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Celiac disease and gluten intolerance: Diagnosis and treatment

Kimberly Kaye lives and writes in New Jersey with her longtime boyfriend and their deaf pit bull. Her work has appeared in Draft, NEW, CityBelt, and on OldCookbooks.com.

Gluten-free For Life

Like trans fats, refined sugar and carbs, there is a new dietary -œbad kid- on the block - and its name is gluten. Lurking in a vast array of food, pharmaceutical and cosmetic items, gluten is seemingly everywhere, from cereals and frozen dinners to vitamins and lipstick. And while some nutritionists attribute the expanding selection of gluten-free foods at your supermarket to mere hysteria, for many women gluten intolerance is a complicated reality. At worst, for the three million Americans with celiac disease, it can be a matter of life or death.

Wheat

WHAT IS CELIAC DISEASE?

Gluten is a protein found in grains such as wheat, barley, spelt, rye, kamut and triticale. For those with celiac disease (also referred to as celiac sprue or gluten-sensitive enteropathy), consuming these proteins triggers an autoimmune response within the body, causing the immune system to attack healthy tissue, resulting in chronic inflammation.

Over time, this inflammation can damage intestinal villi (tiny projections in the small intestine which aid nutrient absorption), eventually leading to malnutrition, osteoporosis, anemia, infertility and neurological problems. Additionally, celiac disease has been linked to other autoimmune diseases such as thyroid disease and diabetes and those with celiac disease who do not remove gluten from their diets also risk higher rates of stomach cancers as time goes on.

Across the globe, celiac disease effects 1 in every 266 individuals – in the United States, the number is closer to 1 in 133. Due to the genetic nature of the illness, people with family members with diagnosed celiac disease are at particularly high risk (1 in 22 for blood relatives). Despite its prevalence, celiac disease can be difficult to identify. A study from Columbia University reported it can take an average of 11 years from the onset of symptoms to get a formal diagnosis, with numerous misdiagnoses in between. And while many patients show distinct symptoms such as diarrhea, gastrointestinal distress, fatigue, joint pain and blistery skin rashes, others are asymptomatic or have no symptoms at all, leaving a startling number of people with celiac disease undiagnosed for years – if they are fortunate enough to be diagnosed at all.


WHAT IS GLUTEN INTOLERANCE?

Gluten intolerance, by comparison, is a less serious condition (though still unpleasant), more akin to food allergies such as lactose intolerance. While gluten intolerance can lead to symptoms such as abdominal pain, bloating, diarrhea, gassiness, headaches and fatigue, it is not an autoimmune disease, and therefore has fewer long-term complications once gluten has been removed from the diet. However, this does not mean that gluten intolerance should be left untreated. Chronic gastrointestinal distress caused by gluten intolerance can cause serious discomfort and wreck unnecessary havoc on the body.

If you are experiencing gastrointestinal discomfort from gluten intolerance, you are not alone. Gluten intolerance may be more prevalent than previously thought. Dr. Christiane Northrup, a noted women's health expert, estimates that as many as 1 in 4 women are at least gluten sensitive.


DIAGNOSIS FOR CELIAC DISEASE

While there is no clinical diagnostic test for gluten intolerance, celiac disease can be diagnosed using a simple blood test. A small intestine biopsy (performed during an endoscopy) may also be necessary. Diagnosis can also be obtained through a biopsy of the distinctive, itchy rash associated with celiac disease, which can appear on the face, torso and limbs.


TREATMENT FOR CELIAC DISEASE

Once diagnosed, people with celiac disease need to remove all gluten from their diet – permanently. Additional blood tests can be performed periodically after going gluten-free in order to monitor the success of the dietary changes.


TREATMENT FOR GLUTEN INTOLERANCE

For those who do not test positive for celiac disease but show symptoms of gluten intolerance (after eating gluten), an elimination diet may be in order. Suffers can try eliminating all gluten from their diet while keeping a daily journal of symptoms. If symptoms subside, then a gluten-free diet can be adopted permanently. If symptoms continue, patients should consult with a physician – another medical condition or food allergy may be to blame.


GLUTEN-FREE SHOPPING

Gluten-free food and shopping lists are widely available on the internet and through major celiac disease organizations, such as the American Celiac Disease Alliance or Celiac Sprue Association. Many gluten-free foods are also available for purchase through websites, such as GlutenFree Mall.

 



For more gluten-free information and recipes, visit these links:
Tips to live gluten-free

Gluten-free recipes

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