Is a gluten-free diet in your future?

The Italians are way ahead of the game in diagnosing celiac disease. Since this condition is very prevalent in the Italian population, all children are routinely screened for it by age six.

by Marianne Crafts-Brandner — 

Is someone you know on a gluten-free diet? It is quite possible that person has celiac disease, an intolerance to gluten that causes damage to the intestine.

Gluten is found in the following grains: wheat, rye, barley and wheat-related grains such as triticale, kamut and spelt. Oats, although they do not contain gluten, must be avoided as well because they may be grown in fields subject to cross-contamination with wheat.

Individuals with gluten intolerance treat their condition by avoiding all gluten. There is no known cure for the disease, but following a gluten-free diet reverses the intestinal damage, in most cases. Strict adherence to the diet is the only treatment option available at this time, other than the medications and nutritional supplements used to help repair the damage and restore health.

Celiacs often experience great difficulty in being diagnosed. They may or may not have recognizable symptoms such as diarrhea, constipation and abdominal discomfort. Or these complaints may incorrectly suggest various other gastrointestinal problems such as lactose intolerance and irritable bowel syndrome. The severity of the symptoms varies with the individual and the amount of gluten ingested.

The nature of the condition varies widely, as well. It is actually more common for celiac disease to present atypical symptoms; in the absence of digestive complaints, the disease may continue to masquerade as other disorders.

A study by the Celiac Disease Foundation revealed that the disease is very often misdiagnosed, as the nature of the disease presents obstacles to correct diagnosis. For example, when gluten damages the intestines, it affects their ability to absorb nutrients. This malabsorption and increased intestinal permeability, often called leaky gut, cause a wide variety of ill effects that reach far beyond the digestive system. Some of these conditions, such as osteoporosis and arthritis, may not manifest until later in life. Others become apparent sooner; anemia is one such common condition.

Celiac disease may be labeled as any number of things before the root of the problem is discovered. These are just some of the common misdiagnoses made: irritable bowel syndrome, allergies, spastic colon, thyroid disease, colitis, diabetes, chronic fatigue syndrome, parasites and ulcer. Therefore, it may be worthwhile to rule out celiac disease before undergoing an extensive battery of tests.

Another important aspect of celiac disease is that all three of the following factors must be present before the disease manifests. First is the genetic component; an individual carries a gene that predisposes them to the disease. The second factor is exposure to gluten in the diet. Third is the autoimmune factor.

Something always triggers the adverse reaction to gluten. This could be an infection, such as mononucleosis or Epstein-Barre virus, or exposure to toxic environmental chemicals. A stressful event in the individual’s life may initiate symptoms. The third factor, the autoimmune reaction, helps explain why celiac disease is frequently misdiagnosed as chronic fatigue syndrome and other autoimmune diseases. It also explains why individuals in their 60s or 70s, recovering from the death of a loved one, often develop celiac disease.

The disease appears to have become more prevalent recently. While it is accepted that one out of every 133 people is a celiac, some experts are beginning to suspect the condition may be even more common. Autoimmune diseases, in general, are on the rise, partly due to an increasing number of environmental stressors. More investigation is needed regarding other factors that may trigger these autoimmune reactions.

Although we cannot control most environmental stress factors that trigger celiac disease, we can be aware of certain drugs and treatments that cause increased intestinal permeability. One well-known example is non-steroidal anti-inflammatory drugs (NSAIDS). Also, stressful cancer treatments such as radiation and chemotherapy can interfere with intestinal absorption. More research is needed to determine whether these kinds of drugs and treatments actually trigger celiac disease.

The Italians are way ahead of the game in diagnosing celiac disease. Since this condition is very prevalent in the Italian population, all children are routinely screened for it by age six. Older Italians who suspect they have developed the condition get tested immediately. For this population, the time between onset of symptoms and diagnosis is usually several weeks at most. Contrast this with the average time in our country of eight to 10 years.

If you or someone you know is struggling to solve a health problem, perhaps it’s time to consider the possibility of celiac disease. Trying a gluten-free diet is part of that process — and it may be part of the solution.

More information about all aspects of celiac disease can be found at www. celiac.com.

Marianne Crafts-Brandner is a certified nutritionist. She  offers individualized nutritional counseling, specializing in special diets. scrafts-brandner@cox.net or 602-615-8065.

Reprinted from AzNetNews, Volume 25, Number 2, April/May 2006.