It is impossible to go into any supermarket in this day and age and not see a growing section of gluten free foods. Many people see gluten as the root of all evil but it, like many other foods, has a role in our diet. Some people cannot have gluten for one reason or another but there are distinct differences in the conditions associated with gluten. The first step is understanding what gluten is. Many different wheat and other grains have a protein known as gluten which helps to bind certain foods together. It is a necessary component of certain grains and allows food to maintain its shape and consistency. This is one of the reasons that flour and water can be turned into glue. Gluten is a very elastic and binding protein.
While many people can eat gluten without any problems, some react poorly to it. There are a few different conditions and it is important to understand each. The more significant one is Celiac disease. This is not an allergy but an autoimmune disease. The distinction is important because the treatment is different. If a person has an allergy to a substance, they can develop rash, hives, tongue swelling, shortness of breath, throat closing and they would respond to anti-histamines, steroids and allergy treatment. In an allergy, the body produces histamine which is released and causes the classic symptoms of an allergic reaction. In celiac disease, the gluten stimulates the body to have an immune reaction and generate antibodies. These antibodies can cause the various symptoms of celiac, from joint discomfort, diarrhea, liver inflammation, poor absorption of nutrients, osteoporosis, infertility and many others. The most serious concern is intestinal lymphoma.
Celiac is not a problem of digestion, although it can because digestive symptoms; and it is not an allergy. Celiac is also very common with approximately 1 in 150 people having the disease. The diagnosis is made through blood testing for antibodies, genetic testing for specific markers, or a biopsy of the stomach lining with and endoscopy, a camera that looks inside the stomach. The antibody test will not be accurate if the person is avoiding gluten as it will lead to a false negative result unless the person stimulates the production of celiac antibodies. The genetic test shows if someone is likely to develop the disease but it is possible to have a genetic mutation without any symptoms or problems. Finally, the biopsy can show changes in the intestinal lining that suggest celiac. The most serious concern for celiac is the development of intestinal lymphoma.
Gluten sensitivity is a completely different entity that does not have the same issues as true celiac disease. A person can feel unwell with intestinal issues, joint issues, and other symptoms that are not representative of celiac. The gluten sensitivity cannot be detected in the blood and does not carry the same risk of lymphoma. It is very difficult to diagnose gluten sensitivity for those reasons. Generally speaking, if a patient feels better avoiding gluten then they certainly can.
The bottom line is that celiac disease and gluten are common and potentially serious issues that greatly impact a patient’s quality of life. It is important to recognize the condition, diagnose it early and treat appropriately. It is equally as important to understand the difference between each condition and respond accordingly. If you suspect that you have celiac disease or gluten sensitivity, you should speak with your physician and find out what your options are.
