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Dr Russ Blog - Gluten and You
Gluten and You
Created on 2/12/2010

S has recently been told that she might be sensitive to gluten and asks how to go about getting appropriately tested for such a thing.

It's a great question, S, and one that seems to come up more frequently than it did in years past.

A growing number of people are concerned they may be "sensitive" to gluten, a protein found in grains like wheat, rye and barley but also in products one might not normally think would be a source of this protein (such as medications). Food sensitivities do not involve the immune system, and so are different than food allergies, but can still result in troublesome symptoms.

On the other hand, however, is celiac disease, also called sprue. In this disorder, ingestion of gluten actually causes damage to the intestines, significantly impacting the absorption of vital nutrients.

Adding to this challenge is the fact that symptoms of celiac disease are largely silent, meaning you may not even know something is wrong. Some of the more recognizable symptoms in adults include fatigue, abdominal discomfort, mood and skin changes. Undiagnosed celiac disease can lead to significant health complications like anemia.

The"gold standard" test for the presence of celiac disease is performed through a biopsy of the small intestine, but most people don't need to go that far. If you are concerned about the possibility of celiac disease, ask your doctor what they think, and then discuss the following blood tests with them:

- anti-gliadin antibodies (probably not very helpful)
- anti-endomysium antibodies *
- anti-tissue transglutaminase antibodies *
        * more widely accepted

If these blood tests are negative it is unlikely you will need to undergo the biopsy.

Testing is focused on antibodies because celiac disease appears to be an autoimmune disorder, where the body's immune system reacts abnormally and actually injures itself.

If you are found to have celiac disease the good news is that treatment is straightforward and very effective - avoid gluten!

Sounds easy, but it can be challenging when you consider all the products out there that contain gluten (pastas, breads, etc.). Many people ask about signage within stores to help identify gluten-free foods, but this can't happen until the FDA provides specific guidelines (something the FDA is actively working on). 

The good news, however, is that more and more gluten-free foods are becoming available.

Not everyone needs to be tested for celiac disease, but if you have a family member with the disorder it's a good idea for you to be tested, too, because the illness runs in families.

I hope this helps, S, and that you are well.
Dr. Russ

** Information on this web site is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this web site for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. **

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