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Wheat Allergy? Gluten Sensitivity? Or Is It really Celiac Disease?

So you're having some digestive upset, bloating, diarrhea, and cramping, interspersed with mood shifts with confusion and exhaustion. You monitor the condition, readi up on it, talk with others about it and everything points to a problem with gluten. Is gluten just a buzz word or might it really be causing your gastric distress?

Your symptoms can suggest a spectrum of illnesses related to how your immune system responds to gluten. These can include a wheat allergy, gluten sensitivity, or a full blown autoimmune response referred to as celiac disease.  Symptoms for these overlap with a few specifics added on, such as hives and congestion for wheat allergy, and osteoporosis and cancer for celiac disease. Celiac disease can have no symptoms for years, although it is doing internal damage.

By some estimates the prevalence of wheat allergy is less than 1% in children who usually outgrow it, while celiac disease affects 1% of adults (1 in a hundred) among those of European descent, and rates of gluten sensitivity are unknown. More research is needed on all of these to be certain, especially since the numbers of people affected by celiac disease and gluten sensitivity seem to be growing.  

The easiest way to diagnosis a wheat allergy is to avoid wheat and see if symptoms improve. Similarly an easy diagnosis of gluten sensitivity is to avoid gluten and see if symptoms improve. Gluten is in wheat but also in rye and barley and trace amounts in many things we eat.

The stronger diagnosis is made with antibody, gene testing and biopsy. In the case of wheat allergy, a blood and skin prick will reveal IgE antibodies. Gluten sensitivity may show AGA antibodies in the blood. By far, the most sensitive (accurate) test for celiac is the Tissue Transglutaminase Antibody (tTG-IgA) test. It will pick up about 98% of the people who have celiac and give a negative response for 95% of those who do not have it. Blood tests may also reveal EMA antibodies, while a biopsy usually reveals damage to villi in the wall of the intestines. Genetic testing in celiac disease often show HLA-DQ2 or HLA-DQ8 gene variations, but these only suggest risk for and not the presence of celiac.

If you give up gluten to see if your symptoms improve and then do a blood test for celiac, blood tests will come back negative because there is no gluten for your body to react to. Stay on gluten before the blood tests are done to get true results.

Getting a clear diagnosis for celiac is important because the treatment is a strict gluten free diet for the rest of your life.  Treatment for wheat allergy is to avoid wheat, for gluten sensitivity is to avoid gluten or eat very small amounts. But celiac is a greater lifestyle adjustment without exception. Eating celiac causes gastric and energy upsets as well as internal damage.

Get informed and read some great books on celiac and allergies available at the Diabetes Mall store.

Wheat Belly by William Davis, MD Gluten-Free Recipes For People With Diabetes by Nancy Hughes Celiac Disease: A Hidden Epidemic by Peter H.R. Green and Rory Jones

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