Gluten-Free and Celiac Disease
Gluten, being gluten-free and celiac disease. Low FODMAPS and being gluten-free.
Gluten is a protein found in wheat, barley and rye. In celiac disease, an autoimmune disorder, eating this protein leads to an immune reaction and damage to the small intestine. This damage means that nutrients aren’t absorbed properly (which for example may manifest as early osteoporosis, iron-deficiency anemia) and is associated with an increased risk of lymphoma. It can also lead to immune responses elsewhere in the body leading to hepatitis, colitis, skin rashes, nail issues, joint pains et cetera. The later the age of diagnosis, the more likely other autoimmune diseases will develop – for example Addison’s disease, autoimmune thyroid disease, Type 1 diabetes. So, it needs to be diagnosed early and treated with a strict gluten-free diet.
I recommend close reading of the material at www.celiac.org
Recently there has been a lot of excitement about the possibility that a non-celiac gluten sensitivity (NCGS) disease may exist. Professor Peter Gibson at Monash in Melbourne, Australia published a study in 2011 that suggested gluten ingestion may lead to GI symptoms. And certainly there are many advocates of pursuit of a gluten-free diet to treat many GI and other ailments. HOWEVER, a more-rigorous follow-up study by this same Professor Peter Gibson led him to conclude that there was NO evidence of NCGS. It appears there is more credence to the idea that many of the GI complaints actually relate to eating foods containing FODMAPS .
So – a low FODMAPS diet may be the “way to go” for non-celiac patients with GI symptoms.
As always, a thoughtful history and physical exam, along with appropriate testing, by a gastroenterologist go a long way to determine what is going on. Tests to determine what is going on may include blood tests (TTG-IgA antibody testing, done in conjunction with IgA testing) and endoscopy (EGD) with biopsies. Other tests may be necessary in the IgA deficient (a condition more common than celiac disease but, if present, may yield false negative serum screening tests). The most specific of these is the IgG DGP-AGA antibody (this is a deamidated gliadin peptide-anti gliadin antibody).
It is IMPORTANT to be on a GLUTEN CONTAINING DIET (i.e. not restricted) when the testing is done.
If true celiac disease is found, the resources and advice at www.celiac.org is first-rate. Note that there are whole-grain options that are gluten-free: these include millet, quinoa and buckwheat (also known as kasha it IS not related to wheat and does not contain gluten).
Based in the heart of uptown and the Garden District of New Orleans, Dr. Huilgol (”Dr. Viv”) and the team at NOLA Gastro is committed to working with you to investigate what is going on, so you can make the correct choices for you.
GI health matters. Let’s work it out together.
Call 504-249-5901 and make an appointment…