Gluten intolerance covers a range of gut problems caused by ingesting proteins found in wheat, barley, rye and in some cases, oats. The three main groups affected are those with a direct sensitivity to gluten, coeliac disease and people who are allergic to wheat. Although symptoms can appear similar and the terms are often used interchangeably, gluten intolerance isn’t the same as coeliac disease.

Coeliac disease is a serious life-long autoimmune condition of the small intestine, in which the body’s immune system attacks itself when someone with the condition eats gluten. This damages the healthy lining of the small intestine and stops nutrients being absorbed from food.

Gluten intolerance is also a permanent condition that damages the small intestine every time gluten is consumed, regardless of whether symptoms are present or not, but it is unclear whether the immune system is involved.

Identifying the active protein

In 1887, British doctor Samuel Gee was the first to make a record of gluten intolerance, which he described as a “malabsorption of ingested food” in children. Removal of wheat flour and wheat products from the diet was later seen to alleviate symptoms associated with the disease – and to this day a gluten free diet is currently the only successful treatment.

It was later found that a particular protein in wheat was active in patients with gluten intolerance and could not be removed from the gut by digestive enzymes. Equivalent proteins in rye, barley and possibly oats were also found to cause problems. So foods and drinks containing malted grains and any processed foods that contain this protein have to be removed from the diet.

The main cause of gluten intolerance is genetics, and the specific genes associated with the condition have been isolated. The genes produce molecules that interact with gluten proteins and activate the abnormal intestinal response. But not all people with the offending genes develop gluten intolerance, which suggests that other environmental factors are implicated. These could include early weaning onto solid food, breast feeding and gastrointestinal infection.

Symptoms in untreated conditions can vary which can lead to delays in diagnosis. Symptoms vary from fatigue, headaches, abdominal complaints, diarrhoea, joint complaints to vitamin and mineral deficiencies, such as iron and calcium. Bones can become weak and brittle.

Gluten intolerance is also associated with other autoimmune diseases: type 1 diabetes, autoimmune thyroid and liver disease and inflammatory bowel disease. An increased risk of intestinal cancer is also associated with undiagnosed gluten intolerance. Neurological conditions are also associated with.

How common is gluten intolerance?

Over the past two decades the perception of gluten intolerance has changed from being a rare disease that affects children of northern European ancestry, to a very common condition of people of all ages worldwide with 1.4 million Americans being diagnosed with the condition every year.

The condition recently received high profile coverage in the media after a gluten-free diet was shown to have improved the performances of top sports stars. Recent studies have shown the condition isn’t just confined to western countries or those of northern European descent – gluten intolerance, for example, is as common in the Middle East.

Despite it now being seen as more common, the condition is under-diagnosed for a number of reasons. Often individuals display only mild symptoms, and even though new and more accurate techniques have been introduced diagnosis still depends on determining changes in cells lining the intestine. Because of this it often takes until adulthood to be diagnosed, in fact, more than 60% of newly diagnosed patients are adults, with 15–20% over 60 years of age.

Food for thought

The only known effective treatment for gluten intolerance is a life-long gluten-free diet. But studies have shown that some groups, such as adolescents, find it difficult to keep off gluten products. Poor product information on gluten containing foods is also be a problem for people on gluten free diets, as is cross contamination when food is being made. Useful labelling isn’t always helpful because people differ in their sensitivity to gluten so a particular dose may cause a response in one person, but not in another.

The availability and price of gluten free foods is another factor, often there are limited ranges and are considerably more expensive than conventional products. So in patients on a gluten-free diet, intestinal damage can continue to happen even if in small increments, and may be outside the control of the person with the condition.

The use of starches and gums is the most widespread for mimicking gluten when making gluten-free bakery products, because they have gluten like properties. Some on the milder end of the intolerance scale may not see that having some gluten every now and again is a problem, while for others it’s a battle to maintain a completely gluten-free diet. But the signs are things are getting better – both in terms of diagnosis and available foods on the market.

The authors do not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article. They also have no relevant affiliations.

This article was originally published on The Conversation.
Read the original article.

Gut Feeling Week

As I’m sure you know, this week is Coeliac Awareness Week 2013 and runs until this Sunday, May 19th. Coeliac UK have named it Gut Feeling Week and are focusing on the proper diagnosis of coeliac disease by encouraging more people to check their symptoms.

Their website has lots of useful information about the work they will be doing this week.

