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Issue 94: Got Gluten?

If eating conventional pasta, bread, crackers or other standard grain products create less-than-optimal gut responses, then you may be quick to suspect wheat as the culprit. The truth is, however, that it may be gluten—the protein found in wheat, rye, barley and possibly oats. 

For that reason and others, gluten is quickly becoming a sensitive topic. In fact, an estimated one in 133 Americans has celiac disease, which occurs when ingesting gluten makes the immune system turn on the intestines by damaging the villi—tiny, fingerlike projections in the small intestine that absorb nutrients from food.

"Celiac disease is not just a disease of the gut," says Shelley Case, R.D., nutrition consultant and author of Gluten Free Diet: A Comprehensive Resource Guide. "It's multi-system and multi-symptom—with serious implications." In fact, it’s linked to malnutrition that can lead to anemia, osteoporosis and mental unhealth, among other things.

It’s prevalent, too. There may be as many as three million Americans who have celiac disease, but most may not even recognize it because it is so difficult to pin down. "It takes most adults about 12 years to get a definitive diagnosis of celiac disease," says Michelle Pietzak, M.D., a pediatric gastroenterologist and professor of pediatrics at the Keck School of Medicine of the University of Southern California.

Diagnosis has had its own challenges, too. In the past celiac disease was diagnosed by blood tests and intestinal biopsies, but these would turn up positive only if there was villi damage. Nowadays, however, there are less invasive tests that are much more expedient. 

Celiacs aren’t the only ones dealing with this sensitive topic, though. As many as one in seven folks may have what’s termed Non-Celiac Gluten Sensitivity or NCGS. For those with NCGS, celiac testing has turned up negative or inconclusive results, but they know something needs to change. 

Obviously, many with NCGS start by changing their diet. They avoid gluten at all costs. The problem, however, is that it’s easier said than done since gluten is in so many products including standard grain products, salad dressings, cold cuts, some potato chips and much more.

While NCGS is not celiac disease, it’s certainly not any lightweight problem. It may cause malabsorption, abdominal pain or distention, weight loss or weight gain, muscle wasting, peeling nails, bone pain, joint pain, fatigue, nausea, vomiting, nasal discharge and more.

For those with NCGS—and celiacs as well—lifelong, full removal of dietary gluten is important. They will need to keep a watchful eye, too, because studies indicate that amounts of gluten as low as 0.1 grams can lead to relapses and negative changes in intestinal tissue.

Gluten. There simply is no safe amount for those who are gluten-sensitive.

So go ahead and ask, “Got gluten?” It could definitely make a difference in your health.


This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

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