Dear Dr. Peg,
I want to know more about having a gluten allergy and how common or serious it really is. A lot of my friends have this allergy and their symptoms are starting to make me suspicious too.
-Suspicious of Gluten
Dear Suspicious,
So gluten makes the news again. It’s happened a lot in recent years and the story changes with time. I’m glad you asked this question, because it gives me an opportunity to share the latest.
Gluten is a protein that is found in wheat, rye and barley. It is everywhere, not only in the obvious places like bread but also in many cereals, cheese spreads, chocolate milks, beer, dried fruits, other processed and prepared foods and even some medicines and cosmetics.
Most people can eat — or wear — gluten without difficulty. Others cannot, due to problems that range along a spectrum from gluten sensitivity to Celiac disease to true wheat allergy.
True wheat allergy, more common in little children, causes an allergic type reaction shortly after eating wheat. The symptoms are swelling and itching in the throat, hives, nasal congestion and watery eyes, cramps, nausea, vomiting, diarrhea and sometimes anaphylaxis, a serious systemic reaction with life-threatening trouble breathing. Kids often grow out of wheat allergy by age 5 and it is much less common in adults.
Celiac disease is also known as gluten intolerance. It too involves an immune reaction but is not a true allergy. Celiac disease is an autoimmune problem that often runs in families. It is more common in Caucasians and women. Some people have symptoms starting in childhood. Others don’t have problems until adulthood, when the disease might get triggered by a stressful event like surgery, pregnancy, a viral infection or emotional stress.
When a Celiac patient eats gluten, their intestines react by creating an immune response, also known as inflammation. This inflammatory response causes damage to the small intestine. The small intestine is normally lined by tiny projections called villi that look sort of like a long shag carpet. Their function it is to absorb nutrients.
In Celiac disease, the villi are flattened by the autoimmune response. The damaged intestine can not properly do its absorption job. Because of this, gluten intolerance results in many other problems.
If your intestine cannot absorb iron, you can become anemic.
Calcium malabsorption can lead to osteoporosis. General nutrient malabsorption can lead to poor growth in children or unexplained weight loss in adults. There are even some cancers, like intestinal lymphoma and bowel cancers, that are more common in untreated Celiac patients, though nobody is yet sure why.
Get content from The Daily Lobo delivered to your inbox
The word Celiac comes from the Greek word for bellyache. Typical symptoms of gluten intolerance are abdominal pain, bloating, cramping and diarrhea or constipation, all after eating something with gluten in it.
For reasons that are not yet clear, this condition can also cause symptoms that are seemingly unrelated to the intestine. These include canker sores, headaches, seizures, joint pain, discolored teeth, tingling and numbness, infertility and a certain kind of itchy skin rash. There is even some speculation that Celiac disease contributes to mental conditions like ADHD and depression.
About one in 133 Americans have Celiac disease, and more get it every year. Speculation about the cause is widespread. One theory proposes that the rise in Celiac disease is caused by overuse of antibiotics, anti-inflammatory medications and antacid medications, combined with our low-fiber, high-sugar diet, combined with genetic alterations in gluten proteins by the wheat industry.
Celiac disease could be what your friends have, but it is more likely that they have a milder condition called gluten sensitivity. I say milder because although gluten sensitivity doesn’t damage the intestines the way Celiac disease does, many of the symptoms are the same, and people who are sensitive to gluten can be pretty miserable.
Diagnosis of gluten problems is difficult. Many people with full-on Celiac disease will have characteristic antibodies in their blood, but not everyone does. People with gluten sensitivity are often diagnosed by removing gluten from their diet and watching to see whether their symptoms resolve.
If you think you might have a gluten problem, it is probably wise to see a doctor. Or, if you want to investigate on your own first, you can always give yourself a gluten-free trial. I recommend you stick with it for at least three weeks. Avoiding gluten is harder than you might think.
As I mentioned above, that stuff is everywhere, and even a little bit can cause a problem if you are very sensitive. Read labels closely. Fortunately, as awareness about this condition grows, you can find more gluten-free products marked and marketed as such, on the shelves and even on restaurant menus.
Go gluten free for three weeks and see how you feel. If your symptoms go away, you may have found the key.
For more information, go to celiac.org or make an appointment at Student Health and Counseling at 277-3136.
Peggy Spencer is a student-health physician. She is also the co-author of the book “50 ways to leave your 40s.” Email your questions directly to her at pspencer@unm.edu. All questions will be considered anonymous, and all questioners will remain anonymous.
