Neither pâté nor canker sores are photogenic, so enjoy this flippin' adorable puppy.

I ate some bad paté the other day.

Bad for two reasons: one, it just wasn’t that good. Two, despite what I thought was a careful ingredient check, I got glutened.

How do I know? Because I woke up the next morning with a canker sore. Ugh.

It’s been a while since I had one of those; in fact, it’s probably been since the last time I ate something I shouldn’t have. These days the correlation is pretty strong, but it took me a while to realize that the two were related. I don’t remember now if I found out by reading it online, or just by connecting the dots with my own symptoms.

So, does one condition necessitate the other? As with so much celiac research, the answer is, “sometimes, maybe.”

Canker sores in general are poorly-understood. They’re not cold sores nor are they related to herpes in any way. They’re not contagious. They don’t appear on the outside of your mouth. According to the Mayo Clinic, canker sores are, “small, shallow lesions that develop on the soft tissues in your mouth and at the base of your gum.”

It’s an accurate description; if I get one it’s a week or so of annoyance until it goes away. In high school I got them intermittently, thankfully never to the degree of severity that you can find if you search online (I don’t recommend you do this search, and I double-don’t-recommend looking at pictures).

The Mayo Clinic lists a whole variety of possible causes: a minor injury to the mouth, food sensitivities, bacteria, a compromised immune system, stress, lack of B-12, folate and iron, being female, products containing sodium lauryl sulfate…and of course, celiac disease.

In terms of prevention, the best thing to do is treat yourself well: make sure your vitamin levels are on target, don’t cheat on the gluten-free diet, don’t stress too much.

If you get particularly painful canker sores, there are a handful of pastes and medications on the market, many of which you’d need a prescription for / are really geared towards a debilitating outbreak. I don’t have any experience with them, but I do find that ice feels nice and a standard OTC mouthwash twice daily seems to shorten the duration notably.

Interestingly, some research from Tehran suggests that for some celiacs, canker sores are the only outward symptom. So if you know anyone who refuses to get tested for celiac but gets canker sores, this might be the way to finally get them into the doctor’s office.

Is this a symptom you or anyone you know gets? How do you handle it?