Despite increasing awareness of gluten intolerance, many people continue to be misdiagnosed or undiagnosed because the condition is misunderstood. It's believed as many as one in 20 people in the United States is affected by some form of gluten sensitivity. Because symptoms are so numerous and widely varied, it is often mistaken for something else, such as irritable bowel syndrome. Gluten intolerance affects the intestines specifically, but many of the symptoms seem to be unrelated. Skin rash, headaches, joint pain, numbness, tooth or gum problems, and fatigue can be indications of the condition that could go unrecognized. Despite growing interest among doctors, PhD programs, and online support groups, there remains no effective test for gluten intolerance. Until now, most patients who don't have celiac disease have been told there's nothing wrong with them at all.
Gluten intolerance can be separated into two categories: celiac disease and non-celiac gluten intolerance. Celiac disease is diagnosed through blood tests and a biopsy of intestinal tissue. Biopsies in patients with celiac disease will reveal damage to the villi, tiny cilia on the intestinal lining necessary to absorb nutrients from food, whereas non-celiac gluten intolerance will not. The villi are damaged when the body interprets the presence of gluten as a threat and sends out antibodies. The antibodies attack, and the result is the flattening of the villi.
This damage will not be present in non-celiac gluten intolerant people. The only way to diagnose this condition is to switch to a gluten-free diet and see if symptoms diminish. However, people who suspect they have a type of gluten intolerance shouldn't adopt a gluten-free diet until comprehensive testing for celiac disease is complete. Removing gluten from the diet can produce negative tests results even if the condition is present, interfering with proper diagnosis.
Gluten is a mixture of two proteins called glutenin and gliadin. It is typically found in grassy grains like wheat, barley, rye, and spelt. Because oats are usually harvested and processed together with these grains, cross-contamination can occur. Therefore, gluten can be present in oat products as well. It's also present in other foods in the form of protein additives.
The only treatment for all types of gluten intolerance is removing gluten more or less entirely from one's diet. Great care must be taken because it is present in many sources that aren't as obvious as bread, pasta, or cereal. Many convenience foods such as gravies, custards, soups, and sauces are thickened with wheat, rye, and barley flour. Some colorings and additives also contain gluten. The USDA currently doesn't require food labels to include information about gluten content, so it's necessary for consumers to educate themselves about what ingredients usually include gluten in order to avoid them.
It's unclear why intolerance to a substance that's been a staple of the human diet for thousands of years is on the rise. Positive blood tests for celiac disease have risen four-fold in the last 50 years. It can develop at any time, including childhood and old age. Some experts believe some change in the environment has triggered the onset of this condition.
In any case, further research is needed for more complete understanding of this problem. In the meantime, it's important for people to be educated to recognize the symptoms and be aware of this condition as a possible cause. Until a better solution is found, recognizing gluten as the problem and eliminating it is the only answer.
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