Gluten Intolerance, Sensitivity Are Very Different Disorders
So-called “gluten-free” diets have become the latest food craze. Millions of Americans claim to be “gluten-intolerant” or “gluten-sensitive,” and attest to feeling better when cutting wheat products out of their diets. Hundreds of brands of new “gluten-free” foods grace American grocery store shelves. But what is “gluten-intolerance?” Is it the same as “gluten-sensitivity?” And is it serious?
The two disorders are different
Gluten-intolerance is usually referred to as “celiac disease” or “celiac sprue.” It is a serious immune disorder that damages the small intestine, causing an inability to absorb necessary nutrients.
People with gluten sensitivity test negative for celiac disease in diagnostic examinations, and they have none of the signs of damage to the small intestine present in people with celiac disease. Many people with gluten sensitivity have antibodies in their blood to a protein called “gliadin” (antigliadin), and some doctors consider that a sign of gluten sensitivity. However, not all scientists agree that it is a true test for the disorder, instead preferring to have patients stop eating gluten for a period of time and see if their symptoms subside. Gluten sensitivity can cause some of the same symptoms as celiac disease, such as bloating, gas, and diarrhea. Some people with gluten sensitivity say they have other symptoms, such as headache and fatigue, as well.
Gluten Is Type of Protein in Wheat
Gluten is a protein found in wheat and wheat by-products. In celiac disease, the body’s own immune system overreacts when exposed to gluten. This causes fat, protein, vitamins, and minerals, to simply pass through the small intestine without being absorbed. The villi (small, hairlike projections) in the small intestine of people with celiac disease are damaged by this process, and they become less able to properly take in nutrients. If untreated, this can lead to malnutrition, and in serious cases, even death.
For reasons that are not clear, the incidence of celiac disease is on the rise, and it affects about one in 100 people. It is four times more common than it was 60 years ago. Gluten sensitivity affects about 6 percent of American.
Symptoms of celiac disease include:
- intermittent diarrhea
- abdominal pain
Malabsorption can happen in undiagnosed celiac disease, which causes:
- joint pain
- mouth sores
- weight loss
- weakness and fatigue
- foul-smelling stools that may be oily
- stunted growth (in children)
Once diagnosed with celiac disease or gluten sensitivity, you should avoid gluten-containing foods such as:
- graham flour
Whether you have celiac disease or gluten sensitivity, there are many commercial gluten-free foods now on the market. But check the label to make sure the product is truly “gluten-free,” and that it is made only with corn, rice, soy, buckwheat, or other gluten-free grain. The label should also state the product was not processed in a facility “contaminated” with any wheat-containing foods such as gravies, pasta, lunch meats, or salad dressing.
There are many foods which are naturally gluten-free, including fruit, vegetables, and fresh meat and fish.
What about wheat allergy? An allergy to wheat is totally different than celiac disease or gluten sensitivity. It has nothing to do with how wheat is tolerated by the digestive system. Like other allergies to foods such as eggs or peanuts, a wheat allergy can cause difficulty breathing, hives, and rash in susceptible people. A wheat allergy can lead to shock, which is an emergency requiring treatment with epinephrine.
For more information, contact the Celiac Disease Foundation.