Celiac Disease: Gluten Free Diet (cont.)
Betty Kovacs, MS, RD
Betty is a Registered Dietitian who earned her B.S. degree in Food and Nutrition from Marymount College of Fordham University and her M.S. degree in Clinical Nutrition from New York University. She is the Co-Director and Director of nutrition for the New York Obesity Research Center Weight Loss Program.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is a gluten-free diet?
- Who needs to follow a gluten-free diet?
- Celiac disease
- Dermatitis herpetiformis
- Gluten ataxia
- Wheat allergy
- Non-celiac gluten sensitivity (NCGS)
- Irritable bowel syndrome (IBS)
- What are the difficulties with following a gluten-free diet?
- What foods do you avoid on a gluten-free diet?
- Foods that are unsafe to eat
- What foods can you consume on a gluten-free diet?
- Foods that are safe to eat
- What are resources for a gluten-free diet?
- Celiac Disease (Celiac Sprue) FAQs
Dermatitis herpetiformis, also known as Duhring disease, is an intense burning and extremely itchy rash made up of blisters and bumps. It usually occurs equally on both sides and is found most frequently on the elbows, buttocks, knees, scalp, and back. This is sometimes referred to as "the gluten rash" or the "celiac disease rash" and has been used to diagnose celiac disease for some people. Strict adherence to a gluten-free diet is recommended to prevent flares and complications.
Gluten ataxia is an immune-mediated disease caused by the consumption of gluten in genetically susceptible people. Ataxia is poor coordination and unsteadiness due to the brain's failure to regulate the body's posture, and regulate the strength and direction of limb movements. Antigliadin antibodies (AGA) are produced in response to gliadin, the prolamin found in wheat. Gluten ataxia was first detected in 1998 in people who had ataxia with elevated AGAs. All of these patients in this initial description had gait ataxia, some had limb ataxia, and more than half had peripheral neuropathy. About a third had celiac disease. A gluten-free diet is the treatment for gluten ataxia.
The nutrients found in food can prevent disease and sustain life. They can also cause health problems in susceptible people. Food allergies can wreak havoc on a person's health and quality of life. Roughly 5% of individuals in Westernized nations have a true food allergy. A true food allergy is an abnormal response to a food triggered by the body's immune system. Symptoms can range from vomiting, diarrhea, and abdominal cramps to hives or eczema to itching and swelling in the mouth or possibly to a life threatening anaphylactic reaction.
Wheat allergy is defined as an adverse immunologic reaction to wheat proteins that is immunoglobulin E (IgE) mediated. It can present as respiratory symptoms (baker's asthma or rhinitis, more common in adults), food allergy (gastrointestinal symptoms of gas, bloating, diarrhea, and abdominal pain, hives, angioedema, or atopic dermatitis; mainly in children) and contact hives (urticaria).
The top eight food allergens in the United States are peanuts, milk, eggs, fish, crustacean shellfish, soybean, tree nuts, and wheat. Only about 0.1% of all food allergies is a wheat allergy. Wheat allergy symptoms usually occur in the mouth, nose, eyes, and throat (swelling, itching, and irritation); the skin (rash, hives, swelling); respiratory tract (wheezing, difficulty breathing, anaphylaxis); and gastrointestinal tract (cramps, nausea, emesis, gas, bloating, diarrhea, and abdominal pain). The testing options for a wheat allergy include either an IgE serum assay or skin prick test to wheat. Only wheat flour is required to be restricted and there should be no permanent damages caused by it.
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