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Disclaimer: The content of all articles in this WeChat public account “Life in Balance” is to share information only. It is not intended to diagnose or treat any illnesses. Information here is not a substitute for advice from doctors or other health professionals. We do not make any implicit or explicit promise that anything described here will cure any illnesses.)
有慢性肠胃问题的人有着和常人不同的生活。他们总是小心翼翼，如履薄冰。他们生活在不断的担忧，甚⾄是恐惧当中。他们⽣怕⼀不小心吃错了东⻄就会引发下⼀轮的不适。他们在旅行的时候从不忘记带上备用药。他们可以吃的东西非常有限。尝试了各种药物和方法之后，他们总是将希望寄托在下⼀个新药或者下⼀个偏方上。但是似乎没有什么可以真正解决问题。随着时间的流逝，他们不得已学会了适应和接受：也许我就是这个样子。
People having chronic digestive problems have a different life. They live on eggshell. They tip toe around food. They live in constant worry and even fear. They are afraid of the wrong food trigging another bout of discomfort. They never go on a trip without ample supply of pills. They have a very restrictive diet. Having tried different kinds of medicines and remedies, they always pin their hope on the next pill and miracle cure. But nothing seems to really eradicate the problem. Over time, they have learned to adapt, to live with it, to accept it as part of their identity: that’s just the way I am.
我曾经就是这些人中的⼀员。“肠胃不好”曾经是我身份认同的⼀部分。我很清晰地记得⼩时候经常吃的那种帮助消化的橙红色的药丸，长大之后看到这种颜⾊我仍然会感到不适。我尝试过在各种各样的地⽅寻求答案和解脱。我喝过太多的中药制剂。我吃过无数的中成药。我吃过⽆数的西药。我做过针灸。我做过艾灸。我甚⾄做过胃镜，就是那种将⼀根喉管从您的喉咙⼀直插⼊胃中的检查。
I was one of them. “Poor digestion” has defined most of my life ever since I was small. I so vividly remember having to constantly taking the orang-colored pasty pill to ease digestion even as a toddler. Later even the sight of that color trigger unpleasant memories. My search for an answer and relief has led me to all sorts of places. I became an expert in ingesting the bitter, brown-colored tea from traditional Chinese herbs. I’ve also taken tablets from the herbs. I’ve taken pills from the western medicine. I’ve tried acupuncture. I’ve tried moxibustion. I’ve even had the invasive gastroscopy, where they insert a pipe through your throat all the way to your stomach.
有时候有些东西会有点⽤，但从来不能给我带来很多的解脱。后来当我开始彻底改变了饮食和⽣活⽅式之后，确实好了很多。但有些症状却怎么都不能清除：肚胀，不舒服，厚厚的⾆苔。和很多⼈⼀样，我学会了容忍，对付和接受。
Once in a while, something will help a little, but nothing really helped a lot. Over the years, as I started to adopt a healthier lifestyle and more nutritious diet, it gets better. But some symptoms remain: the bloating, the discomfort, and the thick coating on my tongue. So like many people, I’ve learned to anticipate, to manage, and to accept.
最终的根除纯属意外，揭示给我的原因也是我从没有料想到的。
Then, the eventual complete relief comes from the most unexpected place, revealing causes I would never have imagined possible.
⼤约两年前，我决定做⼀个全⾯的脑部健康的血检。其中⼀项结果让我很是吃惊：我的胰岛素过⾼，需要控制⾎糖。神经科专家建议我不要再吃任何简单碳水化合物，包括所有用白面做成的⻝物。
About two years ago I decided to do a comprehensive blood panel for cognitive function. One of the findings was shocking to me: my insulin level was too high. I needed to better control my blood sugar. The neurologist advised I stop eating simple carbohydrates all together, which includes all foods from white flour.
