The Effects Of Gluten In Diet

Gluten, the name for a group of proteins found in wheat, barley and rye, is one of the eight most common food allergies in the United States, according to the American Celiac Disease Alliance. Three separate gluten-related disorders display similar symptoms but only one, celiac disease, has a distinct clinical profile. Experts don't doubt that the other two are real but as Harvard Medical School gastroenterologist Daniel Leffler says, defining them in medical terms is "a moving target."

Celiac Disease

When people with celiac disease eat foods containing gluten, their autoimmune systems respond by producing signature antibodies that show up in blood tests. In addition, genetic screening will reveal abnormalities in two specific genes. Even though everyone with CD has these genetic markers, for reasons unknown, not everyone with the genetic predisposition gets CD. Babies may be born with the disease or it may emerge at any stage of life. In CD, the villi, hair-like protrusions in the small intestine crucial for the absorption of food nutrients, are flattened, damage observable in tissue collected during an intestinal biopsy. Current estimates are that about 1 percent of the American population has CD and prevalence is on the rise, according to the Mayo Clinic.

Non-Celiac Gluten Intolerance

Other adverse reactions to gluten affect an estimated 10 percent of the population, according to a CNN report, but while outward symptoms may resemble those associated with CD, antibody tests will be negative, screening will show no genetic abnormalities and villi will appear normal in biopsied tissue. According to Leffler, non-celiac gluten intolerance, NCGI, is a "default" diagnosis that doesn't yet have a clinically acceptable definition. This "spectrum" of interrelated conditions is poorly understood, but intensive research continues and the picture becomes clearer with every study published. The American Celiac Disease Alliance says that wheat allergy is also thought to be caused by an autoimmune reaction -- but of a different kind than the one causing CD. Finally, gluten intolerance is the name given to adverse reactions that are neither CD nor wheat allergy and are not believed to involve the autoimmune system.

Symptoms and Diagnosis

When CD and its relatives present symptoms such as vomiting, unintentional weight loss, bloating, abdominal pain, flatulence, and constipation or diarrhea, doctors may suspect that gluten is the culprit. Unfortunately, the main reason that CD is so often misdiagnosed is that symptoms often suggest causes other than the digestive disorders associated with "classical" CD. Among them may be neurological impairment, fatigue, lactose intolerance and other food allergies, a wide range of apparent immune system disorders, skin rashes, and vitamin and mineral deficiencies. Sometimes, there are no symptoms at all, even though the small intestine is steadily incurring damage. Typically, adults with CD suffer for years before the condition is correctly diagnosed.

Treatment and Prognosis

At present, the only treatment for CD and other forms of gluten sensitivity is strict adherence to a gluten-free diet, which requires a major change in eating habits. Many sauces and prepared foods contain gluten, so people must become experts at scanning labels. In time, the villi of most celiacs will regenerate, but untreated CD is associated with significantly increased risks for serious medical conditions including other autoimmune disorders, colon cancer and non-Hodgkin's lymphoma. Pharmaceuticals designed to detoxify gluten before it reaches the small intestines of people with CD are under development.