Gluten is a combination of two proteins, gliadin and glutenin, that occur in grains such as wheat, rye, barley, and, to a lesser extent, oats. Its elastic and stretchy nature helps make bread dough rise, but gluten also gives rise to many IBS symptoms in people who have an autoimmune reaction to this protein, which turns to poison in their systems.
Celiac disease is a genetic condition that causes the immune system to attack gluten in the diet. However, you can have gluten intolerance or a gluten allergy and not suffer from celiac disease. Unfortunately, celiac disease is often called gluten intolerance, which leads to some confusion; having the abnormal genetic component is the key to celiac disease.
Fortunately, the symptoms of gluten intolerance and allergy usually aren’t as severe as those of celiac disease and are usually confined to the gastrointestinal tract.
According to the NDDIC, celiac disease affects people in all parts of the world. It was originally thought to be a rare childhood condition but is now identified as a genetic disorder. More than 2 million people (1 in 133 people) in the United States have the disease. The incidence increases to 1 in 22 people for those who have a first-degree relative — a parent, sibling, or child — diagnosed with celiac disease.
Gluten triggers an immune response that flattens out the absorptive fingers, called villi, in the small intestine in people who suffer from celiac disease. Flattened villi can’t reach out and grab nutrients from your food. With hampered absorption, you can develop malnutrition and vitamin deficiencies. Following is a list of some other serious implications of celiac disease:
Weight loss and muscle wasting, which can occur from poor absorption of protein, fats, and even carbohydrates
Anemia and fatigue resulting from improper absorption of iron and vitamin B12
Edema (fluid retention) of the lower legs caused by protein deficiency
Nerve symptoms of tingling and numbness resulting from B1 and B12 deficiencies
Muscle cramping due to magnesium deficiency
An itchy rash due to B vitamin deficiency
Arthritis and osteoporosis resulting from magnesium and calcium deficiencies
Symptoms of celiac disease, gluten intolerance, and gluten allergy are very close to those of IBS. Abdominal pain and bloating, diarrhea, and constipation are mutually shared symptoms, but gas and stool that clears the house with its odor and oily, mucus-filled, floating stools (with high fat content) are unique to celiac disease.
Some people can develop even more widespread symptoms, such as tooth discoloration, joint pain, mouth ulceration, hypoglycemia, nosebleed, short stature, amenorrhea (skipped menstrual period), infertility, miscarriage, and seizures.
In celiac disease, the most difficult symptoms to reconcile are the behavioral changes. In children the range of emotions can be from complete withdrawal to violent outbursts. Adults can experience depression.
Even a decade ago, the incidence of celiac disease was thought to be 1 in 5,000 people; now it’s increased to 1 in 100. How can this happen if celiac disease is a genetic condition? The celiac gene comes from one or both parents. If you have two defective genes, one from each of your parents, you’re sure to develop celiac disease.
Some researchers speculate that the increased consumption of wheat gluten products may be causing celiac disease to express itself in people who have only one defective gene, thus explaining the increased incidence of this condition.
Eat gluten-free
In addition to wheat bran and germ, semolina flour, and couscous, among others, you may be surprised to find out that food products such as binders and fillers commonly found in processed meat; soy sauce; malt found in beer, coffee, and cocoa mix; soft cheese; licorice; and cough drops contain gluten.
It may not be too hard to cut out some or all of the items, but what grains can you eat on a gluten-free diet? The many tasty alternatives include quinoa, corn, millet, rice, buckwheat, sorghum, amaranth, teff, wild rice, and Indian rice grass.
If you’ve done some research and suspect that you have celiac disease, you should not begin a gluten-free diet before you’re diagnosed by a doctor. As soon as you avoid gluten, your intestines begin to heal, and the gliadin and glutenin antibodies disappear.
When you go for diagnosis testing, the results won’t be accurate. Instead, avoid the biggest gluten offender, wheat, for one week, keep up your food diary, and check to see if your symptoms are altered. If they are, you can keep eating gluten grains until you have your blood test or small intestine biopsy.
If you’re diagnosed with celiac disease, the prescribed treatment is avoidance of wheat, rye, barley, and oats for the rest of your life. Removing the damaging gluten from scraping and irritating your intestines allows the intestinal villi to heal and stay vital and healthy for the proper absorption of nutrients.
Take the gluten challenge
If you think you may still have difficulty with gluten but don’t suspect that you have celiac disease and aren’t diagnosed with that condition, you may have a gluten allergy and can undertake a gluten challenge to determine whether gluten triggers your IBS symptoms.
Spend at least one week documenting your normal diet in your food diary, and then eliminate wheat from your diet completely for two weeks. (Wheat is the most common of the gluten foods and the one that people seem to be most intolerant of.) Continue to chronicle your food intake and your physical and emotional symptoms to reflect the change in your diet.
After two weeks, you may introduce wheat back into your diet, ideally in a simple form — perhaps biscuits or pasta rather than yeast bread. Again, conduct this wheat challenge on a weekend in case you have an IBS reaction.
