Celiac disease is an autoimmune disorders caused by gluten, a protein in wheat, rye, barley, spelt and oats. The gluten prompts T-cells to release antibodies to destroy the villi of the small intestine, interfering with nutrient absorption and causing gastrointestinal problems. There are also many people who may not have full-blown celiac disease, but who are still gluten intolerant, or gluten sensitive. For both groups, acid reflux may be a real health issue.
Celiac Disease vs. Gluten Sensitivity
Unlike celiac disease, which is a result of an autoimmune reaction caused by gluten, gluten sensitivity manifests symptoms less severe and individuals normally test negative for celiac disease. A 2011 study in the journal "BMC Medicine" evaluated celiac disease, gluten sensitive and healthy, gluten-tolerant individuals for intestinal permeability. The research found that gluten sensitivity and celiac disease are different entities on the gluten intolerance scale, with celiac disease being at the one end and gluten sensitivity being somewhere in the middle, showing no discernible changes in intestinal mucosa.
Symptoms
Symptoms vary for celiac disease and gluten sensitivity. The damage to the villi in the small intestine in celiac disease may lead to other autoimmune disorders, infertility, osteoporosis, neurological issues and possibly cancer. Gluten sensitivity may manifest as fatigue, mind fogginess, irritable bowel syndrome and tingling in the arms and legs. But the symptom that is common to both is the gastrointestinal symptoms such as bloating, flatulence and reflux, or gastroesophageal reflux disease, more commonly referred to as GERD.
Gastroesophageal Reflux Disease
The back-up of liquid or food into the esophagus from the stomach causes GERD. The acidic contents from the stomach irritate the esophagus which can lead to heartburn, belching, regurgitation, nausea and vomiting, sore throat and coughing. Sometimes GERD is symptom-free or may be related to the improper closing of the lower esophageal sphincter that closes the stomach off from the esophagus. Ongoing bloating, belching and gas caused by gluten sensitivity may put pressure on the sphincter resulting in the reflux.
Treatment
Celiac and gluten sensitive people have a high incidence of GERD. A 2003 study in "Gut, an International Journal of Gastroenterology and Hepatology" studied 205 celiac patients and found GERD in almost 20 percent of the subjects. Treatment for celiac disease and gluten sensitivity is the avoidance of gluten-containing foods in the diet. This means cutting out all wheat, barley, rye, spelt and oats and foods containing these from your diet.
References
- Harvard Health Publications: Getting Out the Gluten
- Finer Health and Nutrition: Frequently Asked Questions about Gluten Sensitivity
- "BMC Medicine"; Divergence of Gut Permeability and Mucosal Immune Gene Expression in Two Gluten-associated Conditions: Celiac Disease and Gluten Sensitivity.; A.Sapone, et al.; March 2011
- University of Maryland Medical Center: Study from University of Maryland Center for Celiac Research Places Gluten Sensitivity on Center Stage of Spectrum of Gluten-Related Disorders
- UT Health Science Center: Patient care --- conditions, diseases
- "Gut, an International Journal of Gastroenterology and Hepatology"; Reflux Oesophagitis in Adult Coeliac Disease: Beneficial Effect of a Gluten Free Diet; A Cuomo, et al.; April 2003
