Gluten is a type of protein found in grains like wheat, rye, and barley. Most people are able to eat gluten without any concern, but some people are intolerant to gluten, or have a gluten-related disorder. In other words, ingesting products that contain gluten can lead to extreme discomfort, pain, or, in some cases, serious medical conditions.
Types of gluten-related disorders
There are three types of gluten-related disorders.
Celiac disease is an autoimmune condition. When a person with celiac disease eats gluten, his or her body reacts by initiating an immune response. However, the immune response is directed at the lining of the intestines. This damages the lining of the intestines, which affects how well the body can absorb nutrients. Because many people with Celiac disease experience difficulty getting all the nutrients they need, nutritional deficiencies and malnutrition are possible.
Non-Celiac gluten sensitivity (NCGS) is also characterized by an intolerance to gluten. In non-celiac gluten sensitivity, though, the body’s immune system doesn’t attack the intestines every time gluten is ingested. Therefore, unlike celiac disease, it does not result in intestinal damage. Because non-celiac gluten sensitivity is a relatively newly-recognized condition, it’s still unclear whether gluten truly is the cause, or if another sugar or chemical compound in wheat is to blame.
Although celiac disease and non-celiac gluten sensitivity are both triggered by gluten in wheat, they are distinctly different from a wheat allergy. When someone is allergic to wheat, he or she will experience an allergic response involving histamine after eating wheat. Because it is an allergic response, rather than an intolerance, a wheat allergy can be diagnosed by use of a blood test or a skin-prick test.
The symptoms of a wheat allergy are also different from those of celiac disease or non-celiac gluten sensitivity. As with any allergic response, a reaction to wheat might cause itchy eyes, wheezing, hives, or congestion. Digestive symptoms, such as nausea, diarrhea, or bloating, are possible, as well.
For a straightforward, simple explanation of the differences between the three gluten-related disorders, check out this chart from the UCLA Division of Digestive Diseases.
Symptoms of gluten sensitivity
The symptoms of celiac disease and non-celiac gluten sensitivity can be similar to each other.
A multitude of symptoms is possible with both celiac disease and non-celiac gluten sensitivity, as noted by the University of Chicago Celiac Disease Center:
“There are hundreds of signs and symptoms of celiac disease, many of them subtle and seemingly unrelated… Symptoms may or may not occur in the digestive system. For example, one person might have diarrhea and abdominal pain, while another person has infertility or anemia. Some people develop celiac disease as children, others as adults.”
The symptoms of celiac disease are almost always more severe than those associated with non-celiac gluten sensitivity. Additionally, it’s been suggested that in people with non-celiac gluten sensitivity, the symptoms will be more outside the gastrointestinal tract, such as fatigue rather than nausea.
Potential symptoms associated with both conditions include:
- Abdominal pain and bloating
- Diarrhea or constipation
- Iron deficiency
- Delayed puberty, short stature, or failure to thrive
- Infertility or miscarriage
- Hair loss
- Neurological disorders
- Liver dysfunction
The best way to avoid the complications and pain associated with celiac disease and non-celiac gluten sensitivity is to get a firm diagnosis. It isn’t possible to do this while eating a gluten-free diet, so if you suspect you have celiac disease or non-celiac gluten sensitivity, speak to your physician before cutting gluten completely out of your diet. However, if you believe you have a wheat allergy, avoid any products containing wheat and speak to a physician as soon as possible.
Chronic pain and gluten sensitivity
Several types of pain can be associated with gluten-related disorders.
Abdominal pain is certainly one of the most prevalent types of pain associated with celiac disease and non-celiac gluten sensitivity. However, because of the potential for malnutrition with both of these disorders, there are additional types of pain that can occur. For instance, joint pain is relatively common with both disorders. Peripheral neuropathy, which can cause pain, tingling, and numbness in the hands and feet, is also possible.
Additionally, bone density can be affected, potentially leading to mild (osteopenia) or severe (osteoporosis) bone density loss. Individuals with lowered bone density are at an increased risk for broken or fractured bones. Typically, the longer it takes to be diagnosed and make the necessary lifestyle changes, the higher the risk is for bone loss.
Embracing a gluten-free diet
A gluten-free diet is the most crucial lifestyle change for people diagnosed with celiac disease or non-celiac gluten sensitivity.
There is no known treatment for celiac disease, non-celiac gluten sensitivity, or wheat allergy, other than a gluten-free diet. The most common ingredient to avoid is wheat, but many people with a gluten-related disorder also need to avoid other grains and cereals. For some individuals, even eating a very small amount of something that contains gluten – such as the crumbs left behind on a cutting board – might trigger a reaction.
Thankfully, gluten-free products are becoming more common in stores and restaurants, so it’s getting easier to maintain a gluten-free diet. Stores are carrying more gluten-free cookbooks, too. If you’re adventuresome, the internet is full of blogs that churn out one mouthwatering recipe after another, and plenty of these blogs are gluten-free.
For instance, Gluten-Free Goddess has lots of recipes, plus this excellent information on gluten-free substitutions for different types of flours. Kitchen Operas has a huge array of recipes arranged by season, as well as several very helpful how-to posts. Several gluten-free blogs feature vegan and vegetarian recipes, like Beard & Bonnet. Many, such as Sondi Bruner, also have a lot of allergen-friendly recipes.
Have you ever tried to follow a gluten-free diet?
Image by Emily Carlin via Flickr