Gluten Enteropathy, Gluten
Sensitivity, Gluten Intolerance…. What is YOUR problem with bread?
A conversation between
two friends:
“I just got a
diagnosis from my doctor. I have Celiac
disease and HAVE to avoid gluten…it actually damages my small intestine.”
“I’m
going gluten free, too.”
“You have
gluten enteropathy, too? Are you
sure? It’s not THAT common….”
“I think
I have a gluten problem… I’m not sure but I don’t feel great when I eat bread. I feel better when I don’t do grains. They make me feel bloated, tired, head-achy,
dizzy, and gassy.”
“Oh…When I eat
gluten, I have really bad diarrhea, get very bloated, have stomach cramps, and
I’ve become anemic. I had a blood test and a biopsy to confirm and
I definitely have the disease.”
“I don’t
have a “disease”…I just feel better when I don’t eat bread, crackers, cereal,
pasta.
It
seems as if everyone is avoiding gluten these days….and spending a LOT of money
on gluten replacements made of corn, rice, potatoes, amaranth, quinoa…..what is
going on?
Sixty million gluten-free products
are consumed in the U.S. each day. But
the question remains as to how many of these products are consumed out of
necessity
There
is a condition that requires the
avoidance of gluten. It is called Celiac
Disease, gluten enteropathy, or Celiac sprue.
For years, I saw a patient or two a month (maximum) to learn a gluten-
free diet for diagnosed Celiac disease.
Now, every other patient I work with tells me they can’t have
gluten. What gives?
Celiac disease is a chronic disease of the
digestive tract that interferes with the digestion and absorption of gliadin, a component of gluten.
Gluten is a protein commonly found in wheat, oats,
rye, and barley. When people with Celiac disease ingest gliadin, the villi in
their small intestine become damaged by an immunologically mediated inflammatory
response. As a result of this damage to
villi of the small intestine (finger-like projections that aid in the
absorption of valuable nutrients) there
is maldigestion and malabsorption. People with uncontrolled Celiac disease can
be malnourished and experience persistent diarrhea . A small number of people have only subtle symptoms .
Celiac sprue has a strong hereditary
component. The prevalence of the condition in first-degree relatives is
approximately 10%.The frequency of celiac sprue in the United States is
relatively low, estimates suggest that approximately 1% of the population is
affected
The
blood test for celiac disease is very sensitive, he says, but a person needs to
be eating gluten for the test to detect antibodies that indicate celiac
disease. There is also a biopsy that can
be done to confirm the diagnosis of gluten enteropathy.
To get
a valid diagnosis, the test must be done before gluten is eliminated from the
diet. If you truly have Celiac disease
and eliminate gluten from your diet, the antibodies in the blood slowly
decrease and become normal in about 6 months.
So, if you are tested for Celiac after being gluten free for a period of
time, you may test negative even though you truly have the disease. As soon as gluten is re-introduced,
antibodies and inflammation will return.
So, if
only 1% of the population has Celiac disease, what’s with all this gluten-free
media blitz?
There
are some people who are sensitive to gluten.
When you test them, they test negative for Celiac sprue because they don’t
have the condition. But…they may have
symptoms when they eat wheat, oats, rye, or barley including fatigue,
headaches, bloating, gas, some diarrhea,
irritability, dizziness. They feel
better when they avoid gluten. Eating
gluten does not damage their small intesting and will not cause malnutrition , osteoporosis, or anemia.
Though
Celiac disease can be diagnosed through a blood test and an intestinal biopsy
that shows damage to the villi, there’s no reliable test for gluten
sensitivity. The intestine is not damaged from gluten and it appears normal on
biopsy. There is no immune response
causing inflammation, so it is not present in sensitivity issues.
Rather,
for gluten sensitivity, “the diagnosis rests on history.
If you
think you react badly to gluten, see a doctor for Celiac testing before you
start any gluten-free diet. One has to first rule out and investigate Celiac
disease. Since 10% of people diagnosed
with real gluten enteropathy have a first degree relative with the disease, it’s
important to know if you have it. Also,
with gluten enteropathy, having a little bread
here or there causes actual damage to the intestine. So, remaining without gluten is imperative.
Be
careful when choosing from the growing number of gluten-free products on the
market shelves, They’re typically higher in carbohydratesand lower in fiber, higher in fat than regular
bread products. .You might be better off baking your own bread with corn meal,
quinoa, amaranth, or quinoa
Another thought….are you gluten intolerant
or are you uncontrolled Metabolism B. Is
it gluten that causes your fatigue, headaches, bloating, dizziness…or is a
response your body has to high carbohydrates; including bread, crackers, pasta,
cereal, fruit, milk, yogurt, rice, legumes?
If you have uncontrolled Met B and
you go gluten free…..you may feel “better” as you are using less pasta,
crackers, cereal, breads….but might feel your “best” on a program that helps
regulate insulin.
If you believe you do not have Celiac
disease, feel better (but not great) without gluten…you may want to consider
reading the informative website: www.themetabolismmiracle.com. If your problem is an insulin/carb problem,
gluten free will only get you part way to feeling great!
