Gluten Intolerance versus Celiac Disease

Celiac disease (CD) is an autoimmune disease triggered by the ingestion of gluten, a protein found in wheat, barley, rye and some other grains. The immune system attacks the gastrointestinal lining, resulting in a reduction in nutrient absorption.  Autoimmune diseases can affect the entire body, and CD is associated with other problems such as immune deficiency and dermatitis herpetiformis, an itchy skin condition that goes away when gluten is removed. Nobody knows why eating gluten causes so many seemingly unrelated conditions such as chronic anaemia, neurological problems, osteoporosis, joint pain, chronic fatigue, short stature, skin lesions, epilepsy, seizures, dementia and cancer.

According to the Mayo Clinic, CD is on the rise. Its 2009 study published in Gastroenterology found that 1 in 100 people has celiac disease, making it four times more common now than it was in the 1950s. Further, it can take as long as seventeen years to diagnose. The study compares a sampling of blood taken from veterans from Warren Air Force Base between 1948 and 1954 with the blood of a sampling of people today. The comparison showed that more people are intolerant of gluten today than fifty years ago.
Although gluten intolerance has some of the same symptoms as CD, it does not present as an autoimmune gut-lining problem and is therefore not seen using endoscopy or found with a biopsy. The endoscopy is generally normal in cases of gluten sensitivity, although sometimes reflux can be found, as in Shane’s case. Sensitivity is usually diagnosed by symptoms or sometimes with an antigiladin antibody blood test. This test is not specific for celiac disease but measures as many as three different immune responses to gluten. The immune system is not designed to fight food but is supposed to react to germs. An elevated immune response to gluten means the immune system is being led astray by gluten and not operating properly.
An endoscopy is the gold standard procedure used to diagnose CD. A gastroenterologist may order this test if the screening blood test for CD are positive. CD blood screening tests, such as one that looks for endomysial antibodies are not very accurate, because doctors and researchers have not yet figured out the exact cause or triggers of intolerance itself.
Although there are many other non mainstreams tests promising to identify gluten intolerance in stool or blood, their accuracy is also uncertain. So if you suspect the gluten is bothering your child, the best test remains an elimination trail: Take it out of the diet and see what happens.
When we need to be super strict?
For people who have full-blown celiac disease, ingesting even tiny amounts of gluten derivatives can cause a severe reaction or long term damage. The damage can be done before the diagnosis is made, and the connection to eating gluten may not be obvious. In addition to removing easy-to-easy gluten-based flours from the diet, people with CD need to be careful of items such as commercial salad dressings, because for them starch additives (such as malt) are potential dietary bombs. Finding hidden gluten can be complicated and time consuming.

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