A few years ago, people on the cutting edge of diet fads were buzzing about “gluten sensitivity,” or sensitivity to the protein found in wheat and some other grains. What most of them didn’t realize was that true gluten sensitivity means that a person likely has a serious — and often undetected — disease called celiac disease or celiac sprue.

In celiac disease, the small bowel’s fingerlike projections (villi), which absorbs nutrients, become flattened in the presence of gluten. This renders the villi helpless to do their job, resulting in the inability to absorb nutrients fully. This malabsorption can result in a host of medical conditions, from anemia to infertility. It is estimated that one in 150 people suffer from celiac disease and only one in 2,500 are diagnosed.

For the latest on the disorder, I talked with Richard J. Ferrell, MD, a leading researcher on the disease and assistant professor of medicine at Harvard Medical School in Boston. He explained that celiac disease results from an inappropriate immune response to ingested gluten in genetically predisposed people. It mostly affects those who are of Western European descent. In general, most adults are negatively affected by overconsumption of gluten. However, when the immune system becomes unable to compensate from the extent of the exposure and behaves erratically, the disease state is born.

Celiac disease can start at any time, from infancy onward. In fact, 20% of new cases occur in people age 60 and over. Dr. Ferrell says that this is because in many patients the disease results from what he calls a “one-two hit.” One, you are born with it in your genes, but the disease doesn’t develop unless you get a “second” hit at some point in your life. Doctors believe this second hit is something that causes a break in the lining of the small bowel, allowing gluten into deeper recesses of the body where it triggers the inappropriate immune response. They speculate that this could result from a gastrointestinal virus or heavy use of nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen). Or it could be because of physical and biochemical distortions to the structure and function of the intestinal membrane as a result of excess consumption of glutens or other inflammation-provoking materials. There are tests that can be done by a naturopathic physician or informed gastroenterologist to help determine which of this group of substances has the greatest potential destabilizing effect on an individual.

SYMPTOMS
The most common symptom of celiac disease is diarrhea. Infants with the disease generally get diarrhea, along with abdominal distention and sometimes vomiting, in the weeks or months after they have started to eat cereal foods. Often this is a direct result of introducing grains too early in the diet. Some experts recommend waiting the better part of the first year of life before introducing unsprouted (high gluten) grains into the diet. Older children often have a discoloration or mottling of their teeth, a result of their system’s not absorbing enough calcium. In adults, the most frequent symptoms are episodic or nocturnal diarrhea, flatulence and bloating, a combination that often results in the mistaken diagnosis of inflammatory bowel disease.

About half of adults who have celiac disease do not have diarrhea. Instead, they become anemic, the second most common symptom in adults, followed by other deficiencies, including that of folate, calcium and other vital nutrients. Sometimes the only symptom is recurrent mouth sores.
The spectrum of responses to celiac disease is extremely broad, says Dr. Ferrell. There are people for whom even a tiny amount of gluten will cause extreme symptoms. Yet some can go a lifetime with it and not have any diagnosed problems other than a little gastrointestinal distress from overdoing it on the pasta. At the other extreme, there are people, including children, who must entirely eliminate gluten — primarily wheat, but often all grains — from their diet.
For more on celiac disease, read on…

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GETTING TESTED
Dr. Ferrell reports that simple blood tests, which focus on antibodies to tissue underling the mucosa, are extremely successful for diagnosing celiac disease. The most widely used is an antigliadin antibody test, replaced by some clinicians with an antiendomysial antibody test. If a blood test is positive, the patient may then have an endoscopic biopsy of the small bowel to confirm the diagnosis.

With such a wide range of symptoms, though, it is confusing to know who should consider testing for celiac disease. Dr. Ferrell advises it for anyone with a family history or anyone with chronic diarrhea. Remember, too, that the disease prevents proper nutrient absorption. Those who have bone disease, osteopenia or osteoporosis should talk with their doctors about being tested because the disease may be blocking proper absorption of calcium and vitamin D. Likewise for those who have unresolved anemia, constantly recurring mouth sores (every few weeks or so), abnormal liver blood tests or who are of Western European descent and think they have irritable bowel syndrome — their abdominal distress may actually be the result of celiac disease.

Should you receive a diagnosis of celiac disease, depending on the severity of your disease, the doctor may prescribe a gluten-free diet or have you reduce the amount of gluten you consume. That said, it is increasingly clear among many mainstream and alternative practitioners that over-consumption of wheat (and gluten) is implicated in a number of conditions and diseases. A general practice of reducing gluten consumption can avoid complications of low-level celiac disease as well as a number of other health issues. Stay tuned to Daily Health News for more information on establishing a gluten-free diet.
Be well,

Carole Jackson
Bottom Line’s Daily Health News

Source…
Glut in Your Gut
• Richard J. Ferrell, MD, assistant professor of medicine, Harvard Medical School, Boston.