Selena De Vries, RD on Digestive Enzymes for Celiacs: Yay or Nay?
Here’s a question that was submitted to Selena De Vries, RD during a recent Tuesday Instagram Q & A.
Question – What are your thoughts on digestive enzymes?
Answer – Digestive enzymes are made up of proteins that help to degrade different types of molecules – carbohydrates, fats, and proteins. They can be helpful in a few circumstances.
#1 You have been diagnosed with pancreatic insufficiency. This is a condition in which your pancreas does not make enough digestive enzymes to adequately digest your food leading to digestive distress. It is relatively rare but if you have this condition, you will be prescribed enzymes from your gastroenterologist.
#2. You have lactose intolerance. At the beginning of diagnosis, a secondary lactose intolerance can develop and it is common in celiac disease because of small intestinal damage. However, it’s important to understand that lactose intolerance does not mean eliminating all dairy containing foods. Only certain dairy products contain lactose and with lactose intolerance, it is often dose dependent. This means you can have some lactose containing dairy until you hit your unique threshold. Once you pass your threshold, symptoms develop. So, sometimes short term use of an over the counter lactase enzyme taken with food can help so you don’t need to also restrict lactose containing foods from the diet.
#3. You have a FODMAP sensitivity of either of the following: galactans, fructans. FODMAP is a acronym that includes carbohydrates that are highly fermentable and can cause GI distress in susceptible individuals. If you have persistent symptoms, this may be due to an additional diagnosis such as irritable bowel syndrome (IBS). The low FODMAP diet is a short term exclusionary diet that is an evidence based diet to help manage this condition. With celiac disease, there is often a significant shift in the diet towards foods that contain FODMAPs and this is actually a common cause of persistent symptoms in people with celiac. Taking enzyme supplements that are targeted toward the specific FODMAP group that the person is unable to tolerate helps to expand the diet and improve enjoyment of food.
- However, most people wonder about taking just a general over the counter digestive enzyme.
- These won’t do anything to help digestion. It will drain your pocket of money though!
- Your pancreas works just fine if you’ve been diagnosed with celiac. There is no reason to supplement with a general digestive enzyme just because you’ve been diagnosed.
Further to this, even if you have persistent symptoms, they contain such minute amounts of multiple different enzymes, that they don’t contain enough of any one type to be helpful.
And, they are quite costly. Save your money and work with an experienced gut health dietitian, like myself, if you’re struggling with symptoms.
When it comes to enzyme supplementation, it’s all about understanding the person’s symptoms and tailoring the recommendations to the specific individual. Generalized advice isn’t going to help anyone find relief.
Live Gluten Free with Ease – an intimate small group coaching program to help you master the gluten free diet so you can live gluten free with more ease.
- Book a free 20-minute strategy call online video chat
- Fill out the 5 question application (after you book the time for the call)
- Check your email for confirmation and link to our call
During this Zoom call, we will get to know each other a little more! I’ll ask you about your struggles and challenges with celiac disease and discuss your goals. Then, if appropriate, I’ll share more about me and how my program may help you reach those goals.
Looking forward to talking soon!
Does This Describe You?
- Overwhelmed with the conflicting information you read on the internet?
- At a loss. You can’t, possibly, fathom that there is anything left to try to feel better?
- Frustrated that you are continuing to struggle with ongoing symptoms such as constipation, bloat and fatigue?
Ask to Join the Symptom Relief Facebook Group
This Group Is For You If You Want To:
- Discover if it’s gluten or something else that’s the issue
- Identify your digestive triggers
- Create a do-able plan for long-term relief
🎙 Selena De Vries speaks with Andrea Hardy on her podcast, ‘Let’s Gut Real.’ Listen to the podcast here!
Selena De Vries is dedicated to helping individuals struggling with digestive issues find food freedom. Selena understands that celiac disease not only effects one’s physical health but also effects one’s emotional health. Using an integrative approach in the management of digestive health conditions, she provides support for those with celiac disease/gluten sensitivity and nutrition coaching for other digestive health conditions.
