Just when you thought you were being so good by leaving the cream cheese off the bagel – you should probably ditch the bagel altogether.
Maybe you’ve heard (or even said) things like, “I think I’m allergic to dairy because the cheese on my pizza makes me bloat.” Oh, really? What makes you think it’s the cheese? Because more people have heard of lactose intolerance than gluten intolerance, they figure that must be what’s making them feel icky.
Most people have no idea that they have a gluten sensitivity or celiac disease, so they usually start pointing to all the wrong culprits: cheese (dairy), tomato sauce (acids), or soy. But they’re blaming the wrong foods. These people have no idea that the typical American diet comprised of bagels, pasta, pizza, cakes, cookies, and pretzels could be wreaking havoc on nearly every system in their bodies, so they continue to eat them and wonder why they don’t feel good.
So how many people fall into this category? No one knows for sure. We do know that 1 in 100 people has celiac disease – but most don’t know it. No one knows how many people have gluten sensitivity, but estimates are that it may be as high as 50 percent, or even 70 percent, of the population. Top that with those who have a wheat allergy, and – here, let us get our calculator out – tons of people + gobs more = an astoundingly high percentage of the population!
Recognizing Different Types of Gluten-Related Problems
Lots of people – maybe even most people – have some form of gluten sensitivity. But is it sensitivity, allergy, or celiac disease? Sometimes it’s tough to tell. These sections delve deeper into the types of gluten-related issues.
There’s really no such thing as an allergy to gluten. If you happen to be allergic to all three gluten-containing grains (wheat, rye, and barley), then you might have reason to say that you were allergic to gluten – even though you’re really allergic to the three grains that fall under the gluten umbrella. But most people misuse the term and say they’re allergic to gluten when what they really mean to say is that they have an intolerance or sensitivity to gluten, or they have full-blown celiac disease.
Allergies to gluten-containing foods are just like other food allergies. They’re all responses to a food allergen, and the reaction that someone has to those foods varies from person to person and from one food to another.
Allergic symptoms can be respiratory, causing coughing, nasal congestion, sneezing, throat tightness, and even asthma. Acute allergic reactions to food usually start in the mouth, with tingling, itching, a metallic taste, and swelling of the tongue and throat. Sometimes symptoms are farther down the intestinal tract, causing abdominal pain, muscle spasms, vomiting, and diarrhea.
Any severe and acute allergic reaction also has the potential to cause anaphylaxis, or anaphylactic shock. This life-threatening condition affects different organs, and symptoms can include a feeling of agitation, hives, breathing problems, a drop in blood pressure, and fainting. In some cases, an anaphylactic response to an allergen can be fatal unless the person having the allergic reaction receives an epinephrine (adrenaline) injection.
Gluten sensitivity can mean a lot of different things, and that label is often misused; it’s a very fuzzy term. Basically, it’s a sensitivity to gluten – hence the clever term. Often used interchangeably, the terms sensitivity and intolerance mean that your body doesn’t react well to a particular food and you should avoid it. Symptoms of gluten sensitivity are usually the same as those of celiac disease, and as with celiac disease, they usually go away on a gluten-free diet.
Unlike gluten sensitivity, celiac disease is well-defined. It’s a common, yet often misdiagnosed, genetic intolerance to gluten that can develop at any age, in people of any ethnicity. When people with celiac disease eat gluten, their immune systems respond by attacking the gluten molecule, and in so doing, the immune system also attacks the body itself. This is called an autoimmune response, and it results in damage to the small intestine, which can cause poor absorption of nutrients.
Although the damage occurs in the gastrointestinal tract (specifically in the small intestine), not all symptoms are gastrointestinal in nature. That’s because celiac disease is multisystemic – the symptoms show up in many different ways and can occur in just about every organ of the body. In fact, symptoms are vast and varied, and they sometimes come and go, which makes diagnosis difficult.
Does someone who has gluten sensitivity also have celiac disease? Not necessarily. Or maybe. How’s that for ambiguity? The upcoming sections clarify.
Some people who are told by a healthcare professional that they have “gluten sensitivity” actually have celiac disease, but their testing was done improperly or was insufficient to yield conclusive results.
Say, for instance, that someone is IgA deficient (IgA is a special type of protein that the body produces to fight infections), and many people are. Most of the time it doesn’t cause a problem. But it makes testing for celiac disease difficult, because most of the celiac tests are based on starting with a normal level of IgA. If a person doesn’t have enough IgA in his body, that would make some of the celiac tests appear to be normal when actually the person’s levels should have been elevated (indicating celiac disease) if he weren’t IgA deficient. In other words, the person has celiac disease, but because testing was incomplete (the doctors didn’t test to determine if he was IgA deficient), the results were interpreted incorrectly.
Another reason you may have celiac disease but be told you have gluten sensitivity is if the type of testing you undergo is specific to gluten sensitivity, not celiac disease. For instance, a stool test and a few types of saliva tests check for gluten sensitivity, but if you have celiac disease, they’ll be positive. So you would, in fact, have celiac disease – but the only test you’re taking in this case is for gluten sensitivity, so that’s what you’ll be “diagnosed” with.
Sometimes in the very earliest stages of celiac disease, testing for celiac disease will be negative, but the tests for gluten sensitivity may be positive. In this case, the person has celiac disease, but it’s too early to show on tests. If that person continues to eat gluten, the testing will eventually be positive (and damage will be done!).
Some people do, in fact, have gluten sensitivity that is not celiac disease. Symptoms are generally the same as those for celiac disease (see the very next section), and, as with the disease, health improves on a gluten-free diet.
Sorting Out the Symptoms of Gluten Intolerance
Ask most