不⽤说，对于⼀个在中国北方长大，靠馒头和面条裹腹的⼈来说，这是个多么残忍的要求。但是，父亲的阿尔茨海默⽒症给予了我避免同样命运的坚定决心。为了保护脑健康，我什么都愿意做。于是我停止了⼀切面食。无论从精神上还是身体上，这都是⼀个充满挑战的经历。
Needless to say this is such a tall order for somebody who has grown up in north China on bread and noodles. However, my dad’s Alzheimer’s has instilled in me a strong determination to avoid the same fate. I will do anything to protect my brain health. So I stopped, cold turkey. It was quite a challenging experience, mentally and physically.
停止面食的⼀个⽉之后，我注意到⼀个很奇怪的现象：饭后的胀气几乎全部消失了， 厚舌苔不见了。
One month after I stopped eating all flour, something else got my attention: my bloating almost completely went away, and my tongue cleared up.
肠胃问题伴随了我的一生，我根本就不知道“正常”的感觉是什么。难道这才是⼀个⼈应该有的感觉？没有胀⽓？没有不适？什么都没有？！我几乎不敢相信。
I’d been living with digestive discomfort all my life, and I did not even know what it felt like to be normal. This is what you are supposed to feel after eating? No bloating? No discomfort? Nothing? Nothing at all? I could not believe it.
这是怎么回事？
What is happening?
当时，我研究健康和营养已经有⼀段时间了。所以很快就意识到了原因：麸质。
At this time, I’ve been steeped in health and wellness for quite a while. It did not take me long to realize what it is: gluten.
这当然不是我第⼀次听说麸质。对美国和世界其它地⽅的⽆麸质饮⻝趋势我相当了解。但是，我从来没有，做梦也不会想到，我⾃⼰会和无麸质有任何的关系。我曾经认为，无麸质无非是另外⼀个时尚潮流罢了。我们人类赖以为⽣这么久的东⻄怎么会突然成了健康隐患？我⼀直拒绝相信。
It is not the first time I’ve heard gluten. I was very aware of the gluten-free trend in the US and other parts of the world. But I never, not in my wildest dreams, have related this to myself. I used to think this thing called gluten is just another health fad. How on earth can something we humans have been eating for thousands of years suddenly cause problems to everyone? I would not believe it, until now.
在美国和许多⻄⽅国家，对麸质的认识和⽆麸质⻝品的开发在过去⼗⼏年呈爆发式的增⻓。根据 Grand View Research的报告，2019年全球⽆麸质产品市场规模为210亿，预计到2027年将超过 400亿，年增⻓率接近10％。但是在中国，对这个话题的讨论不多，公众对它的了解也很少。
The awareness of gluten and development of gluten-free food has grown exponentially in the US and a lot of western countries. According to a report by Grand View Research, the global gluten-free products is a 21 billion market in 2019, and is expected to reach more than 40 billion by 2027, with an annual growth rate close to 10%. But in China, it is not a much talked about topic and there is very little awareness among the public.
什么是麸质？
What is gluten?
麸质是某些⾕物中⼀种蛋⽩质的统称。常⻅含有这种蛋⽩的⾕物是⼩⻨，⼤⻨和⿊⻨。它是让⾯团富有弹性的那种成份，俗称“⾯筋”。不要将麸质与麸⽪混淆，麸⽪是⼩⻨种⼦的外层。
It is the collective name for a type of protein found in some grains, most common of which are wheat, barley and rye. It is part of the grain that make the dough stretchy and elastic.
什么是麸质敏感？
What is gluten sensitivity?
如果你对麸质敏感，你没有办法很好地消化含有麸质的⻝物。这种敏感性的范围很广，从轻微的不适到严重的免疫失调。患有乳糜泻的⼈对麸质极其敏感。如果⻝⽤麸质，会引发⾃身免疫系统对肠道的攻击。时间⻓了，小肠绒毛（小肠上的小毛状突起）就会严重受损，导致身体难以吸收营养。
If you are intolerant or sensitive to gluten, you cannot digest it well. The sensitivity could be a wide spectrum, ranging from slight discomfort to full on immunity attack. People with celiac disease are extremely sensitive to gluten. Every time gluten is consumed, immunity system triggers an attack on the intestines. Over time, the villi, the small hair-like protrusions on the small intestines, get damaged, leading to difficulty of absorbing nutrients.
