Gluten Intolerance

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Gluten Intolerance

Gluten is a protein found in wheat, barley and rye. If a person has a gluten intolerance (gluten sensitivity, gluten allergy), this protein can cause digestive system problems such as stomachache, diarrhea or gas. Gluten intolerance (gluten allergy) is sometimes confused with celiac disease or is also considered a food allergy. Avoiding common foods is a treatment strategy for all three diseases, but these diseases have different mechanisms from each other.

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    Celiac Disease, Non-Celiac Gluten Sensitivity, and Food Allergy: What’s the Difference?

    Gluten is a protein found primarily in wheat, barley and rye. Celiac disease is an autoimmune condition in which the immune response is directed at one’s own body rather than foreign substances such as viruses or bacteria. Celiac disease can only develop in people who have certain genes called HLA-DQ2 or DQ8. Thirty percent of the population carries these genes. Without these genes, celiac disease cannot develop, but only a small percentage of those who have the genes will develop celiac disease.

    In those with celiac disease, gluten causes immune inflammation in the small intestine. Left untreated, it can lead to extra-intestinal manifestations such as celiac disease, anemia, chronic fatigue, osteoporosis, impaired spleen, infertility, neurological disorders, skin rashes, and cancer.

    There is a blood test for celiac disease, but like any test it is not 100% accurate. Even if this blood test is negative, a gastroenterologist may need to perform an endoscopy if the person has a high suspicion of celiac disease or a family history.

    Those diagnosed with celiac disease need to completely and permanently avoid all forms of gluten in their diet. The help of a dietitian or nutritionist is recommended.

    Some patients have signs of celiac disease, but blood tests and endoscopies are negative or normal. This condition is called non-celiac gluten sensitivity. Symptoms can be similar to celiac disease, such as abdominal pain, bloating, gas, diarrhea, lethargy or fatigue. Symptoms improve when gluten is removed from the diet and return when gluten-containing foods are reintroduced.

    The existence of gluten sensitivity is controversial because there is no specific test for this disease. It is not thought to be an autoimmune disease and is not associated with complications of celiac disease.

    Celiac disease and gluten sensitivity are quite different from food allergies. In a food allergy, the immune system can overreact to a particular food, causing serious and even life-threatening symptoms. In patients with food allergies, symptoms begin shortly (from a few minutes to an hour) after ingestion of food and may experience hives, shortness of breath, dizziness or vomiting.

    If you believe you may be allergic to a food, you should see an allergist. People with food allergies should be very careful in avoiding food triggers, as allergic reactions to foods can be life-threatening. If you have a severe food allergy, it is recommended that you carry an adrenaline auto-injector with you.

    Some people who have trouble eating gluten-containing foods and improve while following a gluten-free diet may have common gluten sensitivity rather than celiac disease.

    Diagnosis of Gluten Intolerance (Gluten Allergy)

    Because no biomarker of gluten sensitivity has been identified, there is no specific medical test that can be done to confirm the diagnosis. To diagnose gluten sensitivity, both celiac disease and wheat allergy must be excluded. Negative antibody test and small intestine biopsy indicate celiac disease; Negative wheat allergy tests will rule out the possibility of allergy.

    In the diagnosis, an elimination diet followed by a dietitian is followed by re-introduction to gluten-containing foods and the patient’s symptoms are observed. This method is most commonly used to assess whether health is improved by eliminating or reducing gluten from the diet.

    If you think you may have a gluten sensitivity, it’s important to consult your dietitian or doctor before giving up gluten.

    Treatment for Gluten Intolerance (Gluten Allergy)

    Scientific studies on the treatment of non-celiac gluten sensitivity are limited. However, the best recommended treatment is a gluten-free diet. It is recommended to consult a dietitian for dietary rules and a list of prohibited foods.
    There is no research showing that gluten sensitivity eventually leads to celiac disease, and this is not currently thought to be the case by experts working in the field of gluten-related disorders.

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