Gluten allergy, or celiac disease, is a common cause of intestinal disease that affects an estimated 3 million Americans. Gluten allergy is an abnormal immune reaction to gluten, a protein found in a variety of bread products. The disease prevents the absorption of nutrients, which can lead to to diarrhea abdominal pain. The most effective treatment for gluten allergies is to avoid foods containing gluten.
Cause
Evidence suggests that gluten allergy may have a genetic basis. A 2011 article in "Clinical Genetics" reports a variety of genes that are associate with gluten-sensitive enteropathy. Researchers have identified 27 genes that increase the risk of the disease; however, the way in which they work and cause disease is still unclear.
Gluten enteropathy is considered an abnormal immune reaction to the gluten found in a variety of wheat products. The small intestine is predominantly affected. A number of abnormal antibodies have been found in association with the condition.
Signs and Symptoms
Gluten is found in foods that contain wheat, rye, barley and oats; unless these products are specifically labelled as "gluten-free." Adults with gluten allergy experience bloating, diarrhea and weight loss. The severity of symptoms varies between individuals. Because of a failure of the intestine to absorb essential nutrients, folate and vitamin D deficiencies may occur. Mineral deficiencies of calcium and iron are also common. The disease can occur at any age. Affected infants may have diarrhea, abdominal distension and weight loss. Children may have a delayed onset of puberty and shortened stature due to malnutrition.
Diagnosis
Diagnosis of celiac disease is now relatively straightforward. The original practice of taking intestinal biopsies by endoscopy, both before and after trying a gluten-free diet, is now rarely needed. Antibodies specific to the disease -- such as the antiendomysial antibody and tissue transglutaminase antibody -- can be detected in the blood. These antibodies are very specific to celiac disease and allow for easy outpatient diagnosis. Patients diagnosed with celiac disease also should have a bone scan to identify any bony disease.
Treatment
The most important element of treatment is to avoid gluten. When eating bread products, patients should ensure they eat foods labelled as gluten-free. Rice, corn and potatoes are excellent sources of calories that are also free from gluten. A diet free from gluten usually causes rapid relief of stomach pain and diarrhea. People with vitamin and mineral deficiencies also should take nutritional supplements.
References
- "Clinical Genetics"; Celiac Disease: Moving from Gene Associations to Casual Variants; B Hrdlickova et al.; September 2011
- "Davidson's Principles and Practice of Medicine"; Nicki R. Colledge et al.; 2010
- "Nelson Textbook of Pediatrics, 18th Edition"; Kliegman et. al.; 2008
- Celiac.com: Celiac Disease Prevalence is on the Rise; Tina Turbin; 2011