麸质敏感如何影响健康？
What could gluten-sensitivity do to our health?
乳糜泻是麸质敏感中严重的，如果不及时发现，对健康影响巨⼤，甚⾄可以危及⽣命。美国女演员詹妮弗·埃斯波⻄托在她的书《詹妮弗的⽅式：我的乳糜泻之旅》中描述了她在寻找答案时的痛苦经历。
Celiac disease undetected could wreak serious havoc on one’s health, and could even be life threatening. American actress Jennifer Esposito described her painful search for an answer to her deteriorating health in her book: Jennifer’s Way: My Journey with Celiac Disease.
对于很多⼈来说，症状并不那么严重，但⼀样会带来很多困扰。它有可能表现为胃肠道症状，例如腹泻，便秘，腹胀，腹部不适等，也可能与消化症状完全⽆关，例如⽪疹，过敏，抑郁，关节痛，⼝疮，⾃闭症，甚⾄不育。是的，甚⾄是不育！
For a lot of people, the symptoms are not as dramatic, but could be as frustrating. It could manifest itself as gastrointestinal symptoms, such as diarrhea, constipation, bloating, abdominal discomfort, etc, it could also be something that is completely unrelated to digestion, such as skin rashes, allergies, depression, joint pain, mouth sores, autism, and even infertility. Yes, even infertility!
事实上，已经证实与与乳糜泻有关的病症有200多种！我个⼈认为麸质可能不会直接导致这些疾病。但是，因为我们的身体是⼀个非常复杂的自我修复机器，当⼀个部件无法正常运⾏时，整个系统就可能会崩溃，所以会导致的症状相当多。具有相同症状的两个⼈可能有完全不同的诱因。而诱因相同的两个人又可能具有完全不同的症状表现。
There has been around 200 symptoms that have been founded to be to linked to celiac disease. I personally think gluten may not directly lead to these diseases. However, our body is such an extremely complicated healing machine, when one part is not functioning as it is supposed to, the whole system breaks down, which can lead to every possible symptom there is. Two people with the same symptom may have completely differently causes. Two people having the same causes may have completely different manifestations.
值得⼀提的是，有些⼈可能根本没有任何明显的症状，他们也不知道自己对麸质有敏感。他们只是整个健康没有处于佳状态，症状要经过很长时间才会显现出来。
What is also worth mentioning is that some people may not have any obvious symptoms at all, and they have no clue they could be sensitive. They are just not performing at their optimal level, and symptoms may take years to develop.
为什么麸质敏感突然成了个全球性的⼤问题？
Why are we suddenly sensitive to gluten?
麸质敏感这个现象可能并没有我们想像的那么“突然”。早在公元⼀世纪，希腊医师卡帕多细亚的阿雷塔乌斯就对这种疾病进⾏了描述，说病⼈⽆法很好地消化⻝物，称其为腹腔素质，源于希腊语“腹部”。但是在随后的⼏个世纪中，没⼈能够更多了解其原因或治疗⽅法。
The sensitivity to gluten may not be as sudden as you think. As early as first century A.D, the greek physician Aretaeus of Cappadocia wrote about the disease, describing patients who would not digest their food well, calling it coeliac diathesis, stemming from Greek word “koala”, meaning abdomen. But for the centuries afterward, no one knew the cause or treatment.
残酷的第⼆次世界⼤战让这个疾病的研究取得了⼀些进展。荷兰在1944年经历了著名的“饥饿冬天”，当时⻝物极其短缺，几乎没有任何⾯包。荷兰儿科医⽣威廉·卡雷尔·迪克（Willem-Karel Dicke）发现患有乳糜泻的儿童的症状有所改善，有的⼈甚⾄体重有所增加。
It took the horror of World War II that some advancements was made. Holland went through the famous “Hunger Winter” in 1944, when very little food was available, almost no bread at all. Dutch pediatrician Willem-Karel Dicke found children with celiac disease were seeing improvement in their symptoms, and some even gained some weight.
