Lately, it seems like everyone is talking about gluten free products. What is gluten exactly and does it need to be avoided by all?
Gluten refers to a family of proteins found in the grains of wheat, barley, and rye. Celiac disease is a form of gluten intolerance, but strictly speaking, it is not an allergy. It is a rather a complex immune phenomenon involving antibodies that the body produces when someone eats gluten. These antibodies lead to damage of the lining of the small intestine, which can affect absorption of foods and can lead to malnutrition.
Most kids with celiac disease will have abdominal symptoms when they ingest gluten. Some will also have a rash similar in appearance to eczema. There is a genetic component to celiac disease, it tends to run in families, and is more common among Caucasians than among other racial and ethnic groups. The best way to diagnose celiac disease is by blood test to measure IgA levels against gluten components. The only real treatment is to remove gluten – primarily wheat – from the diet. People with celiac disease who avoid gluten usually do quite well, but approximately 15 percent of patients will have non-responsive celiac disease.
A wheat allergy is different from celiac disease. A wheat allergy occurs when IgE antibodies to wheat are present, and can cause symptoms that are different from celiac disease. The proteins to which these antibodies are directly may be different from those in celiac disease. This type of allergy can be diagnosed with a skin test or a blood test for IgE levels to wheat. In severe cases, a true wheat allergy can result in anaphylaxis. The signs are usually a rash, vomiting, abdominal pain, wheezing and/or circulatory collapse. The treatment is strict avoidance of wheat, careful reading of labels, and to have an epinephrine autoinjector with the patient at all times.