Check out some of the links below.

• Awareness Week 2013 – Gut Feeling Week
• Gut Feeling – how you can get involved
• Download your Gut Feeling toolkit
• Awareness Week special offers

Newburn Bakehouse research

The guys at Warburtons Newburn Bakehouse are also helping to support the campaign. They have conducted research within their Facebook community regarding the diagnosis of coeliac disease.

Some of the main points from the research are:

• 52% of people diagnosed with coeliac disease were originally misdiagnosed
• 63% of those people were misdiagnosed with Irritable Bowel Syndrome (IBS)
• 32% of people take over five years to be diagnosed
• 45% of people were diagnosed between the age of 26yrs – 45yrs, and stomach cramps and tiredness were their most common symptoms before diagnosis

Nutritionist Christine Bailey

So from this research it’s pretty clear that early and correct diagnosis is an issue that needs fixing. Let’s hope this week goes some way towards that.

Also to help support Coeliac Awareness Week, Warburtons have renowned nutritionist Christine Bailey taking part in a live Facebook Q&A on their Facebook Page this Friday at 2pm. So think of any questions you may have for her and I’ll join you there!

Have a great week!

Whether you have a food allergy or intolerance, are vegetarian or vegan or even need to find a child-friendly venue or a place with disabled access, Leave It Out can help.

Simply enter your post code, click which intolerance you have and Leave It Out will show you your nearest restaurants.

You can even win dinner for two at a restaurant of your choice by writing a review or sending the site a new listing. Got a fantastic local restaurant you want to talk about? Just register here (it takes about 30 seconds) and write a review. Or if you want to see your favourite local restaurant listed just contact the Leave It Out team.

You’ll also find lots of informative articles on the site written by Medical Consultant Dr Adam Fox and Dietician Tanya Wright, such as Coeliac Disease And Malt Extract and When And How Can Wheat Allergy Occur?

We think this site is going to be a great resource. Remember to get your reviews and recommendations in. And you might be enjoying a gluten free pizza free of charge at the end of the month!

Dr Robert Anderson, a gastroenterologist based in Melbourne, Australia, is working on a vaccine or pill to prevent or switch off a person’s reaction to gluten.

Currently there are two types of treatment being developed. One would work alongside a gluten free diet and protect sufferers from the occasional ingestion of gluten. The other would train the immune system to accept gluten and would enable a sufferer to follow a regular diet.

The first system uses enzyme therapy which breaks gluten down into tiny particles and therefore doesn’t cause inflammation of the intestine.

The second system uses immunotherapy and allows patients to eat a regular diet by stopping the immune response in the gut.

Phase 1 of the trials are due to be completed in 2010 and Anderson says that patients would receive a series of injections of the vaccine, followed by occasional maintenance doses.

Are you coeliac sufferer? How would your life be different if you could take a pill before a meal or receive regular shots to stop your reaction to gluten? Is it something you’d do?

Read the full article in the Los Angeles Times.

In fact, coeliac disease is actually an autoimmune disease where your body’s immune system attacks its own tissues. Not nice. And if you’re someone who’s suffering from coeliac disease this reaction is triggered by gluten – the wheat protein found in wheat, barley and rye. (Sufferers may also be sensitive to oats.)

So how do you know if you have coeliac disease? Signs and symptoms vary from person to person and can range from mildly irritating and uncomfortable to downright debilitating. And of course, some of the signs and symptoms of coeliac disease are also really similar to irritable bowel syndrome; wheat intolerance; stress; anaemia; chronic fatigue syndrome; and too many nights on the town!

One coeliac disease sufferer may have bloating and diarrhoea. Whilst another may have irritability and nausea. And of course it’s entirely possible to have no signs or symptoms of coeliac disease at all. But if not treated a sufferer will ultimately suffer malnutrition as the disease stops nutrients being absorbed.

So what are the some of the signs and symptoms of coeliac disease?

• Bloating
• Nausea
• Abdominal pain
• Diarrhoea
• Wind
• Indigestion
• Constipation
• Tiredness
• Mouth ulcers
• Depression
• Infertility
• Joint ache and bone pain
• Weight loss or weight gain
• Osteoporosis
• Muscle cramps
• Tooth discoloration
• Itchy skin

If you think you have coeliac disease or have any of the signs or symptoms above we recommend you seek medical advice from your doctor as soon as possible.