Gluten Intolerance and Celiac Disease 

Gluten is a natural protein that is found abundantly in grains like rye, barley and wheat. It has been observed that a fair percentage of individuals are susceptible to developing disabling symptoms after the ingestion of gluten or gluten containing products, thus leading to gluten intolerance or celiac disease. For these individuals, gluten intake may lead to digestion problems like diarrhea, flatulence and abdominal pain. Untreated or poorly managed gluten intolerance or celiac disease can also lead to persistent gastrointestinal discomfort, permanent damage to the small intestine and difficulty in assimilating and processing dietary nutrients obtained from food. Consequently, all these factors eventually lead to malnutrition.

Gluten Intolerance and Celiac Disease

1. Difference Between Gluten Intolerance and Celiac Disease

Celiac disease and gluten intolerance involve two different responses to the gluten protein. In gluten intolerance, the body takes the gluten as an invader and mounts an attack directly with inflammation both inside and outside the digestive tract. As for celiac disease, it is an autoimmune reaction to gluten in which such symptoms as malnutrition or osteoporosis only occur when the immune system, spurred by the gluten protein, attacks the lining of your small intestine.

2. Gluten Intolerance

People sensitive to gluten may develop inflammation and villi destruction with persistent exposure to gluten. The villi damage may affect the absorption of major nutrients including minerals and vitamins. Individuals who develop gastrointestinal distress upon consumption of gluten products should eliminate all inflammatory proteins like gluten from their systems in order to prevent the risk of permanent damage to gastrointestinal tract.

3. Celiac Disease

Celiac disease is marked by the destruction or damage to intestinal lining owing to the immune system’s reaction triggered by the consumption of gluten containing foods. As a result, nutrients flush through the gastrointestinal tract without being optimally assimilated. Several physical factors may contribute, such as traumatic shock, severe illness, physical injury and genetics.

Risk Factors of Celiac Disease

Positive family history of celiac disease (CD) in index family members can increase the risk of developing CD in offspring (1 in 22 cases). People with certain genetic disorders or immune conditions have a greater possibility of developing CD. Some disorders associated with celiac include:

  • Intestinal lymphoma
  • Intestinal cancer
  • Lactose intolerance
  • Turner syndrome
  • Down syndrome
  • Lupus syndrome
  • Sjogrean’s disease
  • Addison’s disease
  • Autoimmune liver disease
  • Thyroid disease
  • Type 1 diabetes
  • Rheumatoid arthritis

Symptoms of Gluten Intolerance and Celiac Disease

Although, the patho-physiological events that lead to gluten intolerance are different from the ones observed in celiac disease, the symptoms of the two conditions are just about the same. Symptoms may vary from person to person in terms of frequency, severity and food intake. In some individuals, the symptoms may appear soon after the consumption of food while in others the symptoms may be delayed by a few hours.

Listed below are the common sign and symptoms associated with this condition:

  • Foul smelling stools
  • Stunted growth and malnutrition in children
  • Asthma
  • Dermatitis and eczema
  • Skin rash
  • Joint and muscle pain
  • Mouth ulcers
  • Frequent headaches
  • Irritability and depression
  • Unusual fatigue
  • Nausea
  • Cramps and abdominal pain
  • Flatulence
  • Bloating and gas
  • Constipation or diarrhea

When to See a Doctor

  • It is highly recommended to see a healthcare professional in the following situations:
  • If digestive discomfort and diarrhea lasts for more than 2 weeks.
  • If your child is irritable, pale or he is not growing at a normal pace or has foul smelling bulky stools.
  • Celiac disease tends to have genetic reason. If any person in your family has celiac disease, consult your doctor regarding nutritional counseling and testing.
  • Make sure you consult your doctor before eliminating gluten from your diet in order to confirm that you are sensitive to this protein. If you stop the gluten intake prior to lab investigations, there’s a pretty good chance for results to change.

How to Prevent Gluten Intolerance and Celiac Disease

If you are diagnosed with gluten sensitivity or celiac disease, then it is necessary to eliminate all gluten containing products from your diet. You may seek referral to a registered dietician by your doctor in order to facilitate a smooth transition to gluten-free diet.

Gluten is found in wheat, rye, barley and any foods made with these grains. Thus the only way is to avoid all the foods that may contain gluten.

Foods to Avoid

Category

Foods

Wheat-based foods

White flour, whole wheat flour, durum wheat, graham flour, triticale, kamut, semolina, spelt, wheat germ, wheat bran, bromated flour, pasta, couscous, bread, flour tortillas, cookies, cakes, muffins, pastries, cereal, crackers, non-labeled oats, gravy, dressings, sauces, etc.

Rye-based foods

Rye, rye flour, rye bread, etc.

Barley-based foods

Malt, malt flavoring and malt vinegar, pearl barley, barley groats, barley flakes, etc.

Other foods with gluten

Broth in soups and bouillon cubes, breadcrumbs and croutons, some candies, fried foods, imitation fish, some lunch meats and hot dogs, malt, matzo, modified food starch, seasoned chips and other seasoned snack foods, salad dressings, self-basting turkey, soy sauce, seasoned rice and pasta mixes, etc.

Beverages

Instant coffee, instant tea, some herbal teas, instant cocoa with grains added; malted milk, chocolate or flavored milk with cereal fillers added; rice or soy beverages using barley enzymes; beverages with flavoring syrups of unknown content or those that contain cereal grains or malt; some root beers, ales, lagers, malted wine coolers, etc.

Tips to Remember

  • Always check the label before buying packaged foods, as the ingredients in food products change frequently.
  • Remember that "wheat-free" does not automatically mean "gluten-free". While a product may not contain wheat, it can still contain rye or barley in some form.