What is a Gluten Allergy?
Gluten allergy is a term that is used to describe gluten-related conditions. It is not a medical term and it is not a true allergy. Gluten allergy often refers to celiac disease or gluten sensitivity.
So, what is celiac disease and gluten sensitivity?
Celiac disease is an immune disorder of the small intestine that impairs digestion of certain food. It is triggered by exposure to gluten in the diet and causes inflammation and damage of the small intestine in genetically susceptible individuals. Gluten is a protein found in grains such as wheat, barley, and rye. When gluten is removed from the diet, the intestinal inflammation improves. Celiac disease usually presents between the ages of 10 and 40, but it can occur in infants. Symptoms in older children and adults include constipation or diarrhea (most common), flatulence, abdominal distension, and possibly symptoms of malabsorption (weight loss, severe anemia, vitamin deficiencies, decreased bone density).
Many people have mild and nonspecific symptoms including fatigue and iron deficiency, or they do not have any symptoms. Those who think they have celiac disease should contact their primary care provider before starting a gluten-free diet. Providers can order tests to aid in the diagnosis. The tests are most accurate when a gluten-rich diet is maintained because it shows how the body reacts to gluten.
The best treatment is a gluten-free diet – avoid foods that contain rye, wheat and barley such as bread, pasta, pastries, cereal, certain sauces and condiments, and beer. If celiac disease is not treated it can lead to other serious health problems. People who have celiac disease usually feel better a couple weeks after starting a gluten-free diet. This can be a major lifestyle change because many people consume gluten-containing foods on a daily basis. Gluten-free foods include meat, eggs, rice, quinoa, potatoes, soy, fruits, vegetables, flours and pastas that are labeled “gluten-free”, and wine and distilled alcohol. Providers might recommend vitamins to supplement what is not provided in a gluten-free diet. It may be helpful to consult with a dietician to better understand the gluten-free diet. A dietician can teach you which foods to eat, plan healthy and balanced meals to provide the most nutrition, and give you gluten-free recipes.
Gluten sensitivity is a condition with similar symptoms to celiac disease, but individuals do not test positive for celiac disease. Symptoms decrease after initiating a gluten-free diet. Unlike celiac disease, individuals with gluten sensitivity do not experience damage to the small intestine. The only treatment is a gluten-free diet.
“Gluten allergy” is different from wheat allergy which is a true food allergy. Individuals allergic to wheat experience a reaction immediately (minutes to hours) after ingestion. Reactions may range from mild skin rashes to anaphylaxis which is life-threatening. Wheat allergy typically occurs in children and is outgrown by adulthood. This allergy is diagnosed by laboratory testing and history. Management of wheat allergy requires avoiding exposure to wheat. Wheat is found in many food products and contained in some cosmetics. It is very important to read food labels and to inquire about menu options at restaurants to avoid wheat.
For more information about celiac disease and gluten sensitivity, visit any of the following websites and contact your primary care provider if you think you have one of these conditions.