Gluten sensitivity
What is gluten sensitivity?
Gluten intolerance (also known as celiac disease or celiac disease) is an autoimmune disease that, without proper treatment (i.e. following a gluten-free diet), leads to destruction of the lining of the small intestine.
In addition, it can be accompanied by a number of extra-gastrointestinal symptoms and co-morbidities.
Gluten sensitivity is genetic and is triggered by environmental provocation, i.e. a diet containing gluten.
There is no cure for celiac disease, which is a lifelong condition, but it can be managed perfectly by avoiding the triggering factor and by diet.
The protein in cereals, gluten, or more specifically one of its components, gliadin, triggers the autoimmune process.
It is therefore logical that if the key protein is excluded from the diet, the pathological process stops.
Furthermore, the intestinal system regenerates and the symptoms disappear.
It is worth noting that, although the symptoms may be similar, celiac disease, non-celiac celiac celiac disease and cereal allergy are three separate diseases.
It is also possible for patients with irritable bowel syndrome (IBS) to think of themselves as gluten intolerant.
In IBS, the consumption of wheat may be a symptom booster, but in their case it is not the gluten that is responsible, but the fermentable carbohydrate and glucan (also a carbohydrate) content of the wheat.
For this reason, self-diagnosis can be misleading and dangerous, as treatment and diet require different methods in each of the three cases.
Coeliac disease requires a gluten-free diet, whereas a grain allergy requires avoidance of the cereal that causes the symptoms (e.g. wheat in the case of wheat allergy).
In IBS, on the other hand, a complex diet and treatment that is best suited to the patient needs to be defined.
A medical diagnosis and the dietary restrictions based on it are therefore essential.
What is coeliac condition?
In addition to gluten sensitivity, it is also important to talk about celiac disease.
This is an autoimmune disease that develops as a result of severe and persistent inflammation in the small intestine.
The disease is usually caused by eating foods that contain gluten.
Celiac disease is also often associated with certain diseases:
- juvenile diabetes (type 1 diabetes mellitus);
- Down’s disease;
- inflammatory thyroid disease;
- allergic enteritis;
- rheumatoid arthritis;
- atopy.
If you have one of these diseases, it is also advisable to have a test for coeliac condition.
Diagnosis of celiac disease
- If gluten sensitivity is suspected, careful investigation always starts with questioning the patient.
The doctor will ask the following questions: - Do you have coeliac disease in your family?
- Since when, what symptoms has the patient noticed?
- What external symptoms can be detected?
After these tests, the diagnosis can be established in a short time with a few targeted tests.
The diagnosis of gluten intolerance requires, in addition to the symptoms and possible malnutrition, the detection of antibodies specific to celiac disease.
This can be done by testing for antibodies in blood serum (serology), which requires a simple blood test and a laboratory test.
On the other hand, a tissue sample from the small intestine can also confirm the following characteristics of gluten sensitivity: thinning and damage to the small intestinal cecum (boholy-atrophy) and improvement in symptoms as a result of a gluten-free diet.
It is very important that until the tests have been carried out and a diagnosis made, the patient should not leave gluten out of their diet! Otherwise, the results of the tests may be false, and only by maintaining a gluten-free diet is there any chance of a fully reliable diagnosis.
Useful facts about gluten and cereals
Gluten is a fraction of wheat proteins whose alcohol-soluble components, gliadins, trigger an autoimmune reaction in genetically predisposed people.
It is not only the gluten in wheat, but also the hordein in barley and the secalin in rye that trigger an autoimmune reaction in people with celiac disease, so people with gluten intolerance should not eat these grains either.
The avenin protein in oats does not trigger an autoimmune reaction in most people with celiac disease, so oats that are not otherwise contaminated with gluten can be consumed by people who are sure that their body tolerates it well.
Increased attention should also be paid to cross-contamination, as food contaminated with gluten can also be dangerous for gluten-sensitive people (contamination can occur during the production or preparation of the food).
For this reason, it is mandatory to indicate on the packaging of products if the food may have been contaminated with gluten.
Furthermore, restaurants are obliged to provide information on the allergen content of the food they serve.
