Gluten Free Basics

I know most people have read and re-read info on celiac disease, gluten intolerance and nonceliac gluten sensitivity. But for those of you who have just been diagnosed or would like a better understanding, this definitely made sense to me. I know it seems, a lot to read but I found this by Dr Jean Mcfadden Layton was not just easy to understand, she managed to answer all my question. Hope it helps you as much as it helped me.

By Dr Jean

Ø  Understanding the basic of Celiac disease, Gluten Intolerance and Nonceliac gluten sensitivity
Ø  What is Gluten

Ø  Is wheat your friend

Ø  Oats or not to Oats- cross contamination

Ø  What gluten-free means

Ø  Reading Labels-terms indicating gluten is in a product

Ø  Finding safe foods

Ø  Realistic expectation

Ø Unraveling symptoms in kids

Understanding the basics:

Of Celiac Disease

Celiac disease is sometimes called Celiac Spruce, Coeliac disease(British spelling), Nontropical Spruce, Gluten-sensitive enteropathy or simply CD. Celiac disease isn’t an allergy and it isn’t a sensitivity to gluten. This disease is an autoimmune condition where your body’s immune system literally attacks the gluten molecule. The body treats gluten as an alien invader and sets out to destroy it with antibodies. This reaction happens in the small intestine. Unfortunately, while your antibodies are attacking gluten, they also attacking the wall of the small intestines, causing extensive damage over time.

Your small intestines has lots of small protrusions or hair like cells called villi that increase its surface area so it can absorb lots of nutrients. When a person has Celiac disease, those villi are damaged or blunted(this is called villous atrophy) and the body loses its ability to absorb many nutrients. Villi atrophy is a gradual process that occurs over the years. The longer a gluten-intolerant person is undiagnosed and continues to eat gluten or remains undiagnosed, the more extensive and severe the damage becomes.

Celiac disease has many symptoms, both gastrointestinal(stomach and intestinal related) and non gastrointestinal, such as headaches, skin rashes and general weakness. That’s the one reason why the disease is so difficult to diagnose. Because the symptoms of all three members of the gluten sensitive spectrum(gluten intolerance, gluten sensitivity and celiac disease are so similar. We list them below, but  not a complete list.

These are some of the classic gastrointestinal symptoms celiac disease, gluten intolerance and nonceliac gluten sensitivity.

ü  Abdominal bloating

ü  Abdominal pain and cramps

ü  Bloody stool

ü Chronic diarrhea

ü  Gas and flatulence

ü  Greasy smelly stool

ü  Nausea

ü  Vomiting

ü Weight gain

ü  Weight loss

The nongastrointestinal symptoms celiac disease, gluten intolerance and nonceliac gluten sensitivity.

ü Dental problems

ü Dermatitis herpetiformis

ü  Eczem
ü Fatigue

ü Headaches

ü Joint or bone pain

ü  Lactose intolerance

ü  Respiratory problems

ü Rosacea

ü Seizures

ü Tingly sensation in hands and feet

ü Vitamin and mineral deficiencies

üWeakness

ü  Weight loss

With lists like these. Such conflicting sometimes vague and common symptoms, you can see how diagnosis can be so hard. Some people go for years with no diagnosis and in those years lots of damage can be done. To make things more complicated some people with celiac disease have no symptoms at all and aren’t diagnosed until other, more acute disease develops. And things can get fuzzier as celiacs can suffer from other autoimmune diseases, such as type1 diabetes, rheumatoid arthritis and thyroid disease.

Gluten Intolerance

The symptoms for gluten intolerance are generally the same as for celiac disease. And even thought the treatment for gluten intolerance is the same as for celiac disease, these two conditions aren’t the same. Gluten intolerance isn’t an autoimmune disease; in other words you don’t have an antibody reaction when you ingest gluten. Gluten intolerance doesn’t result in small intestinal damage and poses no risk for the serious complication that occur with celiac disease.

Gluten intolerance is often used as a broad term that includes celiac disease and nonceliac gluten sensitivity. Technically, though, gluten intolerance is simply a non-autoimmune and non-allergic condition that can still feel miserable.

Nonceliac Gluten Sensitivity

Nonceliac Gluten Sensitivity may be much more common than the first believed. In fact, some studies indicate one in seven people worldwide may have NCGS. This condition can be very difficult to diagnose. Many people with NCGS have negative blood test results so they don’t have an intestinal biopsy. Like celiac disease, nonceliac gluten sensitivity is an autoimmune disorder. But the atrophy of the villi in the small intestines isn’t apparent in those with nonceliac gluten sensitivity, so they can’t be diagnosed with celiac disease. The antibodies that your body produces in reaction to gluten may be produced only in the small intestine and don’t show in the bloodstream,(your intestines is actually part of your immune system, so this is certainly possible). If that’s the case , a blood test won’t show the presence of these antibodies even though your body is making them.

