, such as soy sauce.

Tummy-friendly breads

The good news is that you might not need to cut out bread completely.

Some people with wheat sensitivity have no problems when they eat toast (cooked wheat tends to be easier to digest), sourdough bread, bread cooked with flour made from French wheat, or any bread from a specialist bakery, rather than a supermarket.

"Bakeries in supermarkets use the Chorleywood bread-making process, which cuts out the second rising, to speed up the baking. People seem to have more problems digesting supermarket breads, so I’d always recommend avoiding store-bought loaves," says Dr Skypala.

The anti-bloat FODMAP diet

A specific type of wheat-free diet may help certain people with wheat sensitivity.

Designed originally for people with irritable bowel syndrome (IBS), the low-FODMAP diet is now being recommended by dietitians to people who have problems digesting wheat.

It’s not a catchy name, but FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are types of carbohydrates that aren’t easily broken down and absorbed by the gut.

Essentially, the diet entails cutting out fermentable (FODMAP) foods that can cause bacterial growth, leading to diarrhoea and bloating. That means cutting out wheat and other fermentable foods such as onion, apple, pears, mushrooms, honey, cabbage and sometimes milk.

Long-term health conditions at school

If your child has a long-term health condition, such as asthma or diabetes, talk to their school about how their condition will be managed during the school day.

Watch a video about children with diabetes

There are more than a million children in the UK who have a long-term, or even lifelong, illness and need medicines for the forseeable future.

Children with medical needs have the same rights of admission to schools as other children.

Schools are legally obliged to ensure that all children with health needs are properly supported in school and have full access to education, including school trips and PE.

Schools, local authorities, health professionals and other support services are advised to work together to ensure that children with medical conditions receive a full education.

Common long-term health conditions in schoolchildren

Common long-term conditions that mainstream schools can manage include diabetes, asthma, epilepsy and allergies.

If your child has a long-term health condition, your school must ensure that arrangements are in place to support them.

The school may draw up an individual healthcare plan to help staff identify any necessary safety measures. This will help to protect your child and ensure that others aren't put at risk. As a parent, you and your child should be fully involved with and contribute as much as possible to the individual health plan.

How to talk to the school about your child's health condition

If your child has recently been diagnosed with a long-term condition, or you have a child with a long-term condition who is about to start school, contact your child's school to discuss how it will be managed.

Talk to your child’s GP or hospital specialist about the information you’ll need to give the school. They can also give you advice on the arrangements that the school may have to make, such as keeping medicines on site or helping to administer medicines. The information you give the school should include:

• details of medicines your child needs to take and when they're needed
• any side effects of the medicines
• what constitutes an emergency
• what to do, and not to do, in an emergency
• special requirements, such as dietary needs, and measures that must be taken before your child is physically active
• whether your child will need to be absent from school regularly to meet medical appointments.

Discuss with your GP or consultant how your child’s condition should be managed during the school day. For example, it may be possible to prescribe medicine for your child that can be taken before and after school, instead of in the middle of the day. It will probably be easier if your child’s condition can be managed effectively with minimal involvement from the school.

What to expect from the school

Your child’s school should have a medical conditions policy setting out how it supports children with long-term conditions. This policy will usually be published on the school's website. If it isn't, ask the school for a copy.

This policy will cover the following:

• How medicines will be managed and administered during the school day. Any member of staff administering medicines should be fully trained.
• How medicines will be managed and administered during school outings.
• Who the school will contact if there's an emergency.
• How the school will meet special needs, such as diet.
• How the school will help your child to participate in physical activity and school trips, if needed.
• The school should be able to agree with you on how it will manage your child’s condition during the school day.

Read our information on learning difficulties.

5 ways to stop snoring

Snoring is often linked to lifestyle, and there are some simple changes you can make to help prevent it.

Try these five self-help tips:

Maintain a healthy weight and diet. Being overweight by just a few kilos can lead to snoring. Fatty tissue around your neck squeezes the airway and prevents air flowing in and out freely.

Try to sleep on your side rather than your back. While sleeping on your back, your tongue, chin and any excess fatty tissue under your chin can relax and squash your airway. Sleeping on your side prevents this.

Avoid alcohol before going to bed. Alcohol makes your muscles relax more than usual during a normal night's sleep. This may encourage the back of your throat to collapse as you breathe, which causes snoring.

Quit or cut down on smoking. Cigarette smoke irritates the lining of your nose and throat, causing swelling and catarrh. This means airflow is decreased and you're more likely to snore.

Keep your nose clear, so that you breathe in through your nose rather than your mouth. If an allergy is blocking your nose, try antihistamine tablets or a nasal spray. Ask your pharmacist for advice, or see your GP, if you're affected by an allergy or any other condition that affects your nose or breathing, such as sinusitis.

Over-the-counter stop-snoring devices

There are a range of stop-snoring treatments and devices on sale. These include nasal strips, which open the nostrils wider, throat sprays and devices known as mandibular advancement devices (MAD), which reposition the jaw to improve airflow.

Your pharmacist can tell you what's available.

Medical help for snoring

If self-help doesn't work, there are other treatments you can try.

Read more about medical treatments for snoring.

Getting an allergy test

If you suspect that you or your child may have an allergy, you can use NHS services to get your allergy diagnosed. This may involve having one or more allergy tests.

An allergy test can establish whether you have an allergy and what you're allergic to. This is key to managing your condition.

If you have hay fever, you probably don't need allergy testing as it may be obvious from your symptoms that you're allergic to pollen.

