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THE TRUE GLUTEN-FREE CANDIDATE 

Possibly the only true candidate for a totally gluten-free diet is a person who has damage to the tiny, fingerlike protrusions lining the small intestine called villi. Villi allow nutrients from food to be absorbed into the bloodstream. When damaged, the body cannot absorb nutrients properly, leading to malnutrition—regardless of the quantity or quality of food eaten. This is celiac disease and those suffering from it must abstain from gluten in all forms. Unfortunately, celiac disease can be misdiagnosed as irritable bowel syndrome, Crohn’s disease, diverticulitis, intestinal infections, iron deficiency, anemia and even chronic fatigue syndrome. It is estimated that about one percent of the U.S. population has celiac disease.

Although this article is not meant to discuss or address celiac disease as such, I am including information about the necessary testing that may determine whether a complete gluten-free diet is even advisable. The results of a blood test can help detect celiac disease. If a blood test comes back positive for the appropriate antibodies an upper endoscopy may be performed to assess possible damage to the small intestine, more specifically the duodenum. If there is flattening of the villi, those finger-like projections that absorb nutrients, the doctor will work with the patient to create a gluten-free diet. Genetic testing is also helpful for relatives of those with celiac disease, as the disease is hereditary and common among first-degree relatives.

NEW APPROACH IN DIAGNOSTICS 

A fairly new approach that seeks to provide more sensitive, complete and early screening is available from EnteroLab. Their test is based on earlier research which demonstrated that anti-gliadin antibodies appear in the contents of the intestines before they appear in the blood. EnteroLab utilizes stool samples to test for these antibodies in gluten-sensitive individuals with the hope of positively identifying the condition before more extensive damage to the body has occurred.

People with non-celiac gluten sensitivity generally have an unpleasant response to eating gluten. Symptoms can be similar to those of IBS (irritable bowel syndrome): bloating, diarrhea, and flatulence following the consumption of gluten-containing foods. They may also experience headaches or fatigue following the consumption of gluten. Unlike a true celiac sufferer, these reactions may not occur every time gluten is eaten; there is also no correlation with autoimmunity, making this very different from celiac disease.

Wheat allergy—the third form of gluten intolerance—is a histamine response to any of several different forms of protein, including gluten, found in wheat.

TO BE CONTINUED 

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