Doctors think that the patients with nonceliac gluten sensitivity, the damage occurs in the overall function of the intestines and other tissues and organs of the body. Some doctors who specialize in gluten sensitivity and celiac disease also believe that only people who’ve been suffering from gluten sensitivity for a long time actually have a positive test result; this means that a lot of damage has been done by the time the patient is diagnosed.

Here’s the short answer about nonceliac gluten sensitivity: If your test for celiac disease are negative and other disease are ruled out but you’re still experiencing the aforementioned symptoms, try an elimination diet. If you feel better when you eliminate gluten from your diet(and we mean a complete elimination), then you probably have nonceliac gluten sensitivity.

What is Gluten?

Gluten in a protein molecule found in wheat and other grains such as rye, barley, spelt and triticale. This particle molecule affects certain people with these conditions celiac disease, gluten sensitivity, gluten intolerance and nonceliac gluten sensitivity. Gluten is a molecule unique to certain plants. It consists of two smaller proteins called glutenin and gliadin. When mixed with water, these two protein combine to form gluten. Gluten is a stretchy substance that holds carbon dioxide in baked goods and gives these goods their structure and texture.

The gluten protein causes an autoimmune reaction in gluten-responsive people. Your body perceives the gluten molecule as some type of alien space invader and attacks the molecule with everything in its extensive arsenal. This reaction causes all sorts of unpleasant side effects that range from digestive problem to skin rashes to malnutrition to more serious disease and aliments such as cancer, chronic fatigue, diabetes, migraines, thyroid problems, ulcers, seizures, depression and osteoporosis.

Unlike most other conditions that hurt your body, you have only one way to treat celiac disease and gluten intolerance: avoid gluten, period. Avoid gluten and your life will change: Your energy will return, you won’t have digestive problems, you won’t feel sick and bloated or have skin rashes and dental problem. Some people must avoid for specific health reasons: others do so because they think gluten aggravates another medical conditions such as irritable bowel syndrome, rheumatoid arthritis or asthma. Sound simple enough, doesn’t it? Well.... yes and no. Gluten can hide in the most unlikely places.

Gluten is found in these products:

• Barley
• Bulgur
• Durum
• Einkorn (a wild wheat species)
• Kamut (an ancient relative of wheat)
• Rye
• Semolina
• Spelt
• Wheat
• Wheat pasta
• Triticale (a hybrid of wheat and rye)
• Hand lotion
• Paste glue
• Play-doh
• Prescription medication

Wait a minute! Hand lotion, play-doh and medication. Well, although the grains in the list naturally contain gluten, the gluten molecule can easily be removed from these and used in other products. In fact, gluten is used in many consumer goods as well as food. This perniciousness is why those on the gluten intolerance spectrum have to be careful about reading labels, what they buy, what they eat and how they live their lives. Gluten is sneaky....... very, very sneaky.

Is wheat your friend

The human body didn’t evolve to eat grain. Our hunter-gatherer ancestors ate meat, nuts, vegetables, fruits and grains. In fact, eating wheat and other grains didn’t become common until 4,000 B.C. and wheat wasn’t developed into present form by breeding until the beginning of the 20^th century. Fact, wheat farming started in the Middle East and didn’t reach the northern countries until much later. Developing the modern form of wheat did have some positive aspects, of course; it allowed many people to stop being hunters-gathers and farmer and start to build cities.

Digesting wheat comes naturally to animals such as sheep and cows, with multiple compartments to their stomachs(called ruminants)which helps them to completely digest grains and grasses. Human beings have only one stomach compartment, which means that many parts of the wheat enter our intestines undigested. And those undigested wheat particles can cause many problem, such as inflammation. Inflammation comes in two types: acute and chronic. Acute inflammation which is your body’s response when u cut your finger or have a flu, is a good thing. Your body is responding to pathogens that are attacking your cells; this type of inflammation is short-lived and is how your body heals itself. But chronic inflammation is caused by your body’s immune system attacking your own cells. This causes damage to the cells, which over time cause damage to tissues and organs. Chronic inflammation can cause many disease.

