What is celiac disease? Should I avoid gluten?

It may feel like following a gluten free diet is a relatively new thing, but my peers in the medical world know that it has been around for a long time. Within the medical community, a gluten free diet is something that people with celiac disease have  to follow. But with gluten sensitivity on the rise and the wheat belly craze, avoiding gluten has received so much attention that it now seems mainstream.

What is celiac disease?

Celiac disease is an autoimmune condition that causes the body to react to a protein that is found in wheat, barley and rye. People who have celiac disease experience a reaction between these protein molecules and the tissue in their small intestine when it’s being broken down. This leads to an inflammatory response in the lining of the small intestine resulting in cramping, diarrhea and malabsorption.

Gluten is the general term given to certain plant storage proteins called prolamins found in wheat, barley and rye. The names of the specific proteins are gliadin (in wheat), secalin (in rye) and hordein (in barley). There are other prolamins in rice (orzenin), corn (zien), sorghum (kafirin) and oats (avenin) but they don’t cause the same reaction in people with celiac disease.

Celiac disease vs. wheat allergy

Celiac disease is an autoimmune disorder (and not an allergy) because the immune system reacts to normal body tissue that it would normally ignore whereas an allergy is when the immune system reacts to a protein that it would normally ignore.

A wheat allergy can be caused by any of the proteins found in wheat that causes an allergic reaction. Symptoms can include hives, nausea, vomiting, eczema, asthma, nasal congestion and bloating.

People with a wheat allergy need to avoid wheat whereas people with celiac disease also need to avoid barley and rye. Therefore, people who need to avoid gluten, have a much more restrictive diet.

What about gluten sensitivity?

Gluten sensitivity is a condition that has become quite popular in recent years. In the past, it was thought that you either had celiac disease or not and either had to avoid gluten or not. However, there has been an increase in the number of people who report sensitivities to gluten but are still able to tolerate small amounts. Gluten sensitivity is considered to be an intolerance and not an allergy. I like to use lactose intolerance as an analogy to gluten sensitivity. There are some people who are able to tolerate small amounts of lactose in yogurt or cheese (this would be the case for people who are gluten sensitive and are able to tolerate small amounts of gluten) while other people need to avoid it altogether (this would be the case with people who have celiac disease).

People with gluten sensitivity experience similar symptoms to celiac disease but their bloodwork and histology aren’t indicative to celiac disease. There is no diagnostic testing for gluten sensitivity so it is usually a diagnosis of exclusion. However, both people with celiac disease and gluten sensitivity respond well to a gluten free diet.

For more information about gluten and gluten sensitivity check out the links below:

What is celiac disease?

Gluten Sensitivity vs. Celiac Disease – What’s the Difference Between the Two Conditions?

How do you test for celiac disease?

Are oats okay for people who avoid gluten?

This book is an excellent resource for people who need to follow a gluten free diet – Gluten Free Diet, by Shelley Case, RD – http://www.glutenfreediet.ca/