You’ve probably been hearing more and more people saying “I can’t tolerate gluten” or “I’m gluten-free.” While this can be a life choice there is also a rise in the number of individuals experiencing gastrointestinal and systemic (other organs affected such as skin, nervous system, musculoskeletal, etc.) symptoms related to gluten and wheat. Why are we seeing such a rise in wheat and gluten related disorders? There are several reasons that may be contributing to this rise including modern hybridized strains of wheat that contain higher levels of gliadin, increased consumption of wheat, changes in the gut microbiome, increased use of chemicals/pesticides and increased presence of intestinal permeability. However, not all gluten and wheat related disorders are created equally. At Revitalize Nutrition our dietitians have the skills and expertise to understand and help you navigate these conditions. Let’s explore the differences:
1) Wheat Allergy
A wheat allergy is an IgE immune mediated response to wheat proteins meaning it is an allergic response. The allergic immune response leads to inflammation and impairment in the body’s ability to repair the intestinal cells if there is recurrent exposure. For a wheat allergy removal of all wheat products is necessary to prevent further reactions. Typically, individuals with a strict wheat allergy can consume other gluten containing grains such as barley and rye. As with other food allergies, cross-contamination can occur and result in allergic reactions. Symptoms of a wheat allergy include cramps, nausea, vomiting, bloating, diarrhea, gas, dermatitis, red round welts on the skin, hives, and wheezing.
2) Celiac Disease
Celiac disease is an autoimmune condition in response to gluten found in wheat, barley and rye. The autoimmune response leads to inflammation and an attack on the intestine resulting in damage to the intestinal villi and intestinal mucosa. If you have celiac disease, strict adherence to a gluten-free diet and prevention of cross-contamination is crucial for success managing this disease. Celiac disease can have both intestinal and systemic symptoms. Intestinal symptoms include chronic diarrhea, abdominal pain, smelly, and fatty stools due to malabsorption. Systemic symptoms include bone and joint pain, osteoporosis, tingling leg numbness, muscle cramps, missed menstruation, infertility, recurrent miscarriage, thyroiditis, tooth discoloration, unexplained anemia, seizures, dementia, delayed growth, and leg cramps, and dermatitis herpetiformis.
3) Non-celiac Gluten Sensitivity
Non-celiac gluten sensitivity is a condition with an immune response to gluten but it is not an autoimmune response. The diagnosis of non-celiac gluten sensitivity is used when celiac disease has been ruled out, but one continues to have reactions to foods containing gluten. Unlike celiac disease there is no damage done to the intestinal villi. However, there is inflammation and an increase in immune cells in response to gluten exposure. Symptoms vary from person to person and cross-contamination may result in symptoms for some and not others. Intestinal symptoms include diarrhea, abdominal pain, constipation, and gas. Systemic symptoms include bone and joint pain, osteoporosis, leg numbness, muscle cramps, unexplained anemia, glossitis, headache, fatigue, skin rash, and brain fog. Symptoms will rapidly disappear after removal of gluten from the diet and reintroduction of gluten causes symptoms to reappear.
4) Non-celiac Wheat Sensitivity
Non-celiac wheat sensitivity is a non-immune mediated response to rapidly fermentable carbohydrates (FODMAPs) found in wheat. The reaction may result in the inability for gut cells to repair but no damage is done to the intestinal villi, and there is not an immune response. With a non-celiac wheat sensitivity, a person will only experience intestinal symptoms, which is different from all other gluten and wheat related disorders. Typical symptoms include the production of gas and increased production short chain fatty acids due to the FODMAPs found in wheat.
If you are experiencing any of these symptoms, are concerned that you need to be following a gluten-free diet, or have been told you have one of these conditions, but do not know where to start, we can help! Reach out to begin working with a Registered Dietitian. Together you will develop an individualized plan to navigate a gluten-free diet and lifestyle.
