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    Jennifer F. ,Phoenix Az

Wheat Worries: Understanding the Digestive Problems Gluten Creates!

Wondering what all the wheat-free and gluten-free hype is all about? We have the answers. Gluten is a protein found in certain grains and linked with many digestive problems. The most common of these are Celiac's Disease, IBS, Inflammatory Bowel Disease (IBD), and functional digestive issues. The disease and dysfunction that this protein creates depends on how it interacts with the immune system, the digestive system, and the bacteria in the digestive tract. Dr. Christy Cline a Phoenix naturopathic doctor discusses these interactions. 

Clues You Have A Digestive Problem From Gluten

While the main area of the body impacted by gluten is the digestive tract, other areas of the body can be damaged and show certain signs and symptoms as well.digestive problem from gluten

Celiac's Disease

  • Fatigue (very common)
  • Diarrhea or Constipation
  • Abnormal distention of abdomen
  • Large foul smelling stools
  • Excess gas
  • Weight loss
  • No symptoms (up to 1/3 of patients)
  • Anemia
  • Vitamin Deficiencies
  • Dermatitis Herpetifomis

Gluten Sensitivity

  • Diarrhea or Constipation
  • Excess gas
  • Fatigue
  • Headaches
  • Dermatitis
  • Joint Pain
  • Mental fog
  • Generalized discomfort during or after meals.

What Is the Difference Between Gluten Sensitivity and Celiac's Disease?

Celiac's Disease is classified as an autoimmune reaction where the immune cells over react to the gluten protein in the small intestine causing severe inflammation and deterioration of the finger like projections there. The process occurs as the immune system creates antibodies to the gluten proteins and these auto antibodies cross react with the proteins of the digestive tract (one in particular is the tissue transglutaminase protein). Each time a patient with Celiac's Disease eats gluten, more antibodies are produced against the gluten and the digestive tract proteins. Over time more and more of the digestive tract gets destroyed turning it into a flat surface rather than one filled with finger and hair-like projections. 

Gluten sensitivity is typically caused by the immune system as well but may be a reaction by the bacteria in the small intestine as well. The term gluten sensitivity is used to reference a negative reaction in the person consuming gluten and gluten containing products. The reactions that occur can vary greatly from person to person but may manifest as IBS, IBD, or functional digestive disorders. 

In the immune mediated gluten sensitivity reaction the immune system is trying to prevent the gluten from entering the body. This causes inflammation locally in the digestive system and corresponding symptoms of bloating, pain, gas, etc. It also causes systemic symptoms in more distant areas of the body from the up-regulation in the immune system leading to aches and pains, skin rashes, etc. 

The bacterial mediated gluten sensitivity refers to the fermentation process that occurs with gluten from Small Intestinal Bacterial Overgrowth. It is a negative reaction to gluten but not a sensitivity to gluten in the immune mediated sense. Still it is worth mentioning and you can learn more about SIBO and it's effect on IBD by clicking the link. 

 

By Avoiding Gluten Will My Celiac's Disease Go Away?

If you have true Celiac's Disease the autoimmune reaction will never go away. Meaning every time you eat gluten you will have a reaction to it. However if you avoid gluten and gluten containing products your symptoms will improve and likely go away altogether. This process with likely may take some time and may require other supplements and nutrients to fully heal the digestive system.

Even when you have the Celiac's Disease diagnosis, avoiding gluten completely all the time will be difficult. As you educate yourself on hidden forms of gluten and adapt your lifestyle, it will become much easier. Still your digestive system will always be more susceptible to inflammation and as a result digestive tract cancer. Many patients with Celiac's also have other food sensitivities as well. Regular check ups are suggested to stay on top of your digestive health. 

 

 

Testing for Celiac's Disease and Gluten Sensitivity?

Testing for gluten sensitivity can be pretty straight forward while testing for Celiac's Disease is a little more complex. To test yourself for gluten sensitivity you have two options, elimination diet or IgG food sensitivity test. The elimination diet for gluten sensitivity involves eliminating all gluten containing products and foods. Gluten proteins are found in Barley, Spelt, Rye, and Wheat. Anything made with these or from these would need to be avoided for 4-6 weeks and re-introduced. The IgG food sensitivity test can be done at a doctor's office practicing naturopathic or integrative medicine. 

Testing for Celiac's Disease can be done with blood tests but not all blood tests are the same and some results can be misleading. The main test for Celiac's Disease involves testing the blood for three antibodies; Tissue transglutaminase IgG, Anti-endomyseal antibody IgA, and Deaminated gliadin peptide IgG. These three tests have a high probability of being elevated when someone has Celiac's Disease but not always.

In cases where the patient has down regulated immune function, sometimes the levels will not be elevated even though the person is still reacting to the protein. Also if you have been avoiding gluten from your diet and you test for the antibodies, they may not come up elevated. The bottom line is, if Celiac's Disease is suspected and initial testing is negative, find a doctor that has a through understating of Celiac's Disease testing. 

 

 

What Steps Can I Take To Optimize My Digestive Function?

Testing and ruling out the above and similar conditions is important for optimal digestive function. Working with a naturopathic doctor can help you make the necessary connections to the foods you are eating and the symptoms you are having. Additionally certain herbs, nutrients and vitamins may be necessary to get the digestive tract the full healing it needs. For example, vitamin b12 is needed for the growth of the hair-like projections on the digestive cells but b12 can't be absorbed without these projections. This and other vitamin deficiencies are common with digestive issues and should be looked at. 

Once you find out what the problem is, the road ahead is not always straight forward. Clinical knowledge and experience is key to getting the best results. Don't agree or have something to share? Let us know your thoughts in the comment section below.

 

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