Selena’s services are available online to anyone in Canada. Living in the Okanagan or anywhere in British Columbia? View Selena’s services or book an appointment!
‘Q&A Tuesdays on Instagram’
Your chance to submit any questions you may have on nutrition, education or receive downright free advice! Ask by 4pm Pacific Time and get your answer the same day!
How it works!
1. Visit Selena’s profile at https://www.instagram.com/celiac_dietitian/
2. Click on her profile picture (screenshot 1)
3. Wait until you see the “ask me a question” sticker and then click it and type your question (screenshot 2)
4. Receive your answer by clicking through Selena’s stories i.e. the same spot where you entered your question
Celiac Total Health Package – 5 sessions
- Includes one initial assessment, 3 follow ups and a meal planning assessment along with a one week meal plan. Selena will recommend labs/procedure to identify any underlying nutrient deficiencies, will provide you with all the education you need to feel confident going gluten free and get you feeling better throughout our appointments, and most importantly, help you prepare and choose healthy GF products and get healthy GF meals on the table that the whole family can enjoy. Book your appointment or contact Selena with questions.
Eating Out With Confidence – 3 sessions
- Are you avoiding eating out due to the fear of being ‘glutened?” If so, this package is for you. Selena will provide you with education and resources that will improve your confidence in eating out safely. You will also get access to her on the go! For example, if you are eating out at a restaurant and need help in ordering your meal to reduce risk of being contaminated, she will walk you through what you need to ask to ensure your meal is at low risk of being contaminated. Book your appointment or contact Selena with questions.
Meal Planning Initial Assessment – 1 hour In-person – Online, video chat or by phone
- If you are struggling with getting healthy meals on the table that everyone can eat, this is for you. Selena will conduct a meal planning assessment and based on your input, she will put together a sample one week meal plan along with brand name food recommendations. You will get recommendations that makes healthy eating (with food restrictions), convenient, healthy and delicious. Book your appointment or contact Selena with questions.
Celiac Initial Consultation – 1 hour 30 minutes In-person, online, video chat or by phone
- Please book if you have been newly diagnosed with celiac disease or if you have celiac disease but are still struggling with symptoms. Selena will conduct a nutrition assessment & will provide an emailed lifestyle plan within 24 hours detailing the nutrition plan going forward. Supplements and lab tests will be recommended on an individual basis and the lifestyle plan will also include educational handouts, recipe ideas, and brand name food recommendations. Allow a minimum of 3 days advance booking as a 3 day food journal is required prior to the appointment. Book your appointment or contact Selena with questions.
Celiac Dietitian on Demand – 30 minutes – Online, video chat or by phone
- This is not for newly diagnosed celiacs or those who are struggling with digestive symptoms. If this is you, please book the initial consult (either celiac or digestive health). This is for you if your symptoms are fairly under control and you have brief questions. For example, a question on supplement use, the inclusion of GF oats in the diet, if you are grocery shopping and want to confirm if a brand name product is gluten free and safe to consume, if you are at a restaurant and want to know how to order an item that will be at low risk for being contaminated, or if you have questions on GF travel. Book your appointment or contact Selena with questions.
Initial Digestive Health Consult – 1 hour 15 minutes – In-person, online, video chat or by phone
- Please book if you are struggling with digestive health concerns or have been diagnosed with a digestive health condition (if you have been diagnosed with celiac, please book the celiac specific consult). Selena will conduct a nutrition assessment & will provide an emailed lifestyle plan within 24 hours detailing the nutrition plan going forward. Supplement, lab tests and lifestyle recommendations will be recommended on an individual basis and the lifestyle plan will also include educational handouts, recipe ideas, and brand name food recommendations. Allow a minimum of 3 days advance booking as a 3 day food journal is required prior to the appointment. Book your appointment or contact Selena with questions.
