With all the confusion lately on gluten intolerance and Celiac disease (Domino’s Gluten-Free Pizza Okay for Sensitive Eaters?), we wanted to post this Q&A again to help give some guidance and clear up the confusion.
What Is Celiac Disease?
Celiac disease is a hereditary allergy to gluten that results in damage to the small intestine. Common symptoms include loose stools, fatigue, weight loss and generally poor health. However, symptoms can vary widely and include constipation, weight gain, and a skin condition called dermatitis herpetiformis.
What Is Gluten?
Gluten is a protein found in wheat, barley, and rye. Gluten is responsible for the springiness and stretchiness of bread. Without it, bread turns out heavy and dense.
How Is Celiac Disease Diagnosed?
Celiac disease can be assessed by blood tests or by a biopsy of the small intestine performed during an upper endoscopy. The blood tests include the tissue transglutaminase antibody test and the newer deamidated gliadin antibody test. The endomysial antibody test is older and is not as senstive as the newer tests.
How Common Is Celiac Disease?
The occurrence of celiac disease is much higher than previously thought. A recent study put the prevalence at 1 in every 133 people, making it one the most common genetic diseases known. Once diagnosed, 1 in 22 first degree relatives, and 1 in 39 second degree relatives, is also diagnosed positive.
How Common Are Gluten Allergies?
Although no studies have been done on the prevalence of gluten intolerance, the prevalence of gluten allergies is certainly higher than that of celiac disease alone.
How Is Celiac Disease Different from a Gluten Intolerance?
Although celiac disease is a gluten allergy, it is only one form of gluten allergy. Many react to gluten and may have elevated serum antigliadin antibodies, but they do not have damage to the small intestine. These people have a negative biopsy of the small intestine, as well as negative antiendomysial antibody and tissue transglutaminase tests.
What Is the Treatment for Celiac Disease and Gluten Intolerance?
The treatment is identical for both celiac disease and gluten intolerance and involves removing all sources of gluten from the diet. This means that a person with a gluten allergy should not eat bread products, pastas, or processed food of any kind that contains wheat, rye, or barley in any form. Individuals require special dietary counseling. Fortunately, many alternative sources for gluten free breads, pastas and other foods now exist and are easier than ever to find.
What Are the Results of Avoiding Gluten?
If you are allergic to gluten, then the result of removing gluten from your diet is generally a reversal of your health problems. Symptoms very often resolve, some faster than others, and you gain a new definition of optimal health. Even celiac disease is reversed, usually resulting in complete recovery of the damage to the small intestine.
What if Someone with a Gluten Allergy Chooses Not to Avoid Gluten?
Of course, they continue to suffer the symptoms that their gluten allergy is causing. However, the long term consequences are much more severe. People with celiac disease are known to be at higher risk for many conditions, including cancer of the digestive tract, thyroid problems, anemia, osteoporosis, and many autoimmune conditions. If you or someone you know suffers from any of the symptoms listed above, be sure to be screened for food allergies via blood testing.
Image thanks to celiacsmart.com
Dr. Stephen Wangen is the award winning author of two books on solving digestive disorders, and a nationally recognized speaker on IBS. He has been on ABC, NBC, and Fox as well as public radio. He was recently named one of Seattle’s Top Doctors by Seattle Magazine.