Written by Dr. Manjusha Das, SIU School of Medicine
The term “gluten-free” has become a universal term to describe another diet trend for some, but for others, it’s a necessity. The gluten-free diet was designed for those who suffer from Celiac disease, a severe inflammatory disease triggered by gluten.
What is Celiac disease?
Celiac disease, also known as gluten sensitive enteropathy, or Celiac Sprue, is a genetic immune disorder in which gluten triggers inflammation in the small intestine. For those who have Celiac disease, symptoms can range from severe abdominal pain and cramping to skin rashes, anemia and even bone loss.
How do I know for sure if I have Celiac disease?
If physicians have a low suspicion for the disease, they usually start with simple blood tests to detect specific antibodies. Those with Celiac disease produce antibodies, which are the body’s defense system, to start attacking the intestinal mucosa. However, diagnosis of Celiac disease must be made by small bowel visualization, usually by endoscopy, and with biopsy of the tissue. Certain signs of inflammation in the biopsy will confirm the diagnosis.
What is gluten and why do people take it out of their diet completely?
Gluten is an elastic protein found in wheat, rye and barley products. It is poorly absorbed by the gut, and can cause damage to the intestinal lining. Gluten continues to be broken down into smaller molecules, but for those with Celiac disease, one of these molecules causes severe damage. In order to prevent recurrence of symptoms, doctors recommend a life-long gluten-free diet.
Could another disorder be causing my symptoms?
Wheat allergy is also an autoimmune disorder that can cause similar symptoms, but it functions differently than Celiac disease. It is a true allergic reaction to gluten that usually occurs minutes to hours after ingestion of gluten. The distinguishing feature between a wheat allergy and Celiac disease is the antibodies that are present in a person with Celiac disease are not present in someone with a wheat allergy. However, both groups of patients will find relief of symptoms after starting a gluten-free diet.
Why do so many people say they feel so much better after going “gluten-free?”
Because eating too much gluten can contribute to damage to the intestinal wall, some people do feel better after eating a gluten-free diet, even if they don’t have Celiac disease or wheat allergy. Eliminating gluten from the diet will decrease inflammation.
If I don’t have Celiac disease, a wheat allergy or non-Celiac gluten sensitivity, would I still benefit from a gluten-free diet? While inflammation may subside, making you feel better, a strict gluten-free diet may prevent you from receiving essential vitamins and minerals. Adherence to a gluten-free diet should only be considered to treat specific diseases.
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