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Who should avoid gluten?

Gluten is a sticky protein found in bread, cookies, and cakes. In Latin, it means "glue" as it literally binds bread, pasta, and dessert to make it denser and more palatable. Lately, it's been labeled a bad thing to eat. But not everyone needs to avoid gluten. These are the three conditions you should be aware of to avoid gluten:

1. Celiac disease

Celiac disease is an autoimmune condition in which gluten flattens and destroys the villi. Villi are small finger like projections in your small intestines and they are essential in absorbing nutrients and vitamins. So in Celiac disease when these villi are compromised, inflammation and malabsorption occur and can lead to all kinds of problems like anemia, stomach pains, weight loss, diarrhea, constipation and bloating.

About 1% of people in the United States have Celiac disease and to diagnosis it, doctors can examine the villi through endoscopy and do biopsies. They can also check blood tests for certain elevated antibodies that react to gluten. In addition, genetic testing is now widely available.

2. Gluten Sensitivity

About 6% of the population have gluten sensitivity which means exactly as it sounds. People just don't tolerate it well and can experience both intestinal and extra-intestinal problems when they eat gluten. Symptoms can be subtle and variable: Abdominal pain, anemia, depression, diarrhea, eczema, fatigue, headache, and joint pain. Unlike Celiac disease, folks with gluten sensitivity do not suffer from flattened or damaged villi in the small intestines. The exact mechanism of gluten sensitivity still needs research. A theory now is that it is the culprit is not pure gluten but the processed version of the grains in this modern industrialized food industry.

Diagnosis of gluten sensitivity is one of exclusion, so your doctor may need to do blood tests at first to rule out Celiac disease. Most people can do a self experiment and go off gluten for 2 weeks to see if you feel better or your symptoms go away. And then you can re-test with ingesting gluten and see if the symptoms come back. Even though gluten sensitivity is not as serious as in Celiac disease, folks with gluten sensitivity can eliminate gluten to improve their quality of life.

3. Wheat Allergy

Wheat allergy is an allergic reaction to wheat and the reactions occur almost immediately (less than two hours) and although rare, it can be fatal. People with wheat allergy need to avoid wheat but they can eat rye and barley. Diagnosis is done by skin prick and blood tests.

Friend or Foe?

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