Gluten Sensitivity or Celiac Disease. What You Need to Know
You have no doubt heard of “gluten.” More products are labeled as such on the grocery shelves, for example. And I bet you know at least one person who is following a gluten-free diet.
But what exactly is gluten anyway?
Gluten is a mixture of proteins found in wheat, rye, and barley. Oats do not contain gluten, but they can be contaminated with gluten. The presence of gluten in flour gives dough its stickiness and elasticity. Gluten also helps the leavening of dough by trapping carbon dioxide gas within it. Thus, allowing the dough to rise into a nice fluffy texture.
Gluten is found in many foods such as cereals, breads, pastas, and processed foods, for example. These foods are made from the just-named grains. Gluten is even found in other products such as lip balms, vitamins and supplements, and medications.
What is celiac disease and what is its relationship to gluten?
If you have celiac disease, you are unable to eat gluten. It is an autoimmune disorder, meaning your body attacks its own cells, causing tissue damage. Rheumatoid Arthritis (RA) and Diabetes Mellitus (DM) are two other examples of autoimmune diseases. In fact, if you have another autoimmune disease, it increases your risk of having celiac disease.
Normally, your body's immune system is supposed to defend itself against bacteria and viruses. However, in the case of celiac disease, ingesting gluten triggers your immune system to attack the gluten molecules, and ultimately its own small intestine lining. This then causes inflammation and damage to the intestine, resulting in poor absorption of nutrients.
What causes celiac disease?
There are three main things including your genetics, the consumption of gluten, and a trigger of some sort. This trigger can be things like stress, surgery, or pregnancy.
What are the symptoms?
Surprisingly, symptoms vary with individuals, and there are many kinds of symptoms. The symptoms can mimic lactose intolerance and irritable bowel syndrome.
Although most think of celiac disease as causing gastrointestinal issues such as diarrhea and weight loss, the truth is that not everyone experiences these symptoms.
In particular, adults tend to have less of these GI symptoms, but other symptoms such as:
- Canker sores
- Fatigue
- Numbness and tingling in the hands and feet
- Anemia
- Osteoporosis (thinning of bones)
- Depression
- Joint pain
- Headaches
- Skin rash
- Eczema
- Vitamin and mineral deficiencies
- Low blood sugar
In fact, these above symptoms are sometimes referred to as extra-intestinal, meaning “outside the intestine,” and there's reported to be hundreds of symptoms.
In children, some symptoms of can include:
- Delayed puberty
- Bloating
- Weight loss
- Headaches
- Attention deficit hyperactivity disorder (ADHD)
- Diarrhea
- Failure to thrive (not meeting expected standards of growth)
As already mentioned above, symptoms of gluten sensitivity are like the symptoms of other diseases too, so you need to see a physician to help you determine what is going on.
To complicate matters, some people with celiac disease have no symptoms at all! This is what is known to medical professionals as “silent celiac disease” or “asymptomatic celiac disease.” However, damage is still occurring to their small intestines, so getting a diagnosis is important.
But how do you find out if you have celiac disease, with or without symptoms?
Your physician can request blood tests that look for specific antibodies. If you test positive for the antibodies, then an intestinal biopsy (this is where a small piece of tissue from the intestine is examined) is done to confirm that you have the disease.
It is important to note that you do not want to start a gluten-free diet until you have been diagnosed otherwise the diagnosis could be missed.
What is the treatment for celiac disease?
Implementing a strict gluten-free diet is the only treatment currently. This allows your small intestine to recover from the damage it has been experiencing due to the exposure to gluten.
It is easier to implement a gluten-free diet when you are experiencing symptoms and want to feel better. However, for those without symptoms, it is just as crucial that you stick to this diet too to prevent damage to the intestine, as well as the development of other health conditions which can include:
- Malnutrition
- Miscarriage
- Possible congenital birth defects such as incomplete closure of the baby's spinal column during pregnancy
- Decreased height in children as they grow up
- Cancer in the G) tract
- Osteoporosis (thin bones)
Now that you have learned about celiac disease, another topic is worth discussing. That is the topic of what gluten sensitivity/gluten intolerance is.
You may also hear this referred to as “non-celiac gluten sensitivity.” In 2011, a study at The Alfred Hospital in Melbourne, Australia, reported that gluten was a culprit in gastrointestinal problems in people who did not have celiac disease. However, this researcher has since conducted more research and now states that the existence of gluten sensitivity/gluten intolerance/non-celiac gluten sensitivity is not fully substantiated, and further research needs to be conducted.
Nevertheless, there are many people and health professionals who believe it exists, and when they follow gluten-free diets, they report feeling better. Many reputable sites such as the Center for Celiac Research recognize it as its own condition. So, it deserves its own discussion.
Like celiac disease, symptoms in someone with gluten sensitivity or gluten intolerance can include digestive problems such as diarrhea, bloating, pain, or constipation. Fatigue, depression, and joint pain are other symptoms that can also be seen.
How this condition differs from celiac disease, however, is that the tissue in the small intestine is not attacked. No antibodies can be found when a blood test is done, so there is no definitive way to diagnose it. Usually, this diagnosis is made by trying a gluten-free diet to see if symptoms improve.
Celiac disease stats for those affected are about 1%. In the case of gluten sensitivity, it is higher at about 6% of the population. People with gluten sensitivity/intolerance are at higher risk of developing celiac disease through repeated exposure to gluten.
What kind of diet do you need to follow?
Now that you have the lowdown on what gluten is, and how it is related to celiac disease and gluten sensitivity, your next step is to take steps to remove the gluten in your diet. Even some non-food items (lip balms, for example) must be replaced.
If you have celiac disease, it is imperative that you never eat gluten. If you do, your intestine will not be able to heal, which can lead to long-term health problems. Even if you experience no symptoms when you eat gluten, but you have the diagnosis of celiac disease, you must stay away from gluten.
If you have gluten sensitivity or intolerance, no damage has yet been done to your small intestine, but to feel better and prevent the possibility of developing celiac disease later, you should also avoid gluten. However, some people with sensitivity or intolerance may cheat and eat gluten-containing foods occasionally. This is still not recommended, as it may bring on your symptoms.
To conclude, people with celiac disease and gluten sensitivity may experience many of the same symptoms. In both cases, gluten is the culprit, and avoiding it will improve your health.
Click here for help with managing a gluten-free diet.
For lactose intolerance information, click here.
