Gluten is a general name for the proteins found in wheat, barley, and rye. Gluten gives dough its elasticity, and it helps dough rise while still keeping its shape. Gluten also gives breads and other products a chewy texture.
For most people, gluten is neither beneficial nor detrimental to health. However, gluten is dangerous for people with gluten-related disorders like celiac disease, non-celiac gluten sensitivity, and wheat allergy. Following a strict gluten-free diet is required for people with these conditions.
Celiac disease is a genetic autoimmune disorder that affects 1-2% of the population worldwide. When people with celiac disease eat gluten, their immune system recognizes the gluten as a foreign invader and attacks it. This abnormal immune response leads to damage in the small intestine. When the small intestine becomes damaged, nutrients cannot be absorbed properly into the body. This can lead to nutrient deficiencies and other serious health problems. A gluten-free diet is the only treatment for celiac disease. Even small amounts of gluten, like crumbs from a cutting board, can trigger intestinal damage.
Celiac disease is hereditary, meaning that it runs in families. People with an immediate relative with celiac disease (such as a parent, child, or sibling) have a 1 in 10 risk of developing the disease.
There are more than 200 symptoms associated with celiac disease! The most common symptoms are felt in the gut, including abdominal pain, bloating, gas, diarrhea, and constipation. However, symptoms are reported in other areas of the body as well. For example, when those with celiac consume gluten, they may experience depression, “foggy mind”, headaches, ADHD-like behavior, weight loss, bone or joint pain, weakness, and/or chronic fatigue.
A simple blood test can screen for celiac disease. However, you must be on a gluten-containing diet for the test to accurately detect celiac disease. This means that people who remove gluten from the diet before being tested may receive a falsely negative test. A biopsy of the small intestine is used to confirm a celiac disease diagnosis.
Other Gluten-Related Disorders
Non-Celiac Gluten Sensitivity
Some people experience the symptoms of celiac disease when they have gluten in their diet, yet do not test positive for celiac disease. This condition may be referred to as “non-celiac gluten sensitivity” (NCGS), “non-celiac wheat sensitivity” (NCWS), or simply “gluten sensitivity”. Removing gluten from the diet resolves symptoms. It is estimated that NCGS affects between 0.5-13% of the general population.
Until recently, it was thought that those with NCGS experienced celiac-like symptoms but did not have any intestinal damage. However, new research suggests that those with NCGS experience an immune reaction and accompanying intestinal cell damage, similar to that of celiac disease. At this point, researchers are still unsure if gluten is causing the immune reaction and cell damage, or if it is another component in gluten-containing foods.
There is no blood test that can diagnose NCGS. NCGS is usually diagnosed by ruling out other gluten-related disorders. The only treatment for NCGS is a gluten-free diet.
Wheat Allergy is an abnormal immune response to the proteins in wheat.
Wheat allergy is among the eight most common allergens, also called the “Big 8”. It is estimated that wheat allergy affects 0.5-9% of the population worldwide. Wheat allergy is most common in children, though they often outgrow the allergy by adulthood.
Symptoms of wheat allergy include irritation of the mouth and throat, hives, nasal congestion, headache, itchy eyes, difficulty breathing, nausea, vomiting, diarrhea, and anaphylaxis. Symptoms may range from mild to severe. Wheat allergy is detected with a skin-prick allergy test or a blood test.
Wheat allergy is treated by removing wheat from the diet. Other gluten-containing grains, such as barley and rye, are safe to consume so long as they are not contaminated with wheat.
The above information is not meant to take the place of medical advice. If you think you or a loved-one may have celiac disease or another gluten-related disorder, contact your physician to discuss your symptoms, diagnosis, and treatment.