But it's important to find out the precise cause if your symptoms are more complicated.

For example, perennial rhinitis – a runny nose all year round – can be triggered by a variety of allergens, such as house dust mites and mould, or a food allergy could be triggered by one of a number of foods in your diet.

Allergy testing can also help monitor a diagnosed allergy. For example, babies and children with certain food allergies often grow out of them.

A test can let the parents and child know they no longer have an allergy to milk or eggs, for example, so they no longer have to avoid that food.

NHS allergy testing

If you suspect an allergy, see your GP. If, after discussing your symptoms, your GP thinks you may have an allergy, they may offer a blood test – formally known as a RAST test – to identify the cause of your allergy.

Your GP may also refer you for testing. Most allergy tests are done in hospital outpatient clinics.

Not every NHS hospital has an allergy clinic, so you may have to wait longer and travel further for testing in some parts of the country.

Find your local NHS allergy clinic.

At the allergy clinic, the type of test you're offered will depend on your symptoms.

Possible tests include:

Skin prick test for allergens

A skin prick test is usually the first test to be done when looking for an allergen. It's quick, painless and safe, and you get the results within about 20 minutes. Your skin is pricked with a tiny amount of the suspected allergen to see if there's a reaction. If there is, the skin around the prick will very quickly become itchy and a red, swollen mark called a wheal will appear.

Blood test for allergens

The blood test used to test for allergens is called a specific IgE test, formally known as the RAST test. It's used to measure the number of IgE antibodies in your blood that have been produced by your immune system in response to a suspected allergen.

Patch test for a skin reaction

The patch test is used to see if a skin reaction – for example, eczema – is caused by contact with a specific chemical or substance. A small amount of the suspect substance or chemical, such as nickel, is added to special metal discs, which are taped to your skin for 48 hours and monitored for a reaction. This test is usually carried out at a dermatology department in a hospital.

Food challenge for food allergies

A food challenge, also called an oral challenge, is the most accurate way to diagnose a food allergy. During the test, you're given gradually increasing amounts of the food you think you are allergic to, to see how you react. Only one food can be tested at each appointment.

Private allergy testing

If you choose to have private allergy testing, make sure you see a trained specialist.

The Allergy UK helpline team can help you find your nearest NHS allergy clinic or consultant. The helpline number is 01322 619 898, and operates from 9am to 5pm, Monday to Friday.

The helpline team can also give advice on dealing with symptoms and products that may be beneficial for sufferers. They also have access to a panel of health experts for questions of a more complex medical nature.

Find out about treating allergies.

Eczema in children: 7 tips to stop the itch

Dr Colin Holden, consultant dermatologist, has these tips for parents of babies and small children with eczema.

Eczema triggers:

• pollens
• pollution
• dust mites
• animal hair
• heat, sun or cold
• soaps and detergents
• woollen clothing
• bacteria on the skin
• some foods
• infections such as flu
• stress

Get an eczema diagnosis

If you think your baby or child has eczema, see your GP to get a proper diagnosis and treatment. If necessary, your child may be referred to a dermatologist.

Don't try to treat eczema by yourself. Each case can need different treatment, which usually involves a combination of moisturisers (emollients) and steroid creams and ointments.

If their skin becomes red and starts to seep liquid, it may be infected, in which case see your GP immediately for antibiotics.

Give your child a bedtime routine

Children with eczema often find sleeping a problem, as their skin can get hotter and itchier at night. Keep their bedroom cool and use cotton sheets or a light, natural-fibre duvet.

Apply moisturiser at least 20 minutes before bedtime to allow it to soak in. Keep pets out of the bedroom, as dogs and cats can make eczema worse.

Your GP or pharmacist may be able to recommend a suitable sedative antihistamine that may help your child sleep during a particularly bad flare-up of symptoms.

Avoid harsh soaps, shampoos and bath oils

Soap and bubble bath can make eczema far worse, as can washing your child too often.

Bathe your baby in warm – not hot – water, and stick to fragrance-free soaps, shampoo and bath oil. Your pharmacist or GP can advise you on what products to buy.

Use lots of moisturiser

Dry skin is more likely to flare up or become infected with a bacteria or virus. Use moisturising creams on your child as directed by your GP to make sure the skin affected by eczema is kept as soft and moist as possible. Avoiding harsh soaps that dry out the skin will also help.

Read more about moisturisers and how to use them on a child with eczema.

Help your child to stop scratching

One of the biggest problems with childhood eczema is the urge to scratch the itchy skin, which may then bleed or become infected.

See if your child scratches at certain times of the day, for example while watching TV, and try to teach them to do something else instead, such as tightly holding their arm.

Praise them for not scratching, or even use a star chart. Keep their nails short.

Cotton bandages, vests and/or leggings can help keep the cream in the skin and help prevent your child from scratching.

Check your child's diet

Eczema usually starts when a baby is around six months old. In about 10% of cases it is triggered by foods, including milk, eggs, citrus fruit, chocolate, peanuts and colourings.

If you suspect a food is causing your child's eczema, it's important to seek advice from your GP before you cut out the food to make sure your child still gets a balanced diet.

Read more about food allergy and intolerance.

Keep your child cool

Heat can make the skin itch more, so after your child has been running around or playing sports try to keep them as cool as possible in loose clothing.

If they've been swimming, rinse off any chlorine from the pool, as this can irritate the skin.

Read more about eczema and how to treat it.