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An allergic response is an overreaction by our body’s defense (immune) system against a particular substance (regarded as an allergen, or an allergy generating substance). The immune system regards it as an invader and mounts a response against it which harms the body more than it protects.

What are food allergies?

Food allergies affects more than 15 million people in the United States alone and 90% of all food allergies are due to eight foods " milk, eggs, peanuts, tree nuts, soy, wheat, fish and shell fish.

The most common type of wheat allergy is due to the presence of a protein in wheat called gluten. Apart from wheat, gluten is also found in barley, oats and rye, and subsequently in all products that are made from any of these grains.

Gluten intolerance is a disorder where a person’s immune system is triggered. A “trigger molecule” in the food activates the immune system and makes it believe that it is a potential invader and may cause harm to the body. Some people have a genetic composition that makes them to respond quickly to gluten and cause a hypersensitivity response. Currently, researchers have been able to find 6 genes (which are variants of the HLA series). Such people are called gluten intolerant. Gluten intolerance can manifest as celiac disease (CD) and non-celiac gluten sensitivity (NCGS).

Celiac disease

Celiac disease is the most severe form of gluten sensitivity. The digestive system is severely damaged, wherein the microvilli " small projections on the inside surface of the small intestines " are gradually destroyed by a hypersensitive immune response. These microvilli play a major role in absorption of nutrients from food. With decreasing number of villi, your intestine’s ability to absorb nutrition reduces greatly.

Symptoms of celiac disease include abdominal bloating and gas, chronic diarrhea, constipation, stomach ache, nausea and vomiting. Failure to absorb essential nutrition can lead to failure to thrive in infants, delayed puberty in adolescents, weight loss, and irritability in mood, among others.

Adults, on the other hand, may experience a range of different symptoms, apart from the digestive problems, that include fatigue, anemia, depression, anxiety, osteoporosis, joint pains, headache, etc.

Diagnosis of this condition is usually done through a blood test that detects antibodies, called anti-gliadin antibodies, in your blood. These antibodies are substances that are produced by our immune system in response to gluten protein. It is important to note that these antibodies can be detected only if gluten is present in the body. Thus, if you feel that your condition might be associated with gluten sensitivity, it is important to not stop consuming gluten on your own or else you will get a false negative result of the blood test. Only after proper diagnosis and recommendation by your doctor you should go on a “gluten-free” diet.

A biopsy of the small intestine is also done as a means to understand the extent of microvilli damage. The results from the blood test, biopsy and symptoms confirm the presence of celiac disease.

Predisposition to celiac disease, among gluten intolerant people, is seen in 3 out of 6 genes (that makes a person gluten sensitive). These are named HLA DQ-2, HLA DQ-7 and HLA DQ-8 (there are variations in populations). Variations in these 3 genes contribute to celiac disease.

Non-celiac gluten sensitivity

Non-celiac gluten sensitivity (NCGS) is a difficult disorder to diagnose and as yet, not much is known about the exact biological reason behind it. Common symptoms of this disorder include mental fatigue, or “brain fog,” physical fatigue, headache, gas, bloating and abdominal pain.

These individuals might have variations in either the same genes as that of celiac disease or other genes, but do not display the typical signs and symptoms of celiac disease. In such individuals, blood tests and biopsy results are negative for celiac disease. This group of individuals display the widest range of signs and symptoms " from acne, acidity and hay fever to ulcerative colitis, multiple sclerosis, chronic inflammation, osteoarthritis and type 1 diabetes. NCGS individuals may suffer from celiac disease.

Silent killer?

According to estimates, gluten intolerance affects 1% (around 72 million people) of the world population. Out of these, 97% (around 70 million) of the cases generally go undiagnosed. About 25% cases that are diagnosed are the ones which manifest with typical symptoms and the rest are “silent” or atypical ones.

The most confusing aspect of gluten intolerance is that it can present itself with wide-ranging symptoms. Some people show typical (and highly unrelated) symptoms like, recurrent digestive complaints, acne, eczema, psoriasis, dandruff, obesity and so on. It affects nearly every tissue in the body, including the brain, skin, endocrine system, stomach, liver, blood vessels, smooth muscles and even the nucleus of cells. It is associated with an astonishing variety of diseases, from schizophrenia and epilepsy, to Type 1 diabetes and osteoporosis, to dermatitis and psoriasis, to Hashimoto’s hypothyroidism to peripheral neuropathy.

Is there a way to diagnose these conditions quickly?

We know with some certainty that these conditions are genetic in nature and many genes have been identified to play a role in gluten sensitivity. While celiac disease is relatively easy to diagnose using blood tests and biopsy, apart from its typical symptoms, NCGS is challenging to diagnose. NCGS also manifests in a variety of ways and makes it extremely difficult to diagnose through conventional means.

Some experts have proposed a quick genetic test that has the ability to find whether a person is predisposed to gluten sensitivity or not. This non-invasive test, that is also available commercially, checks for the HLA series genes that play a major role in gluten sensitivity and can identify the underlying cause of a wide range of signs and symptoms and helps correlate them with gluten sensitivity.

Living with gluten sensitivity

The only treatment of celiac disease is a strict gluten-free diet. For NCGS, the extent to which you eliminate gluten from your diet will depend upon the severity of symptoms after gluten consumption. But it is advisable ...    Continue

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