The gluten-free movement seems to affect many people these days. What was once an obscure food protein few knew anything about has now become involved in the latest fad diets, and is the source of one of the most under-diagnosed autoimmune diseases: celiac disease. But just what is gluten, and what exactly is the difference between gluten intolerance, a wheat allergy and celiac disease?
What Is Gluten?
Gluten is a protein that is found in wheat and its close relatives, including barley and rye. It is also, as those undertaking the gluten-free diet quickly find out, contained in many foods that you wouldn’t expect. Gluten may be found in fries, soy sauce, soups, salad dressings and in many processed foods. In baked goods, this protein is what gives pastries their scrumptious texture, making it an important ingredient in doughnuts, cakes, croissants, rolls and just about everything else that comes out of a bakery. An easy-to-come-by source of protein and thickening agent, it really is no wonder wheat (and gluten) is America’s favorite cereal grain.
Like other food allergies, a wheat allergy is an over-reactive immune system response to a foreign material. With this type of allergy the body misinterprets wheat protein, a harmless substance, as a malicious invader. The immune system then kicks into high gear, releasing the antibody immunoglobulin E, which leads to hives, or in more severe cases, anaphylaxis. Of all gluten issues, wheat allergies are the most rare.
Wheat or wheat protein allergy symptoms vary widely, and may appear from within minutes to hours after exposure. They include common allergy discomforts, such as an itchy or runny nose, hives, cramps and swelling. Vomiting, faintness and anaphylaxis may also occur. Note that anaphylaxis can be deadly, and requires the person to get to the doctor immediately. Most people with severe allergies carry epinephrine with them at all times in case of anaphylaxis shock.
Wheat allergies are much more common in young children than adults, with many sufferers outgrowing the condition by the time they reach elementary school. To prevent any health problems, a strict avoidance of wheat is necessary to treat this condition.
Food intolerances such as gluten intolerance, or “gluten sensitivity,” are fundamentally different from allergies, as they do not involve the immune system at all. Rather, intolerance comes from the body’s inability to digest a food, likely due to a lack of the proper enzymes in the body. Like those who are lactose intolerant, people with gluten intolerance are not able to digest it properly, leading to a wide range of symptoms from mild to severe. While there is no medical test for this condition, and while gluten intolerance is believed to be over-diagnosed, health officials do recognize it as a legitimate medical issue affecting many.
Symptoms of gluten intolerance vary widely from person to person, but most often involve headaches, joint pain and abdominal pain. Brain fogginess after consuming gluten is also widely reported. While gluten intolerance has been blamed for everything from fat thighs to fibromyalgia, studies have yet to show any links.
Just as there’s no way to medically diagnose gluten intolerance, there isn’t any way to treat it either. Sufferers must cut gluten out of their diets to avoid any of the accompanying symptoms. Fortunately, the discomfort caused by eating gluten is only temporary, and isn’t thought to have any lasting health consequences.
Also known as “Coeliac disease” or “sprue,” celiac disease is an autoimmune disorder triggered by gluten. While this condition has probably existed for millennia, it has been making news recently as more and more people find that they are suffering from it. Unlike gluten intolerance, celiac is an autoimmune response, meaning the body’s immune system attacks the body’s own cells. In the case of celiac disease, the body’s immune system attacks the villi—the little hairs lining the intestine that absorb nutrients from food—whenever gluten is present. Estimated to affect millions worldwide, celiac is considered to be one of the most under-diagnosed autoimmune diseases, with only a small fraction of sufferers being diagnosed.
Sufferers of celiac disease may go many years without showing any outward symptoms, and the symptoms they do have can vary a great deal, mostly due to vitamin deficiencies and malnourishment that result from the body’s compromised ability to absorb nutrients from food. Some of the most common symptoms include severe abdominal pain, unexplained weight loss, anxiety or depression, unusual stool formation and fatigue. Other conditions may also develop as related complications and include anemia, kidney stones, osteoporosis and intestinal cancer. In very young children, celiac disease can cause failure to thrive and stunted growth.
Unfortunately, there is no cure for celiac disease, and the only way to manage this condition is to adhere to a strict gluten-free diet. For most celiac sufferers, even a trace amount of gluten from cross-contamination can cause severe damage to the small intestines that will need weeks to heal. It takes at least two years for the damaged villi of the small intestine to recover enough to absorb food properly.
During the healing process, most people with celiac are instructed to take supplements to help replenish missing nutrients in their system. At the moment, a powerful gluten enzyme supplement is also in the works to help break down trace amounts of gluten in the body and mitigate its effects. It won’t, however, completely prevent a gluten reaction. For more information on celiac disease and the latest developments, the Celiac Disease Foundation is a great place to start.
Despite its huge popularity in American foods, from baked goods to condiments, gluten can pose a threat to the health of millions who suffer from one of the above gluten issues. For some, the threat may simply be a headache or abdominal discomfort, but for others, the threat is very severe and requires a strict diet. Fortunately, the plight of gluten sufferers everywhere is becoming better understood. Gluten-free baked goods and eating establishments are more common, and gluten-free alternatives such as quinoa, amaranth and buckwheat are now widely available.
Even though it is now easier than ever to go on a gluten-free diet, doctors advice against it unless you have one of these conditions and are under a physician’s supervision. If you suspect that you or someone you know has celiac disease, gluten intolerance or a wheat allergy, schedule an appointment with a doctor who is familiar with these conditions to receive a proper diagnosis and dietary advice. And if you do test positive and must avoid gluten completely—don’t fret! There are now many great resources available to help keep you on track toward good health.