What is gluten?
Gluten often refers to storage proteins found in all grains. These storage proteins are beneficial in food production, adding flavor, texture or thickening. Gluten found in wheat, rye, barley and hybrids of these grains have a similar in amino acid structure known to cause problems for persons with gluten-related disorders.
Gluten can cause health problems for persons with gluten-related disorders, such as celiac disease, dermatitis herpetiformis and other forms of non-celiac gluten sensitivity. Gluten causes small intestinal damage for persons with celiac disease and dermatitis herpetiformis, leading to mal-absorption, malnutrition, and associated health conditions.
Persons who have gluten-related disorders must avoid gluten to maintain good health.
What types of gluten-related disorders are there?
Gluten-related disorders (commonly called gluten intolerances) are both autoimmune (genetic) and innate immune responses (present at birth). Autoimmune gluten disorders include celiac disease and dermatitis herpetiformis. Autoimmune conditions must be triggered to become active. Once activated autoimmune conditions do not go away. Persons with these conditions will suffer tissue damage in the intestine or skin when eating gluten. They may suffer a number of symptoms and related health issues as a result. Gluten sensitivity (also known as non-celiac gluten sensitivity) is an innate immune response, similar in reaction to lactose intolerance. Although this type of reaction does not cause damage to the intestine or skin, it may cause inflammation and other health-related problems. Avoiding gluten is the only way for persons with gluten-related disorders to maintain good health.
How do I know if I have celiac disease?
Blood tests are available to screen for celiac disease but a positive small bowel biopsy is required to confirm the diagnosis of celiac disease. Skin biopsies are used to diagnose dermatitis herpetiformis. At this time, gluten sensitivity is a “rule out” condition. This means all other possible causes of symptoms are ruled out, followed by a trial period of a gluten elimination diet, and the return of gluten to the diet. If there are no other causes of symptoms, and symptoms disappear during the elimination diet and return with the addition of gluten, the diagnosis of gluten sensitivity is made.
Always rule out celiac disease before starting a gluten-free diet.
Once gluten is removed from the diet, it can take a reintroduction of gluten for long periods to diagnose celiac disease.
How can I learn more about celiac disease?
The Gluten Intolerance Group can help you learn more about Celiac Disease. See our education bulletins.
What is a gluten-free diet?
Gluten-free diets avoid the storage proteins found in wheat, rye, barley, and hybrids of these grains such as spelt and Kamut® (khorasan wheat). A person required to follow a gluten-free diet must avoid all sources of gluten in foods, medications and other products that would be ingested. Ingestion of the product is necessary to induce a gluten-related reaction.
Who should eat gluten-free?
People who have been advised by their health care team, dietitian or physician to be on a gluten-free diet should eat gluten-free foods. This would include persons with all forms of gluten-related disorders.
Are gluten-free products safe for individuals with wheat allergy?
Not necessarily, you should consult your physician. Gluten sensitivities are different than allergies and wheat sensitivities.
Gluten-free foods are foods safe for persons with gluten-related disorders. They have no gluten or very low levels of the ‘gluten’ proteins. Celiac disease is a t-cell mediated reaction. Gluten reactions are to the gliadin and glutenin protein fractions in grains (including wheat, rye, barley and hybrids of these grains, such as Kamut® (khorasan wheat), spelt, and many others).
Wheat allergies involve an IgE-mediated reaction to the wheat albumin and globulin proteins fractions. Persons who have wheat allergies often tolerate rye, barley and other grains avoided on a gluten-free diet.
In rare situations, gluten-free products could also induce an IgE-mediated reaction in persons who may also have a wheat allergy.
By definition gluten-free foods could safely have as much as 20 ppm gluten. If a person with a wheat allergy is sensitive to both the albumin or globulin and glutenin or gliadin fractions, they could have a reaction to gluten-free products. In other words, they may have a gluten sensitivity AND a wheat allergy.