WHEN SHOULD I WORRY ABOUT...

The Truth About Gluten Sensitivity

Dec. 5, 2019

It seems like more and more items in grocery stores are popping up with “gluten-free” on their labels. For almost every food containing gluten, there is an equal option that is gluten-free. Even restaurants and bakeries are offering gluten-free menu options.

It’s everywhere you look, so it must be healthy, right? The reality is that people are adopting the gluten-free lifestyle without fully understanding what it means for their health and diet.

What exactly is gluten? Is it good for us, or bad?

Dr. Eamonn Quigley, gastroenterologist at Houston Methodist, answers these questions, along with others, about the ingredient.

What is gluten?

Gluten refers to a group of proteins (gliadin and glutenin).

What is the difference between celiac disease, gluten sensitivity and a wheat allergy?

Celiac disease refers to a clinical disorder where an immunological reaction to gliadin results in injury to the small intestine. The term gluten sensitivity is, in reality, the same as celiac disease, and the idea that there are people sensitive to gliadin who do not have celiac disease is highly controversial. The same applies to the term “wheat allergy.”

All of these terms imply that there is an immunological reaction to a component of wheat (i.e. the gliadin fraction of gluten). A wheat/gluten intolerance refers to individuals who get symptoms when they eat wheat-based products.

While the cause of these symptoms is unclear, there is evidence that suggests some of these symptoms may be due to carbohydrates, called fructans (also found in wheat), that some people find difficult to digest.

What are the symptoms of a wheat/gluten intolerance?

People who suspect they have a wheat or gluten intolerance could have any one of a host of symptoms, most commonly including:

  • Diarrhea
  • Bloating
  • Abdominal cramps

 

What are symptoms of celiac disease?

In the past, symptoms of malabsorption such as diarrhea, weight loss and vitamin/protein deficiency were used to identify someone with celiac disease. Nowadays, many people with celiac disease are detected because of mild anemia, osteopenia, iron deficiency, folic acid deficiency, infertility and other issues  even though they have little or no gastrointestinal symptoms.

Are there risks/benefits to going gluten-free if you are not allergic or intolerant?

There may be benefits of going gluten-free, but it's been difficult to prove in large studies. The main drawbacks are cost and the possibility that you could be excluding foods that provide essential nutrients. Before changing your diet, check with your doctor or dietitian.

Is gluten intolerance something someone grows into or out of, or is it for life?

If you have a true intolerance, it is permanent.

Besides bread and products containing flour, what other food products contain gluten that consumers may not be aware of?

Other food products that may contain gluten include barley and rye.

In theory, oats should not be a problem, but there is evidence that oats may become contaminated by wheat during milling and preparation, so many advise excluding oats as well.

Are there alternatives to foods containing gluten?

Yes, countless. You can find many great gluten-free and gluten-alternative suggestions from patient support groups such as National Celiac Association (NCA).