When people with celiac disease eat gluten (a protein found in wheat, barley, rye and triticale), a harmful immune reaction occurs in the small intestine. That damages the villi, which are fingerlike projections that aid in absorbing nutrients. This immune reaction is the cause of more than 200 known symptoms that can occur in every organ in the body.
Undiagnosed and unclear
Gastrointestinal symptoms are most common in children; anemia, osteoporosis, chronic fatigue and migraines are more common in adults. Although celiac disease can be diagnosed through a blood test and intestinal biopsy, it is estimated that only one in five Americans with the disease is diagnosed.
Having celiac disease is often confused with having a wheat or gluten allergy. People with a wheat allergy who consume any of the four classes of wheat protein, including gluten, can trigger an immune system response that causes an allergic reaction, with symptoms that span from itching, swelling and difficulty breathing to anaphylaxis. However, they do not experience intestinal damage.
Preliminary research has shown that there are some people who have neither celiac disease nor wheat allergy but still experience symptoms similar to celiac disease when they consume wheat, such as intestinal damage. This condition is referred to as non-celiac wheat or gluten sensitivity.
In the case of wheat allergies, individuals must abstain from eating wheat-based products to avoid harmful allergic reactions. For those with celiac disease or non-celiac wheat or gluten sensitivity, any product containing gluten cannot be consumed.
Following a strict gluten-free diet includes consuming naturally gluten-free foods, packaged products clearly labeled gluten-free, and avoiding cross-contact from all foods containing gluten. While there are more than 20 companies investigating treatments for celiac disease, following a strict, gluten-free diet for life is currently the only treatment.
Celiac disease, wheat allergy, and non-celiac wheat or gluten sensitivity are different conditions with similar, but not identical, treatments. It is important to understand these difference to make the necessary dietary changes.
Marilyn G. Geller, CEO, Celiac Diseases Foundation, [email protected]