Medical student's apparent celiac disease responded to giardiasis treatment

Wild. So how exactly did cutting gluten out of his diet mask his symptoms that effectively? Does gluten somehow feed/provoke the giardia? Or were the dietary changes mostly irrelevant?

This isn’t an uncommon presentation - disease processes that lead to inflammation of the small bowel can be expected to resemble gluten sensitivity.

Gluten consumption, on its own, can cause small bowel inflammation and this effect is well known (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677194/)

That's interesting—I know that NCGS is somewhat controversial and its causes aren't totally understood, so this makes me wonder how many people with NCGS have some other, undiagnosed underlying condition that the gluten's aggravating.

One confounder with gluten is that every single type of bread except well produced sourdough is high fodmap. And fodmaps can produce a lot of digestive symptoms.

Celiac is more well known than fodmap issues, and you'd have apparent causality. Eat bread, feel bad. Don't eat bread, feel better.

But not perfect, as many other foods are high fodmap.

Anyway it turns out those with giardisis are sensitive to high fodmap foods so perhaps that could explain it. (Surprisingly also sensitive to low fodmap foods)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653841/