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Gluten Disease

Gluten Intolerant & Gluten Treatment

Causes and Foods to Avoid Eating

Celiac disease means a person can't eat gluten, a protein found in wheat, rye, or barley. Gluten may also be found in some medicines. Celiac disease is hereditary and the treatment for celiac disease is a gluten-free diet. Other names for celiac disease are celiac sprue and gluten intolerance.

gluten intolerant foodAmong those who suffer from allergies or sensitivities to specific foods, one of the more challenging food sensitivities is intolerance to gluten. Gluten is a combination of two proteins, gliadin and glutenin, found in certain grains (including wheat, barley, rye and oats). Gluten's function is to form a sticky protein that provides the elasticity and structure to baked breads. It is the gliadin portion in gluten that elicits the allergic response, which varies in severity and manifestation of symptoms in those with this condition. The only treatment is complete removal of gluten from the diet, something that can be nearly impossible to achieve.

Although the body's response to gluten sensitivity is an autoimmune reaction, it is not considered a true allergy, but rather is usually referred to as "gluten intolerant enteropathy" or celiac disease and is characterized by damage to the small intestine. It is thought that the increased permeability of the gut lining allows gliadin entry into the intestinal lamina, thereby triggering release of antibodies and inflammatory responses. Repeated insult by gluten ingestion further damages the intestine, causing lesions and villi atrophy. This can lead to many problems including malabsorption, and if in a child, failure to thrive. Some of the most common symptoms are indigestion, abdominal bloating, and diarrhea.

The symptoms of gluten intolerance can be similar to other gastrointestinal diseases, it can be easily misdiagnosed, meaning it may be even more common than the numbers show. Celiac disease is thought to be a genetic disorder which can be diagnosed early in some children; however, others may not experience it until much later in life. Having an environmental trigger is believed to be an important component of the disease. Possible triggers include viral infection, parasites, or recent surgery.

Most people with celiac disease have one or more symptoms, but not all have digestive problems. And some people with the disease don't have any symptoms. Having one or more of these symptoms does not mean a person has celiac disease because many other disorders include these symptoms.

The only treatment for gluten intolerance is the permanent removal of all gluten from the diet. Although the severity of the intolerance varies, some individuals can't tolerate even a molecule of gluten. This means avoiding anything made with wheat, rye, barley and oats. The most obvious foods to eliminate are baked goods such as breads, cakes, cookies, muffins, pancakes, and crackers. Less obvious ones are tortillas, pasta, cereals, and snack bars. Diligent label reading is necessary because even small amounts can be found in unsuspected food sources. For example, wheat flour is frequently added as a flow agent to seasonings and spices or as a thickener to soups and condiments. Gluten is also added as stabilizers in hot dogs, cold cuts, sandwich spreads, and canned meats.

Since it is pretty clear which grains need to be avoided by persons with gluten intolerance, there are still some grains in question. One of these is oatmeal. Current research is inconclusive regarding tolerance to oatmeal. Results range from completely intolerant, ability to tolerate some, to completely tolerant. One concern with oatmeal and other products, is cross contamination. When the oatmeal is processed in the same place as wheat it is possible to become contaminated with gluten. This cross contamination issue can apply to restaurants too. Even though a dish might be made with gluten free ingredients, it could still be cooked on the same grill as wheat battered fish.

Fortunately for gluten intolerant sufferers, gluten-free foods are now available at health food stores and even some major grocery stores. Alternative grains like rice, corn, quinoa, amaranth, or millet are being incorporated into gluten-free pastas, cereals, snacks bars and baking mixes, to mention a few. These products can be expensive so learning to cook gluten-free is also an option. Wheat flour can be substituted with many other flours such as amaranth, rice, sorghum, and soy flours. Baking with other flours takes a little more work than simply switching out wheat for the alternative flour, but there are several cookbooks and websites with gluten-free recipes to help out.

doctor visit If your doctor thinks you have celiac disease (gluten intolerance), you will need a blood test. You will need to follow your regular diet before and while being tested. If you don't, the results could be wrong.

If your test results show you might have celiac disease, the doctor will perform a biopsy to make sure celiac disease is the problem. For a biopsy, the doctor takes a small piece of tissue from your small intestine. To get to your small intestine, the doctor puts a long tube into your mouth and down into your stomach. At the end of the tube are small tools for snipping out the bit of tissue needed to view with a microscope. You will take medicine before the biopsy that makes you very sleepy. It also keeps you from feeling any pain. Many people sleep through the procedure.

man talking with a dietitian about his gluten free dietThe only treatment for celiac disease is a gluten-free diet. A dietitian can help you learn how to select gluten-free foods. A dietitian is an expert in food and healthy eating. You will learn to check labels of foods and other items for gluten. If you eliminate gluten from your diet, your small intestine will heal. If you eat gluten, or use items that contain gluten, you will harm your small intestine.

The lists of foods below will give you an example of what you can eat and foods you should stay away from. This list is not complete. A dietitian can help you learn what other foods you can and can't eat when following a gluten-free diet.

Allowed Foods
Amaranth
Arrowroot
Buckwheat
Cassava
Corn
Flax
Indian rice grass
Job's tears
Legumes
Millet
Nuts
Potatoes
Quinoa
Rice
Sago
Seeds
Soy
Sorghum
Tapioca
Wild Rice
Yucca
Foods To Avoid
Wheat
  • Including einkorn, emmer, spelt, kamut
  • Wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein
Barley
Rye
Triticale (a cross between wheat and rye)
Other Wheat Products
Bromated flour
Durum flour
Enriched flour
Farina
Graham flour
Phosphated flour
Plain flour
Self-rising flour
Semolina
White flour
Processed Foods that May Contain Wheat, Barley, or Rye*
Bouillon cubes
Brown rice syrup
Chips/potato chips
Candy
Cold cuts, hot dogs, salami, sausage
Communion wafer
French fries
Gravy
Imitation fish
Matzo
Rice mixes
Sauces
Seasoned tortilla chips
Self-basting turkey
Soups
Soy sauce
Vegetables in sauce
* Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer.

There are millions of people who believe that they have food allergies when in fact, they actually just have body intolerance to certain types of food. One prime example is milk consumption. Many people drink milk and end up with upset stomachs, gas and even diarrhea. This reaction to cow's milk is food intolerance rather than an allergic reaction. The same thing could occur with other food products such as those that contain gluten, a protein found in barley, wheat and rye.

Another type of food intolerance is an adverse reaction to certain products which are added to food to enhance the taste, provide color, or protect against the growth of microorganisms. Sulfites can occur naturally in foods or are added to enhance crispness or prevent mold growth. Sulfites in high concentrations can sometimes pose problems for people with severe asthma. Sulfites can give off a gas called sulfur dioxide. There are several other diseases that share symptoms with food allergies, including ulcers and cancers of the gastrointestinal tract. These disorders can be associated with vomiting, diarrhea, or cramping. Gluten intolerance is associated with the disease called gluten sensitive enteropathy or celiac disease.