Q: I think it is pertinent to inform people that a “poochie” stomach may be caused by gluten sensitivity. A column on gluten may be helpful. — Sharon C., Denver
A: There is evidence indicating that sensitivity to gluten — two proteins found in domesticated cereal grains like wheat, barley, oats and rye — has an adverse effect on as much as 12 percent of the population.
Gluten sensitivity often accompanies autoimmune diseases such as Graves’ disease, lupus, multiple sclerosis and rheumatoid arthritis. For those with this sensitivity, chronic gastrointestinal discomforts like bloating, constipation, nausea, flatulence and diarrhea are the usual signs of a possible problem with gluten in the diet.
Gluten is so problematic because it is a very complex protein, which makes it difficult to digest. People who think they can’t tolerate gluten should eliminate wheat, barley, oats and rye from their diet to see if the symptoms disappear. This is easier said than done, however, because wheat and other cereals are present in thousands of our most popular food items, like bread, pasta and breakfast cereals.
Gluten sensitivity is not to be confused with celiac disease, which is a severe and permanent intolerance to these grains. When someone with CD ingests gluten, the person’s antibodies attack the villi of the small intestine (tiny “fingers” on the intestinal lining) and destroy them.
Without these villi, the absorption of nutrients is severely compromised and, regardless of the mass quantities of food consumed, malnourishment results. This in turn causes many other physical problems such as anemia, osteoporosis, certain gastrointestinal cancers, seizures, joint pain, miscarriages, malformed fetuses, infertility, memory loss, mood swings and (if it remains undiagnosed in children) stunted growth or failure to thrive in infants.
The latest information finds that CD affects as many as one in 133 people. Unfortunately, it is still assumed by many that the primary symptoms are diarrhea and weight loss, but the most common symptoms are fatigue, abdominal pain and gas. Too often, when patients complain of these symptoms, the diagnosis is irritable bowel syndrome, depression, fibromyalgia, anxiety, Crohn’s disease, colitis, diverticulosis or chronic-fatigue syndrome. It is not uncommon for patients to go a whole year before being correctly diagnosed.
What to do? First of all, never assume. Just because you have been diagnosed with one of these diseases or afflictions does not mean going on a gluten-free diet will suddenly heal you. If you suspect you have CD (particularly if someone in your family has it), do not go on a gluten-free diet until you rule out or confirm CD through a celiac-antibody blood test from your health- care provider.
If you are diagnosed with CD, your next challenge is a major diet overhaul so that the small intestine can heal, which might take from six months to two years, depending on the severity of the damage.
Because the small intestine is part of the body’s system for calcium absorption, osteoporosis can become a complication if gluten sensitivity or celiac disease goes untreated. This will mean paying particular attention to consuming foods that are high in calcium and vitamin D, such as dark- green leafy vegetables and calcium- fortified products like orange juice.
If you discover that you have had some bone loss from gluten sensitivity or celiac disease, you should perform weight-bearing exercises (in which you are forced to work against gravity) such as walking, dancing, strength training, step-aerobics, stair climbing and other cardiovascular activities that involve some degree of impact.
For more information, contact the National Digestive Diseases Information Clearinghouse, 800-891-5389.
Linda J. Buch is a certified fitness trainer in Denver; linda@ .