People who aren’t gluten intolerant and don’t have celiac disease or nonceliac gluten sensitivity can experience these symptoms when they consume wheat.
ü  Asthma
ü  Bloating
ü  Constipation
ü  Eczema
ü  Fatigue
ü  Hives
ü  Upset stomach

The bottom line is that if you feel better without gluten in your life, eliminate it. Gluten isn’t necessary for good health and wheat doesn’t provide essential nutrients.

Oats or Not to Oats – Cross-contamination:

Oats do not contain gluten but if they are grown in a field next to a wheat field or processed in the same plant that process wheat into flour, gluten can sneak into oatmeal and oat flour. If a bakery makes wheat bread and then makes gluten-free bread, all utensils and machinery used can carry gluten molecules into the (supposedly) gluten-free bread.

What gluten-free means

Removing gluten from your life doesn’t’ mean that you don’t eat foods made with wheat, barley and rye. Gluten has found its way into many man-made products. Remember even if gluten hasn’t been deliberately added to a product or food. It can find its way into your life through cross-contamination.

Reading labels:

Labels are the holy grail for those who must avoid gluten. Fortunately manufacturers of all kinds are starting to come around to the fact that those on the gluten intolerance spectrum are demanding transparency in product labeling. 

List of terms indicating that gluten is in a products

•        Abyssinian Hard (Wheat triticum durum)
•        Alcohol (Spirits - Specific Types)
•        Amp-Isostearoyl Hydrolyzed Wheat Protein 
•        Atta Flour
•     Barley Grass (can contain seeds)
•     Barley Hordeum vulgare
•     Barley Malt
•     Beer (most contain barley or wheat)
•     Bleached Flour 
•     Bran
•     Brewer's Yeast
•     Brown Flour
•     Bulgur (Bulgar Wheat/Nuts) 
•     Bulgur Wheat
•     Cereal Binding
•     Chilton
•     Club Wheat (Triticum aestivum subspecies compactum) 
•     Cookie Dough
•     Cookie Dough Pieces
•     Couscous
•     Criped Rice
•     Dinkle (Spelt)
•     Disodium Wheatgermamido Peg-2 Sulfosuccinate 
•     Durum wheat (Triticum durum)
•     Edible Coatings
•     Edible Films
•     Edible Starch
•     Einkorn (Triticum monococcum)
•     Emmer (Triticum dicoccon) 
•     Enriched Bleached Flour
•     Enriched Bleached Wheat Flour
•     Enriched Flour
•     Farina 
•     Farina Graham 
•     Farro
•     Filler
•     Flour (normally this is wheat)
•     Fu (dried wheat gluten)
•     Free flowing agents usually means flour
•     Germ
•     Graham Flour
•     Granary Flour
•     Groats (barley, wheat) 
•     Hard Wheat
•     Heeng
•     Hing
•     Hordeum Vulgare Extract
•     Hydrolyed vegetable protein (unless stated soya)
•     Hydrolyzed Wheat Gluten
•     Hydrolyzed Wheat Protein
•     Hydrolyzed Wheat Protein Pg-Propyl Silanetriol
•     Hydrolyzed Wheat Starch
•     Hydroxypropyltrimonium- Hydrolyzed Wheat Protein  
•     Kecap Manis (Soy Sauce)
•     Ketjap Manis (Soy Sauce)
•     Kluski Pasta
•     Maida (Indian wheat flour)
•     Malt
•     Malted Barley Flour
•     Malted Milk
•     Malt Extract
•     Malt Syrup
•     Malt Flavoring
•     Malt Vinegar 
•     Macha Wheat (Triticum aestivum) 
•     Matzah
•     Matzo, Matzo Semolina
•     Meringue
•     Meripro 711
•     Mir
•     Nishasta
•     Oriental Wheat (Triticum turanicum) 
•     Orzo Pasta
•     Pearl Barley
•     Persian Wheat (Triticum carthlicum) 
•     Perungayam
•     Poulard Wheat (Triticum turgidum)
•     Polish Wheat (Triticum polonicum) 
•     Rice Malt (if barley or Koji are used)
•     Roux
•     Rusk
•     Seitan
•     Shot Wheat (Triticum aestivum) 
•     Small Spelt
•     Spirits (Specific Types)
•     Spelt (Triticum spelta)
•     Sprouted Wheat or Barley
•     Stabilizer
•     Starch, food starch, vegetable starch(unless stated maize or corn starch
•     Stearyldimoniumhydroxypropyl Hydrolyzed Wheat Protein 
•     Strong Flour
•     Suet in Packets
•     Tabbouleh 
•     Tabouli
•     Teriyaki Sauce
•     Thickener or Thickening Agent
•     Timopheevi Wheat (Triticum timopheevii) 
•     Triticale X triticosecale
•     Triticum Vulgare (Wheat) Flour Lipids
•     Triticum Vulgare (Wheat) Germ Extract
•     Triticum Vulgare (Wheat) Germ Oil
•     Udon (wheat noodles)
•     Unbleached Flour 
•     Vavilovi Wheat (Triticum aestivum)  
•     Vital Wheat Gluten
•     Wheat, Abyssinian Hard triticum durum
•     Wheat amino acids
•     Wheat Bran Extract
•     Wheat, Bulgur 
•     Wheat Durum Triticum 
•     Wheat Germ Extract
•     Wheat Germ Glycerides
•     Wheat Germ Oil
•     Wheat Germamidopropyldimonium Hydroxypropyl-Hydrolyzed Wheat Protein
•     Wheat Grass (can contain seeds) 
•     Wheat Nuts
•     Wheat Protein
•     Wheat Triticum aestivum
•     Wheat Triticum Monococcum
•     Wheat (Triticum Vulgare) Bran Extract
•     Whole-meal Flour
•     Wild Einkorn (Triticum boeotictim
•     Wild Emmer (Triticum dicoccoides)

