There is so much buzz about gluten that it almost becomes cliché to say “I'm gluten free.” I have had a lot of people ask me about gluten recently, and no one asks me the same question or uses the same words. "Gluten intolerance," "celiac," "gluten allergy," "wheat allergy," and "gluten free"...it is definitely apparent that there is a lot of confusion.
The first issue with all of the gluten “buzz” is that people (celebrities, listen up!) are diagnosing themselves. I am the first to admit that I, as a dietitian, cannot diagnose.
Celiac disease has to be defined by a blood test, not by symptoms only. Gluten sensitivities, after celiac has been excluded, can be diagnosed by an elimination diet that is supervised by a physician or dietitian. The biggest problem I see with self-diagnosis is that a person can easily miss a more serious issue, or self treat a condition by the wrong methods. This results in potentially serious complications and, at the very least, improper nutrient intake.
Jill Koegel is a registered dietitian and certified personal trainer based in Omaha. She blogs every Wednesday. Read more from Jill.
To set the record straight, I want to define and explain the different kinds of gluten problems that I, as a dietitian, am hearing.
This is a disease triggered by the intake of gluten, which is the protein in wheat, barley and rye. When a person with celiac disease eats gluten, their digestive system essentially “attacks” itself, damaging the parts of the intestine that are responsible for absorption of nutrients. If celiac disease is untreated, it can lead to complications such as other autoimmune diseases, thyroid problems, and cancer. Celiac disease diagnosis begins with a blood test, and should be conducted while a person is still consuming gluten.
Gluten intolerance or sensitivity
This is sometimes called “non celiac gluten sensitivity,” and is a catch-all diagnosis for those people who are symptomatic, but test negative for celiac disease. The sensitivity may involve similar symptoms to celiac, but is less severe. The diagnosis involves elimination of wheat allergy and celiac first, and then it is a process of following a supervised gluten free diet to check symptom responses.
When ingestion of foods containing wheat results in an allergic reaction such as a rash, swelling of the mouth and throat, congestion, or anaphylaxis, a wheat allergy is present and has to be treated. This reaction is often confused with celiac, because it is a body's reaction to the proteins found in wheat. However, celiac is different, in that it involves the digestive reaction and symptoms to gluten, which is just one specific protein found in wheat, barley, and rye.
Having an accurate diagnosis is important because treatment has to be specific to the problem. I like to compare over-diagnosing to replacing your car's motor, instead of diagnosing a noise under the hood. It is costly, both physically and mentally, and if the problem is really something else, your car is going to endure more damage. If you suspect a gluten sensitivity or celiac disease, it is important to first talk to your doctor. Testing should be conducted while consuming a non gluten-free diet, so that reactions can be accurately assessed.
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