Gluten Intolerance: What is it?

 Gluten is a protein found in grains that 99% of the population eat without health risks unless when eaten in excess causing weight gain. Many of the good foods we eat everyday and with every meal contain gluten. Bread, pasta, cereals and many processed foods, even cold-cuts and salad dressings contain the culprit. Some candies contain gluten, too. So, to follow a gluten-free diet is not easy. Most people would not want to follow this restrictive diet for life unless it had proven value.

Symptoms of gluten intolerance include bloating, upset stomach, abdominal pain, weight loss and diarrhea. True gluten intolerance is an autoimmune disease in which the body mounts an inappropriate immune response against its own cells. The disease runs in families. It is sometimes becomes active after surgery, pregnancy, infections or severe emotional stress.

Nutrients including protein, carbohydrates, fats, vitamins and minerals are absorbed into the body via tiny projections in the small intestine called villi. In people affected by gluten intolerance or celiac disease (also known as gluten sensitive enteropathy or sprue), inflammation and damage to the villi occurs when they eat foods containing wheat, rye and barley. The damaged villi cannot absorb nutrients so gluten intolerant people become malnourished and lose weight.

Affected people may also develop lactose intolerance, vitamin deficiency, neuropathy with loss of sensation in feet and hands, skin problems and oral ulcers. Many other symptoms are attributable to the malabsorption: iron deficiency anemia, osteoporosis, fatigue, depression, menstrual irregularity and infertility.

To make a definitive diagnosis, a very sensitive blood test to detect the autoantibodies reacting against the intestine can be done. The autoantibodies are known as: Anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). If you are not eating gluten when you are evaluated, the test will be negative even if the disease is present. In fact, the test must be done before you quit eating gluten because without the stimulus from the abnormal protein, antibodies decrease and return to normal within three-six months. People who have an accurate but negative test and still find they are symptomatic when they eat gluten are said to be gluten-sensitive.

Gluten intolerance can develop at any time. Right now it seems to be a fad to go “gluten-free.” A gluten-free diet is healthy, but there is no scientific evidence that a gluten-free diet is any healthier than a diet containing gluten grains, unless of course, you are gluten-intolerant or actually have the autoimmune disease. A gluten-free diet eliminates wheat, barley, rye and oats, while including corn, nuts, potatoes, rice, soy and wild rice.

Find more information from the Celiac Disease Foundation at: www.celiac.org

Betty Kuffel, MD