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Do you have a gluten problem?

Celiac disease is a condition that is most easily described as an allergy to a protein called gluten. When people with celiac disease ingest gluten, it causes cellular damage to the cells which line the small intestine and results in inability to absorb vitamins and minerals and nutrients. This can result in typical symptoms of celiac disease: anemia, gas, bloating, abdominal pain, and diarrhea. How common is celiac disease? A little bit less than 1% of the general population in the USA have it.

While gluten is usually associated with wheat, a number of other grains like barley and alfalfa also contain gluten and structurally similar proteins which can also cause cellular damage in individuals with celiac disease. Other grains, like oatmeal, are often processed in facilities which also produce gluten-containing grains. Because of this cross-contamination, we usually advise individuals with celiac disease to avoid oats as well as other grains, even though oats themselves do not contain gluten.

We once thought that all patients with celiac disease experienced primarily diarrhea, anemia, and weight loss as symptoms of celiac disease, but we are now recognizing that patients with the disease can experience weight gain, constipation, abdominal pain, skin rashes and a number of other symptoms.

We are also increasingly realizing that a number of patients with Irritable Bowel Syndrome may have a sensitivity to gluten in their diets and that eliminating gluten from their diets may improve their symptoms significantly. Eliminating gluten may improve abdominal pain, bloating, diarrhea, cramps, and constipation in these individuals. This science is still evolving and there still remains considerable controversy. For the record, I believe this is a real problem – I’ve seen many patient whose IBS is much better when they start a gluten-free diet.

A lot of the gluten fad that’s been going on lately has been fueled by the book “Wheat Belly” by Dr. William Davis. I would not recommend this book – it’s full of hype and hyperbole and junk science, much of which has been discredited. Chief among these, is the implicit accusation that gluten levels in wheat have increased over the past decades, which is patently false. The other humorous accusation is that gluten is now somehow “different”. This is also snake oil. Gluten is a molecule, just like water. Neither will ever change in formulation (unlike Coca Cola).

In short, Dr. Davis is interested in selling books, not improving patient health.

If you’re a woman of Northern European descent with any of the symptoms described, you probably should get tested. If you’ve been told that you have IBS and you’ve never been tested, you probably should be tested.

What’s important to understand, however, is that testing should be done while eating a diet which contains gluten. If you’re not on a gluten containing diet, you should probably start back on gluten prior to testing, but always consult with your doctor.

Frequently, biopsies of the small intestine are required for diagnosis.

Treatment is a gluten free diet for life. This can be difficult to follow.

If you’re concerned that you have a gluten problem, gluten sensitive IBS, celiac disease, or any other GI issue, call our office for an appointment – 985-601-2662.