During the last ten years more and more people around the world have become aware of a substantial improvement of their health after they have excluded gluten from their diet and consequently adopted a gluten free diet.
Gluten is the main protein complex of wheat with equivalent toxic proteins founds in other cereals including spelt, rye and barley. The toxic proteins of gluten are mainly gliadins and glutenins.
As recently as just a decade ago diseases caused by or connected to gluten were considered as extremely rare outside Europe and therefore almost completely ignored by health care professionals. But during the last ten years the understanding among scientists of the role of gluten in a wide spectrum of health disorders has changed dramatically even if this new knowledge has yet been embraced by specialist doctors.
In 2012 leading scientists who have done extensive research on gluten have reached consensus on a new classification of gluten-related disorders. That year, 16 of the worlds leading gluten researchers summarised the present scientific view on gluten related disorders in a consensus statement. Now three main forms of gluten reactions are recognised:
Allergic (wheat allergy)
Autoimmune (celiac disease, gluten ataxia, dermatitis)
Possibly immune mediated ( gluten sensitivity)
Wheat allergy is a food allergy affecting the skin, gastrointestinal tract or respiratory tract. IgE antibodies play a central role in wheat allergy. Symptoms may be asthma, rhinitis, urticaria, eczema and anaphylactic shock. Wheat allergy can be diagnosed with a blood test for IgE and skin prick tests.
Celiac disease or sprue has been recognised as a crippling disease with symptoms of diarrhoea, abdominal pain and weight loss and no cure. In 1953 a Dutch paediatrician, Dr. Willem-Karel Dicke, could establish the connection between celiac disease and bread consumption.
He had noticed a decrease of typical abdominal celiac symptoms in children during the Second World War when there was a shortage of bread and how these symptoms got worse when Swedish relief planes dropped bread into the Netherlands. He followed up his observations by recommending gluten elimination in affected children which caused dramatic cures.
Gluten intolerance or celiac disease, is now recognised as a chronic immune mediated inflammation of the small intestine in genetically susceptible individuals. It is caused by a component of gluten in wheat, gliadin, and similar substances in spelt, rye and barley. These substances cause an inflammatory reaction in the intestinal membrane causing flattening of the intestinal mucosa.
Celiac disease has been called gluten intolerance. Intolerance would indicate that the immune system is not involved, but in this case this is not a correct term. Nor is it a common wheat allergy caused by IgE anti-bodies to gliadin but rather an autoimmune disease. In celiac disease there is a production of IgA antibodies. Gliadin and equivalent proteins found in rye, barley and spelt cause the intestinal mucosa to release a substance called zonulin which causes the mucosa to become leaky so that undigested gluten and many other harmful substances can cross the intestinal wall into the blood stream. Additionally the intestinal mucosa becomes unable to perform a normal uptake of nutrients.
Methods for diagnosing celiac disease can however be unreliable. The best way to find out is to cut out gluten for three months to see any changes.
Symptoms for celiac disease:
Large, pale and bulky stools
Foul smelling stools
Poor weight gain or weight loss
Abdominal cramps or flatulence
Deficiency of nutrients such as calcium, iron and vitamins due to poor assimilation
These are the classical symptoms of celiac disease which doctors easily recognise. However it has become increasingly evident that intestinal symptoms may be negligible or absent in nearly half of persons who suffer from celiac disease. Instead they may show a wide variety of symptoms such as anaemia due to a lack of iron, B12 or folacic acid, osteoporosis, arthritis, dermatitis, depression, neurological symptoms, chronic fatigue and many others. Many children who are diagnosed with celiac disease may have no other symptoms than chronic abdominal pain. Others may only have anaemia and vitamin and mineral deficiencies or no obvious symptoms at all.
Gluten and psychiatric disease
Some researchers have studied the connection between celiac disease and bipolar disease, a condition that more people are diagnosed with. The connection between the gut and psychiatric disease has been suspected for 200 years and was confirmed in the 1970’s by the American psychiatrist F.C. Dohan. Celiac disease seemed to be much more common in schizophrenic patients than should have been statistically expected.
Celiac disease and other diseases
People with celiac disease are more likely to develop allergies, asthma and autoimmune disease such as rheumatoid arthritis, conditions which normally improve or even remit with a gluten and casein free diet. Celiac disease is also connected with inflammatory bowel disease, ulcerative colitis and Crohn’s disease.
Skin manifestations, e.g. acne are very common in celiac disease. Dermatitis herpetiformis, a characteristic itchy rash usually on elbows, knees or back is also quite common.
Gluten and neurological disorders
Celiac disease can also manifest as various neurological symptoms such as nerve inflammation, ataxia (loss of muscle coordination and balance), movement disorders and seizures. The neurological symptoms are believed to be caused by antibodies against gliadin which travel in the blood stream to the brain where they cause an autoimmune reaction, especially in the Purkinje cells of the cerebellum - the part of the brain which controls balance and coordination. Damage in these cells may also affect language in children and cause late speech development or poor articulation.
In gluten sensitivity there are no markers for autoimmune disease or wheat allergy and the condition cannot be diagnosed with blood tests or intestinal biopsy. However the symptoms of gluten sensitivity and celiac disease are the same, they include abdominal pain, eczema or rash, headache, foggy mind, fatigue, diarrhoea, depression, numbness in limbs and joint pain. Gluten sensitivity may also be common in IBS a chronic condition with sometimes severe abdominal symptoms such as pain and diarrhoea.
Gluten sensitivity is a new concept and there is very little research about how gluten sensitivity can affect our health in the long run. Today the only way to diagnose this condition is to observe how health and well-being improves by eliminating gluten.
There is increasing evidence that the prime target of celiac disease and gluten sensitivity is not the intestines but the brain and neural system.
Causes of celiac disease
Celiac disease has been regarded as a rare hereditary disease which affects people with a genetic disposition. However the genetic explanation does not give reasons for why the incidence of celiac disease has increased fourfold in the second half of the last century. There must be environmental causes for this development. One explanation given by researchers why celiac disease has become much more common is that the gluten component of wheat has changed over time.
Another factor that may contribute to the increased frequency of celiac disease and gluten sensitivity is an impaired immune system.
When to suspect a gluten related disorder?
In infants and small children you may see symptoms like diarrhoea or constipation. Theses children may have problems to gain weight, they may cry more than usual, and they may have movement disorders. Delayed speech and poor articulation can be other symptoms of gluten disorders. Also in children who are easily disturbed and over-sensitive to impressions, extremely shy or afraid of the dark gluten sensitivity should be kept in mind. Irritability, fits of emotion, hyper activity, obsessive compulsive symptoms and tics can also be symptoms. Many children with celiac disease or gluten sensitivity are addicted to gluten and may limit their food intake to bread and pasta.
When a gluten related disorder appears you normally notice a deterioration of health and behaviour. there may be depression, irritability, phobias or obsessive compulsive symptoms. problems with attention and concentration can surface and the school performance may deteriorate. You may also notice digestive symptoms like pain, bloating or loose stools. The child may complain of headaches and migraine may also appear. Symptoms like eczema and acne can also develop.
Bio-resonance can detect gluten sensitivity and can also be used to strengthen the immune system, as can acupuncture.
Please contact me for a consultation.