Celiac Disease, Gluten Intolerance and Wheat Allergy

Gluten is a protein composite found in grains such as wheat, barley, rye, kamut and spelt. Oats do not contain gluten, however oats are often harvested and processed alongside wheat and thus can be contaminated. Gluten gives baked goods its elasticity and its ability to rise, giving it a chewy spongy texture.

Common foods containing gluten are breads, muffins, cakes, pastries, pizza, pastas, soups, sauces, gravy mixes, sausages, luncheon meats, bread crumbs, salad dressings, condiments, baked beans, malted products and much more.Celiac disease (CD)is a genetic autoimmune disease triggered by eating gluten. The immune system responds by attacking the gluten molecule, and in so doing, it also attacks your body cells resulting in damage to the small intestine. It occurs in people who inherit one or both of the celiac genes (HLA-DQ2 & HLA-DQ8). This reaction causes inflammation and damages the villi which are tiny hair-like fingers that increase the surface area in the small intestine which absorbs nutrients from our food.

Celiac disease is on the rise, with rates doubling about every 20 years, this is shown to be a true increase in prevalence of celiac disease in all Western countries.

Celiac disease cannot be cured, although symptoms may reduce or completely resolve if you follow a lifelong gluten free (GF) diet. However, some studies indicate that following a GF diet may not be all you need to do to help repair and heal the intestinal lining of the gut.  Some studies indicate that corn can have a similar effect on the mucosa as gluten does on celiac disease. So this may need to also be avoided by some people.

Celiac disease is associated with other autoimmune diseases, so if you have any type of autoimmune disease, you may want to be tested for celiac disease.

Autoimmune chronic active hepatitis

Crohn’s disease and Ulcerative Colitis

Insulin-dependent diabetes mellitus (Type 1)

Multiple sclerosis

Myesthenia gravis

Scleroderma

Sjögren’s syndrome

Systemic lupus erythematosus

Thyroid disease (Graves’ disease and Hashimoto’s disease)

Sometimes, symptoms of other autoimmune diseases improve on a gluten-free diet.

Gluten Sensitivity (GS) refers to an adverse reaction to eating gluten that usually does not lead to damage of the small intestine. Only recently have researchers verified and isolated the existence of a non-celiac gluten sensitivity. At this point, to be diagnosed with gluten sensitivity testing is negative for both celiac disease and a wheat allergy yet still exhibiting clear signs of a poor response to consuming gluten. Gluten-sensitive individuals cannot tolerate food containing gluten and may develop gastrointestinal symptoms similar to those in CD, but the overall clinical picture is generally less severe.

In a study published in BMC Medicine, researchers described gluten sensitivity as a disorder distinct from celiac disease, in part because the intestine doesn’t appear damaged. About 1% of the population has celiac disease.  Gluten sensitivity is thought to affect roughly 6-10% of the general population.  Some people with gluten intolerance that do not have celiac disease may develop it if they continue to eat gluten.

Celiac disease and gluten sensitivity share some of the same symptoms. The symptoms manifest in many different ways and often show up throughout your entire body.

Gastrointestinal symptoms: Abdominal pain and distension, acid reflux, bloating, constipation and/or diarrhoea, gas, flatulence, greasy foul-smelling floating stools, nausea, vomiting, weight loss or weight gain.

Non-gastrointestinal symptoms: fatigue, iron-deficiency anemia, vitamin & mineral deficiencies, headaches, migraines, joint/bone pain, depression, irritability, listlessness, and mood disorders, poor concentrate, Infertility, enamel deficiencies and irregularities, clumsiness (ataxia), ulcers, lactose intolerance, eczema, psoriasis, early onset osteoporosis, hair loss (alopecia), bruising easily, muscle cramping, nosebleeds and night blindness.

How a reaction to gluten could cause such a wide range of symptoms also remains unproven.  Dr. Fasano and other experts speculate that once immune cells are mistakenly primed to attack gluten, they can migrate and spread inflammation, even to the brain.

Wheat Allergy is like any food allergy, reactions to wheat can vary significantly and like other classic food allergies can affect the skin, gastrointenstinal tract or respiratory tract. A wheat allergy is a histamine based allergic reaction. When a person with this allergy ingests wheat, a hypersensitive immune system produces antibodies known as IgE. This then triggers an inflammatory response.

Celiac Disease, Gluten Sensitivity, Wheat Allergy and your Reboot

Your Reboot is a wonderful time to include a wide variety of gluten free foods.  Fruits, vegetables and herbs are naturally gluten free.  When choosing Reboot friendly condiments like soy sauce for salad dressings we suggest gluten free choices like Tamari.  After your Reboot, enjoy gluten free whole grains like quinoa, teff, brown rice, wild rice, amaranth and buckwheat (Kasha).

If you are concerned that you may have a possible gluten sensitivity, a Reboot can be a good opportunity to observe this. During the Reboot you will be naturally eliminating gluten containing foods, so after your Reboot you can observe if any symptoms that may have resolved during the Reboot return once you have reintroduced gluten into the diet.

To determine a gluten intolerance, you may need to eat a few serves of gluten in close proximity to have a true result.

Testing for Celiac Disease

Blood Tests

A gluten containing diet must be eaten before any of these tests to ensure accuracy.

The following blood panel, measuring serum antibodies, is a must to test for celiac disease:

Endomysial antibodies (EMA)

Tissue transglutaminase antibodies (tTG)

IgG tissue transglutaminase

Total IgA antibodies

Genotype HLA-DQ2 & HLA-DQ8

A more recently developed test also thought to be highly accurate (when combined with the above antibody tests) is a measurement of deamidated gliadin peptides (DGP).

Intestinal Biopsy

When blood test results suggest a person has Celiac an intestinal biopsy is performed to confirm the disease.  The doctor will take a tiny tissue sample from the villi of the small intestine using a flexible tube inserted through the mouth called an endoscope.

If you have Celiac disease it is important to follow a gluten free diet.  Damage to villi can lead to increased risk for other diseases like certain types of cancers, especially during the first year following diagnosis.   Over time, risk for developing gastrointestinal or haematological (blood) cancers may decline.

I hope this article helps clear up any confusion you may have about gluten intolerances. There is a need for further research to identify these conditions more extensively.