Last year at this time we began hearing a lot more about gluten sensitivity and the push for a more “black and white” diagnosis of it. Right now it seems to land in a grey area of diagnosis because it’s not celiac disease but it sort of acts like it — sometimes. But new work by researchers could have us one step closer to better knowledge, diagnosis and even education of gluten sensitivities.
The University of Maryland’s Center for Celiac Research in Baltimore estimates that 6% of Americans (or approximately 18 million people) have some form of gluten sensitivity, which is why this is an important area to research. So what’s the difference? Celiac disease is an autoimmune disorder and gluten can cause a reaction where the body actually fights itself causing major long-term health problems. Gluten sensitivity may have similar symptoms of celiac, like diarrhea, but doesn’t have those long-term health concerns.
In February BMC Medicine published information from a group of doctors who came together last year to discuss the next steps in defining the difference between a wheat allergy, celiac disease and gluten sensitivity and how to diagnose them.
Wheat Allergy: is an adverse immunologic response to wheat protein, including anaphylaxsis. It is diagnosed by a skin prick test and possibly a subsequent food challenge to confirm the diagnosis.
Celiac Disease: an autoimmune disorder where ingesting gluten is toxic to your body. The gluten wipes out the villi that absorbs nutrients, thus forcing an untreated celiac patient to be malnourished — causing many other health issues. It is diagnosed by blood test and subsequent biopsy.
Then there’s Gluten Sensitivity…
It seems to fall under this category of — “well it’s not celiac disease so…it must be this…” Or as stated in the new research, gluten sensitivity is when…
“…there are cases of gluten reactions in which neither allergic [wheat allergy] nor autoimmune mechanisms [celiac disease] can be identified.”
In the research it talks about the current algorithm (or plan) on diagnosing people with gluten issues and figuring out if it’s an allergy, autoimmune disorder or sensitivity. But more needs to be done. For as long as I have been involved in the area of celiac disease awareness, I have heard people talk about how they are treated like they’re crazy when the go to the doctor and complain about symptoms that aren’t evident on any particular test. This newest information is a step in the right direction to make diagnosing gluten sensitivities much easier.
This week I asked Dr. Alessio Fasano, corresponding author to this information and director of the University of Maryland Center for Celiac Research, about what’s next and even when a plan is officially agreed on.
Dr. Fasano described the next step “…is to identify and validate biomarkers for the diagnosis of gluten sensitivity, so that we do not have to make a diagnosis by exclusion criteria.” So instead diagnosing based on ruling out allergy or celiac, you would have an actual test for gluten sensitivity.
If and when this happens, how you get thousands of doctors on board with the newest information? Dr. Fasano said, “Once we have better idea on what gluten sensitivity is and how to diagnose it, then we need to have an educational campaign among health care professionals. This is the same approach we took with celiac disease 20 years ago.”
This may still take time, but it is headed in the right direction for all people who wonder to this day why something just isn’t right with them.