1945年后，饥荒结束，粮⻝供应恢复，乳糜泻患者的症状⼜出现了。那时迪克博士做出了⼀个重要发现，成为了未来对肤质敏感性研究的基⽯：不含小麦的饮⻝可以帮助乳糜泻病⼈的恢复。
After 1945, when the famine ended and food supplies came back, so did the symptoms of celiac patients. That’s when Dr. Dicke made the important discovery that served as the cornerstone for future research in gluten sensitivity: wheat-free diet led to celiac disease recovery.
关于为什么有些⼈不能消化麸质这个问题，营养界有不同的思想流派，但似乎没有什么结论。有人认为人类就不应该食用小麦，这是许多现代疾病的真正根源。有人认为这与小麦的现代种植方式有关，包括广泛使⽤草甘膦，以及其它除草剂和杀⾍剂，还有谷物的交叉育种。但无论是什么原因，有⼀个东⻄是事实：有些人无法消化麸质。
As to why some people cannot digest gluten, there are different school of thoughts and there does not seem to be a conclusion. Some people think humans should not have started eating wheat in the first place and it is the root cause of many modern diseases. Some people think it has something to do with the way the wheat is farmed in the modern day, including wide use of glyphosate and other fungicides, pesticides, and cross breeding of grains. Whatever reasons there may be, some people suffer from gluten sensitivity is a fact.
我怎么知道我是不是对麸质敏感？
How do I know if I am gluten sensitive?
现在医学界已经开发出⼀些测试麸质敏感性和乳糜泻的方法，例如HLA-DQ，肠活检。如果结果是阳性的，你很可能具有敏感性，但是如果结果是阴性的，并不意味着你完全没有任何敏感性，因为这些测试⽆法囊括所有影响麸质的因素。正是因为这个原因，许多医⽣建议尝试断绝麸质⻝物⼀段时间是最好的确认⽅法。
There have been some diagnostic tests developed to detect gluten sensitivity and celiac disease, such as HLA-DQ, intestinal biopsy. If you get a positive result, very likely you are sensitive. But if you get a negative result, it does not mean you don’t have any sensitivity at all, as there are other factors that cannot be picked up by these tests. For this very reason, a lot of doctors recommend eliminating gluten from diet as the best way to know with greater certainty.
总结
Bottom Line
仔细倾听你身体的信号！有可能它很⻓时间想告诉你些什么，但你从来没有去管它。如果你有慢性胃肠道症状，而且似乎什么都不能将它根除；如果你发现⾃⼰开始对越来越多的食物过敏；如果你患有慢性⽪肤问题，这些都可能与麸质有关。将它从饮⻝中彻底消除三到四个星期，看看对你有什么影响。如果很难完全不吃含面粉的⻝物，可以试着⼀步步减少。也可以尝试⼀下小麦的替代品，例如⼤杏仁面粉，椰子面粉，玉米面粉，地瓜面粉，荞⻨面粉。但是，你需要⾄少三周完全无麸质的饮食才可以看到真正的改善。
Listen to your body, listen to your body, listen to your body! It may have tried to tell you something for a long time, and you have dismissed it. If you have chronic gastro-intestinal symptoms and nothing seems to have completely eradicated it, if you find yourself allergic to more and more foods, if you have chronic skin issues, there is some possibility that it may be linked to gluten. Eliminate it from your diet for three to four weeks and see what happens. If it is too difficult to completely eliminate foods from flour, try to do it gradually. Experiment with other wheat flour alternatives, such as almond flour, coconut flour, corn flour, sweet potato flour, buckwheat flour. However, you need to be entirely gluten-free for at least three weeks to see real improvements.
如果我没有偶然发现我对麸质敏感，我仍然会认为消化不良是我⼀辈⼦的伴侣。它解开了我的迷惑，免去了我更多年的困扰。如果你有慢性胃肠道问题，这绝对是值得尝试的。
I would still think poor digestion is just something I have, if I did not stumble upon the glutenfree diet forced upon me. It solved my mystery and saved me from more years of frustration. If you have chronic gastrointestinal problems, this is definitely worth trying.
