Health Care and Gluten

Have you ever heard of people who have allergies to wheat or bread or pasta? Actually, the reaction is not about the grain, but about something in it called gluten. According to CNN, gluten allergy is caused by celiac disease, an autoimmune disorder that can appear at any age and is caused by an intolerance to gluten. A protein found in wheat, barley, and rye (and countless food products -- like bread and pasta -- that contain those grains), gluten gradually damages the intestines of people with celiac disease, preventing the absorption of vitamins and minerals and setting off a slew of related health problems, which can include fatigue and bad skin. While celiac disease affects about 1 percent of the U.S. population, experts estimate that as many as 10 percent have a related and poorly understood condition known as non-celiac gluten intolerance (NCGI), or gluten sensitivity. More details can be found at this site: http://www.cnn.com/2011/HEALTH/04/12/gluten.free.diet.improve/index.html .

According to the Mayo Clinic, avoiding wheat can be challenging because wheat products go by numerous names. Consider the many types of wheat flour on supermarket shelves — bromated, enriched, phosphated, plain and self-rising. Here are other wheat products to avoid:

• Bulgur
• Durum flour
• Farina
• Graham flour
• Kamut
• Semolina
• Spelt

Certain grains, such as oats, can be contaminated with wheat during growing and processing stages of production. For this reason, doctors and dietitians generally recommend avoiding oats unless they are specifically labeled gluten-free. You should also be alert for other products that you eat or that could come in contact with your mouth that may contain gluten, according to the Mayo Clinic. These include:

• Food additives, such as malt flavoring, modified food starch and others
• Medications and vitamins that use gluten as a binding agent
• Play dough

People with celiac disease who eat a gluten-free diet experience fewer symptoms and complications of the disease, according to the Mayo Clinic. People with celiac disease must eat a strictly gluten-free diet and must remain on the diet for the remainder of their lives. In some severe cases, a gluten-free diet alone can't stop the symptoms and complications of celiac disease. In these cases, doctors might prescribe medications to suppress the immune system. People who follow a gluten-free diet may have low levels of certain vitamins and nutrients in their diets. Many grains are enriched with vitamins. Avoiding grains with a gluten-free diet may mean eating fewer of these enriched products. More details can be found at this site: http://www.mayoclinic.com/health/gluten-free-diet/my01140 .

According to the US Food & Drug Administration (FDA), Celiac disease occurs when the body’s natural defense system reacts to gluten by attacking the lining of the small intestine. Without a healthy intestinal lining, the body cannot absorb the nutrients it needs. Delayed growth and nutrient deficiencies can result and may lead to conditions such as anemia and osteoporosis. Other serious health problems may include diabetes, autoimmune diseases, and intestinal cancers. Some people don’t get immediate symptoms, but when they do, they are typically gastrointestinal-related, such as abdominal pain, bloating, and diarrhea. In infants, there may be a lot of vomiting, and they don’t grow and thrive.” And some people do not have any symptoms at all, but still may have intestinal damage and risk for long-term complications. It is important for individuals with celiac disease, who may vary in their sensitivity to gluten, to discuss their dietary needs with their health care professional. Much more info can be found at this website: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm265212.htm .

According to the Celiac Disease Foundation, the only treatment is the lifelong adherence to the gluten-free diet. When gluten is removed from the diet, the small intestine will start to heal and overall health improves. Medication is not normally required. Consult your physician regarding specific nutritional supplementation to correct any deficiencies. The diagnosed celiac should have medical follow-up to monitor the clinical response to the gluten-free diet.

Adapting to the gluten-free diet requires some lifestyle changes. It is essential to read labels which are often imprecise, and to learn how to identify ingredients that may contain hidden gluten. Even small amounts of ingested gluten can affect those with CD and cause health problems. Dietary compliance increases the quality of life and decreases the likelihood of osteoporosis, intestinal lymphoma and other associated illnesses. Because osteoporosis is common and may be profound in patients with newly diagnosed CD, bone density should be measured at or shortly after diagnosis. Much more information about this topic can be found at their site: http://www.celiac.org/index.php?option=com_content&view=article&id=3&Itemid=9 .

A dietitian can help you select gluten-free foods. A dietitian is an expert in food and healthy eating. You will learn how to check labels of foods and other items for gluten. A dietitian can help you learn what other foods you can and can’t eat on a gluten-free diet, according to the National Institutes for Health (NIH). The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducts and supports research on celiac disease. Researchers are studying new options for diagnosing celiac disease, including capsule endoscopy, which involves patients swallowing a capsule containing a tiny video camera that records images of the small intestine. Several drug treatments for celiac disease are being studied. Researchers are also studying a combination of enzymes—proteins that aid chemical reactions in the body—that might change gluten in ways that prevent it from causing an immune reaction before it enters the small intestine. Much more detailed material is available at this site: http://digestive.niddk.nih.gov/ddiseases/pubs/celiac_ez/ .

Scientists are also developing educational materials for standardized medical training to raise awareness among health care providers. The hope is that increased understanding and awareness will lead to earlier diagnosis and treatment of celiac disease. Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.clinicaltrials.gov .

For people who suffer from gluten allergies, the best course of action is to talk with your doctor about treatment, and consider the need for a gluten free diet. It is a challenge to remain totally gluten free, but the issues surrounding celiac disease are too important to ignore, especially if you are very allergic to gluten. Talk with a dietician about how to best build a diet that is both nutritious and also able to provide options that do not include gluten.

Until next time.