45 Minute Follow Up Appointment – In-person, online, video chat or by phone
This service can only be booked after an initial consultation has been completed. We will identify how the individual is doing on goals, barriers they may be facing, and steps to take going forward. Book your appointment or contact Selena with questions.
- “I contacted Selena when I still wasn’t feeling well a year after my celiac diagnosis. I’d read so much on the Internet I thought I knew everything I needed to know. I was wrong.
- Selena has important advice on how to do GF properly (it’s not as straightforward as I thought) and for regaining your health. She is organized, punctual, and professional. And she has celiac disease herself , so she gets it.
- I think a lot of us, by the time we’re diagnosed, have had more than our share of health care practitioners and may not want to bother with a dietitian.
- Selena played a crucial role in my recovery, and I would highly recommend her, whether you’re newly diagnosed or just trying to feel better.”
- ~ Charlene (long-distance celiac disease client)
- HEALTHBEAN NUTRITION specializes in digestive health. We deliver easy to digest, bite-size pieces of information so our clients can, finally, achieve the healthy & happy digestive system they’ve been striving for. Learn more ...
- HEALTHBEAN PHILOSOPHY– Selena employs elimination diets and/or a specific diets in accordance with her clients’ conditions, and only when deemed necessary. She reserves advice about the gluten-free diet for those who require it – not those choosing to follow the diet as a lifestyle choice. Expect clear, concise instructions on the appropriate diet for you and, maybe even some myth busting! Learn more …
Selena knows first-hand how her undiagnosed celiac disease affected her physical and emotional health. After telling her that, “Well, you have celiac disease,” her MD suggested she, “google the diet,” and out the door she went. Sound familiar?
That’s why Selena established Healthbean Nutrition. She is dedicating her education, personal insights and her own recovery to helping her fellow celiacs make this enormous lifestyle transition – and find joy in eating again! Learn more …
Selena’s Road to Diagnosis
- “When I was going through university, I was exhausted, ALL the time. I had to drag myself out to hang out with friends, and if I had it my way I would have spent most days in bed sleeping. It was not unknown for me to sleep 12-16 hours a day. Call me crazy, but I related it all to the busy-ness of school. I was even checked for anemia at one point (common with celiacs) and I was ‘fine.’
- The symptoms continued through school and the brain fog was undeniable. I distinctly remember during my dietetic internship (like a medical residency except everything is nutrition based) at Kelowna General Hospital sitting in the office, charting on a patient and, literally, feeling like my brain was so fuzzy that I could barely keep my eyes from nodding off. It was awful.
- Another thing I didn’t pay much attention to, was bowels. I was always constipated. Never the other way around. Never. And, I also remember mentioning this to my gastroenterologist just before the endoscopy and he said ‘oh, well with your very low antibody levels and constipation, there is a very low chance that you are actually celiac but we will proceed with the endoscopy since you’re prepped and ready to go.’
- The piece of paper I received after the endoscopy said to follow up with my GP. I did follow up with my GP and the report came back positive for celiac disease. My GP said “well, you’re celiac. But, you’re a dietitian, right, so this should be easy for you!”
- Perhaps I had a leg up in the nutrition part of it, but I think we all know that the gluten free diet is not a walk in the park. And, although, I am so appreciative of the medical care I received, it did open my eyes to the lack of knowledge within the medical community when it came to celiac disease and the lack of support offered to individuals with celiac disease.
That’s how Healthbean Nutrition was born!
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- *Information and perspectives posted on The Celiac Scene are intended to provide general information, without independent verification on the part of The Celiac Scene for the accuracy of the information provided to it. The information is specifically not intended to be a substitute for medical diagnosis or treatment by your physician or other health care professional. Always consult your own physician or other health care professionals about any medical questions, diagnosis, or treatment, especially before trying any diet. Healthbean Nutrition does not accept any liability for any injury, loss or damage incurred by use of or reliance on any content contained herein.