Become a label reading junkie.....

Finding safe foods

You can find safe, gluten -free foods at certain grocery stores, health food stores and the internet. If you can’t find xanthan gum at your health food store, you can order it from Amazon.com, along with light bulbs and diamonds.

To stay healthy, you must become something of a detective. Question your waiter, ask to speak to the chef, demand labels from places that serve food and ask about cross-contamination. Don’t be shy about asking question; this is your health. Being polite is certainly necessary but don’t let anyone tell you that the food is “perfectly fine” unless you’re sure he understands the possible ramification of being wrong.

You must be an advocate for yourself and your family. And you can do some proactive things to make out and traveling safer. These websites offers guides to safe restaurants and grocery store around the world:

The Gluten-Free Restaurant Awareness Program (www.glutenfreerestaurants.org) lists safe gluten-free restaurants by state, helpful travel guide.

Celiac Travel has a printable gluten-free restaurant cards (www.celiactravel.com/cards ) you can carry when you travel. Available in 51 Languages.

The Gluten-Free Travel Site (www.glutenfreetravelsite.com) has reviews on gluten-free restaurants, hotels, resort and cruise ships

Will update with site for South Africa.

Realistic expectation

Although many gluten sensitive people feel better immediately when they eliminate gluten from their diets, you may not be so fortunate. Depending on the severity of your condition and how long you suffered undiagnosed. You may take months to see the true results of a gluten-free diet. Your body has to heal itself. You may have to consider other variables. You may have developed other allergies or intolerance because of the damage done to your intestinal tract. You may have to eliminate casein and/or lactose from your diet to feel better.

If your child needs to be gluten-free, be realistic about the recovery. If your child is older than 5 or 6 he may never completely catch up on the growth charts because of the damage done. But that doesn’t mean he/she can’t live a happy normal healthy life. Healing take time, be gentle with yourself during the transition to a gluten-free lifestyle. Don’t hide in your house.

Unraveling symptoms in kids

Diagnosing one of the gluten sensitive spectrum conditions in children can be difficult. But earlier the disease is diagnosed, the better the chances for a long and healthy life. Adults and children usually have different symptoms of this disease. Gastrointestinal symptoms are more common in children. Children can have very specific symptoms of celiac disease, gluten intolerance and nonceliac gluten sensitivity, including

üADD/ADHD

ü  Autism
ü Behavioral problems

ü Canker sores
üDelayed growth

ü Delayed puberty

üDental caries or soft teeth

ü Failure to thrive

ü  Nosebleeds

ü  Short stature

ü  Weight loss

An infant or child shows symptoms, an accurate diagnosis is crucial. To minimize the risk of developing any of these conditions, don’t introduce gluten to a child until he or she is six months old. Between six and seven months of age, gluten introduction has a lower chance of triggering one of these conditions. If celiac disease is present in your family, you may want to avoid gluten in your child’s diet altogether.

Removing wheat and gluten ingredients from a child’s diet is probably one of the most challenging things you can do. When your child learns that she won’t be able to pizza with her best friend or have cupcakes at the next birthday party, he/she will probably break down in tears. That’s where you come in, your attitude is crucial in making your celiac child’s life better. This is also an incredibly important learning experience. Your child watches everything you do, so adopt a positive attitude and involve your child in baking. Also when a child is diagnosed, you have to decide whether to turn the whole family into a gluten free group or let some family members eat gluten.

Will continue to update............