If eating conventional pasta, bread, crackers or other standard grain products create less-than-optimal gut responses, then you may suspect wheat as the culprit, but it may be gluten—the protein found in wheat, rye, barley and possibly oats.
For that reason and others, gluten has become a “sensitive topic.” In fact, an estimated one in 133 Americans has celiac disease, which occurs when ingesting gluten makes the immune system turn on the intestines by damaging the villi—tiny, fingerlike projections in the small intestine that absorb nutrients from food.
That’s not to say that gluten in and of itself is inherently bad, but for those who are gluten-sensitive, it can turn ugly when gluten proteins and gluten-derived peptides encounter the immune system. For some, gluten intake—even in small amounts or from "hidden" gluten in foods and other products—can cause an immune response that attacks the gut and more. For those people, the body creates antibodies to fight off gluten, thinking it’s a foreign invader.
When the immune system attacks, it damages the small intestine’s membranes, leaving holes in the membranes that can let in large proteins. Once through the ravaged intestinal membranes, the large gluten molecules enter the bloodstream, which carries the gluten system-wide in the body. Wherever those gluten molecules settle in the body, that’s where the immune system attacks. That’s why those with gluten sensitivity can experience unhealthy effects in the intestines and even way beyond the gut—including malnutrition that can lead to anemia, osteoporosis, mental unhealth and more.
Unfortunately, there may be as many as three million Americans who have celiac disease, but many may not even recognize it because it is so difficult to pin down. "It takes most adults about 12 years to get a definitive diagnosis of celiac disease," says Michelle Pietzak, M.D., a pediatric gastroenterologist and professor of pediatrics at the Keck School of Medicine of the University of Southern California.
Diagnosis has its own challenges. In the past, celiac disease was diagnosed by blood tests and intestinal biopsies, but those would turn up positive only if there was villi damage. Nowadays, however, there are less invasive tests that are much more expedient.
Celiacs aren’t the only ones dealing with this sensitive topic, though. As many as one in seven folks may have what’s termed Non-Celiac Gluten Sensitivity or NCGS. For those with NCGS, celiac testing has turned up negative or inconclusive results, but they know something needs to change. Obviously, many with NCGS start by changing their diet. They avoid gluten at all costs. The problem, however, is that it’s easier said than done since gluten is in so many products including standard grain products, salad dressings, toothpastes, lipsticks and much more.
While NCGS is not celiac disease, it’s certainly not a lightweight problem. It may cause malabsorption, abdominal pain or distention, weight loss or weight gain, muscle wasting, peeling nails, bone pain, joint pain, fatigue, nausea, vomiting, nasal discharge and more.
For those with NCGS—and celiacs as well—lifelong, full removal of dietary gluten is important. For them, there’s no safe amount of gluten. They will need to keep a watchful eye, too, because studies indicate that amounts of gluten as low as 0.1 grams can lead to relapses and negative changes in intestinal tissue.
That’s why many are saying, “Goodbye, gluten.”