Unraveling who really needs a gluten-free diet

gluten-free diet

Celiac disease is a genetically predisposed autoimmune disorder that affects the small intestine when gluten is consumed. Many people follow a gluten-free diet when they do not have celiac disease. For those with celiac disease, it is absolutely essential to eat a gluten-free diet. For everyone else who is avoiding gluten, you may be limiting your choices unnecessarily. [© Andresr | Dreamstime.com]

The Gluten-free Phenomenon

In the last few years, the phrase “gluten-free” has become a household term. Whether you are walking down a grocery store aisle or reading a menu at a restaurant, it is no longer uncommon to see these words. For those suffering from celiac disease, these new additions are a welcome sight.

What Is Gluten?
Gluten is the name used for the proteins found in wheat, rye and barley. It acts as glue in foods, helping them maintain their shape, and is found in many foods.

Celiac and Gluten Connection
Celiac disease is an autoimmune disorder that affects the small intestine when gluten is consumed. According to Johns Hopkins Medicine, “When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine. Tiny fingerlike protrusions, called villi, which line the small intestine and enable the absorption of nutrients from food into the bloodstream, are lost. Without these villi, malnutrition occurs, regardless of how much food a person consumes.”

Celiac disease can be confused with irritable bowel syndrome (IBS) or other bowel issues. Patients are diagnosed most often with a blood test, which is a noninvasive approach. However, the gold standard to diagnose celiac disease is through an endoscopy with biopsies of the small intestine. Before any testing for celiac disease, you should continue to include gluten in your diet to ensure accurate results. Many people follow a gluten-free diet when they do not have celiac disease. For those with celiac disease, it is absolutely essential to eat a gluten-free diet. For everyone else who is avoiding gluten, you may be limiting your choices unnecessarily.

Signs of celiac disease can include bloating, gas, indigestion and diarrhea. However, some patients could have constipation or no GI symptoms at all. If you are having digestion issues, you should see your primary care physician first. If there is no diagnosis and symptoms don’t resolve, then you should visit a gastroenterologist who specializes in conditions of the digestive tract.

Anyone can get celiac disease. In fact, about one percent of the population, or nearly three million people, likely have celiac disease and are unaware of it. Celiac disease is a genetically predisposed disorder. Once a family member is diagnosed, you should be aware that you are at a higher risk of having or developing the disease and may want to be tested. However, you can be a carrier of celiac disease and never show symptoms until later in life, if at all. Being a carrier of the gene means you may not have the disease, but may be prone to it. It does not mean you will definitely develop it. Additionally, people with autoimmune disorders such as rheumatoid arthritis, Type 1 diabetes, osteoporosis, abnormal liver function and/or disease, or anemia are at higher risk for celiac disease. If you have one of these autoimmune conditions, you should consider being tested for celiac disease if you have symptoms and are not improving.

Although there is no cure for the disease, there is a lot of research underway for treatment, including prescription drug studies. Currently, the only treatment that is known to ease the symptoms of celiac disease is to eliminate foods containing gluten from your diet.

So What Should I Eat?
The Celiac Foundation’s website or the National Foundation of Celiac Awareness website have a lot of good information on diet options. The most important consideration when choosing your food is to be mindful of reading labels as many unsuspecting foods, and even some medications, contain gluten.

When Am I Going to Feel Better?
If you have celiac disease and start reducing your gluten intake, you should feel better within a couple of weeks. In some cases it takes up to a month before you notice a difference and start feeling better. Often this occurs because you have unknowingly consumed gluten.

Mahmood Solaiman, M.D., is a gastroenterologist with Gastro Associates in Elkridge. Appointments: 410-590-8920.