Gluten is a mixture of proteins found in wheat, rye, barley,
spelt, kamut and a few other grains. Gluten which means glue in Latin is the
substance that gives bread its texture and elasticity. It’s what gives bread
that sticky pull which is so nice when you break a good French baguette; it’s
what gives a muffin its spongy characteristic and it helps form those little cells in warm bread that soaks up butter.
Gluten is not found in rice, corn, quinoa, amaranth or tiff. Despite its name,
buckwheat does not contain gluten. Oats are gluten free but often raised near
wheat or processed in mills that also grind wheat so they can be and often are cross
There are three (possibly more) illnesses caused by gluten – celiac disease,
gluten allergy and gluten sensitivity. Celiac disease is a serious life-modifying
and often life-threatening disease. It is an autoimmune disease meaning that gluten
sets up a reaction in a predisposed individual such that the body attacks its
own cells. Not only can it cause gastrointestinal damage leading to
malabsorption but it can lead to problems in multiple other organs in the body.
Previously rather uncommon with no more than one person in 300 having the
disease, today about 1% of Americans have celiac disease and the incidence
appears to be rising still. It occurs in people who have a genetic
predisposition, these being about one third of the population. But within that
group of predisposed individuals, only some will develop celiac disease for
reasons that remain unclear.
Gluten allergy is uncommon, affecting less than 1% of the population. It’s an
allergy similar to how some people develop G.I. symptoms from, say, shellfish.
Usually the reaction comes on quickly after eating, can be quite severe often
with abdominal pain, nausea, vomiting and diarrhea. The reaction stops once the
offending allergen (gluten) has passed out of the body.
Gluten sensitivity (or gluten intolerance) affects perhaps 10% and possibly
more of the population. It ranges from rather mild to quite severe. The most
common symptom is abdominal discomfort (“bellyache,” nausea, bloating)
in two thirds of affected individuals. The next most common symptoms do not
relate to the GI tract – eczema, “foggy mind,” headache and fatigue, all occurring
in about a third of individuals. One third develop diarrhea when they eat
gluten. Other less common symptoms are depression (20%), anemia (20%), numbness
in hands or feet (20%), acid reflux and joint pains in about 10%. The severity of the symptoms seems to depend
upon how much gluten is ingested at one time. The more one eats, the worse the
symptoms. For some people the symptoms dissipate within just a few hours but,
for others, problems such as diarrhea, reflux or even abdominal discomfort can
persist for days or even weeks.
In a continuing care
retirement community of about 2000 residents where I live, Charlestown probably
has about 20 with celiac disease, a few with gluten allergy and 200 or so with
gluten intolerance/sensitivity. Many will not be aware of the connection
between their symptoms and gluten ingestion. The diagnosis is often missed by
physicians because the symptoms can be vague. Many problems cause abdominal
discomfort and many of the symptoms of gluten associated disease are not
related to the GI tract, such as headaches or rash.
There are no medicines or pills to take. Whether it is celiac disease, allergy
or gluten sensitivity, the only effective approach is to totally avoid gluten.