So – you think you are gluten intolerant. Or you may even have heard of Coeliac disease, and may wonder if you suffer from it. While many people feel uncomfortable after eating wheat products, there are surprisingly few people who suffer from true gluten intolerance, and 1 in every 100 people worldwide suffer from Coeliac disease. Wheat is often blamed for gut upsets and many people self-diagnose as gluten intolerant. But what is wheat or gluten intolerance and what is Coeliac diease?
Let’s start by exploring gluten. Gluten is the gluey and tough substance remaining when the flour of wheat or other grain is washed to remove the starch. First recorded in 1590–1600, gluten is from the Latin word glūten (which means glue). Gluten is a group of nitrogenous proteins found in certain grains, such as wheat, barley and rye. When we experience an allergic reaction or an intolerance to a food product, it simply means that our intestines can’t break down the protein into its constituent amino acids and tiny bits of it remains in our small intestine. These tiny particles then enter our lymphatic system and start to attract the attention of our immune cells. The immune cells then attack this “foreign body”. The next time we have gluten, the immune cells recognise this foreign body, and attack it more vigorously. These attacks become more and more aggressive every time the immune cells detect gluten, and we develop an intolerance to said gluten. The above reaction can happen with any foods that are fatty and rich in protein, such as dairy, eggs and peanuts. The more difficult it is to digest, the greater the risk that we can develop an intolerance or allergy to the food. It is also possible that the walls of our gut become temporarily more porous for reasons unknown at this stage, which allows the tiny particles of food to enter the tissue of the gut and the bloodstream.
Historically, doctors dismissed gluten sensitivity as being “just in your head” (How Not To Die, Michael Greger, MD). They even referred the patients to psychiatrists as the doctors believed the patient had underlying mental illnesses. Fortunately research has shown that gluten intolerance and gluten sensitivity are real, and patients are being taken seriously!
Let’s take a look at gluten sensitivity symptoms. Painful, bloated belly, flatulence, diarrhea, constipation and a general feeling of an uncomfortable gut, including reflux, are a few symptoms of gluten intolerance. Some people complain of brain fog and painful joints as well, and IBS (Irritable bowel syndrome) can also aggrevate the symptoms.
Abdominal pain is also the single most common symptom of an intolerance to gluten. Up to 83% of those with gluten intolerance experience abdominal pain and discomfort after eating gluten. Gluten-intolerant individuals can also be prone to fatigue and tiredness, especially after eating foods that contain gluten. Up to 60–82% of gluten-intolerant individuals commonly experience tiredness and fatigue. Furthermore, gluten intolerance can also cause iron-deficiency anemia, which in turn will cause more tiredness and lack of energy. A gluten-free diet usually clears all of the symptoms mentioned above up, and even if they do eat wheat in moderation, they do not risk serious damage to their small intestine.
However, one of the biggest dangers in suspected gluten intolerance is consulting Dr. Google. Self-diagnoses is extremely dangerous as there can be serious underlying issues, such as Coeliac Disease. As mentioned earlier, this autoimmune disorder affects 1% of the population. Simply put, it is a genetic intolerance to gluten and the gluten can cause serious infections or damage to the villi (tiny finger-shaped processes of the mucous membrane of the small intestine that serve in the absorption of nutriment) of the gut wall, as well as causing damage to the nervous system. Symptoms of Coeliac disease are constant, severe diarrhoea, stunted growth in children or “winter pallor” or unnatural paleness. Other symptoms can include:
- excessive wind and/or constipation
- persistent or unexplained nausea and vomiting
- recurrent stomach pain, cramping or bloating
- any combination of iron, vitamin B12 or folic acid deficiency
- anaemia
- tiredness
- sudden or unexpected weight loss (but not in all cases)
- mouth ulcers
- skin rash (dermatitis herpetiformis)
- tooth enamel problems
- liver abnormalities
- unexplained subfertility
- repeated miscarriages
- neurological (nerve) problems such as ataxia (loss of coordination, poor balance) and peripheral neuropathy (numbness and tingling in the hands and feet) (www.coeliac.org.uk)
There is no evidence to suggest that following a gluten-free diet has any benefits for a Coeliac sufferer. In fact, there is evidence that a gluten-free diet may adversely affect gut health and immune function in people with the disease as it affects the gut flora adversely, promoting an overgrowth of harmful bacteria in the intestines. This is due to the beneficial effects of the components wheat-sensitive sufferers have problems with – such as foods containing fructans (contained in wheat) that act as prebiotics and feed the good bacteria in the gut, and the gluten itself, which can boost immune function.
It certainly is a damned if you do, damned if you don’t situation. For Coeliac sufferers, gluten is definitely the enemy – even twenty parts per million can be toxic to them – but it is easily overlooked. If you suspect you may have Coeliac disease, ask your doctor to do a formal evaluation for Coeliac disease before you embark on a gluten-free diet. If you don’t have the disease, it is recommend to first try a healthier way of eating – more fruits, vegetables, whole grains and beans, whilst avoiding processed foods. Processed foods may be the reason people who go on a gluten-free diet feel better, because the fast food and poison in processed food have been removed from the diet. If this doesn’t help, consult your doctor; increase your intake of pre- and probiotics and have yourself tested for wheat allergy and Coeliac disease. But don’t self-diagnose, and don’t embark on something before you are 100% sure you should!
(Sources: http://www.gutshealth.co.uk: What is Celiac Disease?; http://www.healthline.com: 14 Most common signs of Gluten Intolerance; How Not To Die, Michael Greger, MD; Gut, Giulia Enders)
Historically, doctors did not recognise gluten sensitivity and referred many a patient to a phychiatrist as they thought the symptoms were all “in the patient’s head”
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