Gluten is a protein fraction present in some grains. One of gluten’s proteins, gliadin, is responsible for intolerance or sensitivity reactions to grains such as wheat, spelt, rye, triticale, oats, barley and kamut.
One possible explanation for gluten sensitivity is the deficiency of an intestinal enzyme which results in the incomplete breakdown of gliadin, forming toxic peptides (smaller molecules) that accumulate in the gastrointestinal tract and eventually damage intestinal villi – projections in the mucosa – where nutrient absorption normally occurs. Another theory implicates irregular receptors on the surface of intestinal cells, resulting in the abnormal binding of these proteins to the cells and causing the cells’ destruction. Other explanations involve immune defects or viral infections that result in the inactivation of gastrointestinal cells.
Whatever the mechanism of the intestinal cell damage following gluten (gliadin) intolerance, the resulting condition is a primary chronic intestinal malabsorption that typically involves the part of the small intestine called the duodenum that comes directly off the stomach. This pathological process can be acute, subacute, or insidious. The intolerance usually presents in the first three years of life and may reappear again at any time, however, it may appear for the first time at any age, is never outgrown, and requires a lifetime total avoidance of gluten in order to control the condition. Even a small amount of ingested gluten may create a reaction that can be delayed for 1-2 months.
Many gluten-sensitive individuals are also lactose intolerant. Early intolerance to cow’s milk lactose may increase sensitivity to gluten later in life, and it has been suggested that gluten intolerance can be a sequelae to lactose intolerance.
Classically, gluten-sensitive patients suffer chronic diarrhea or constipation, bloating and cramping. Adults often present with increased appetite, weight loss, weakness and fatigue, though some patients have few, if any, symptoms.
If untreated, this chronic malabsorption can contribute to hypertension, heart irregularities, bone problems, amenorrhea, infertility, spontaneous abortion, diabetes, skin issues, neurological disorders, intestinal ulceration and cancer.
Dietary treatment of gluten intolerance involves the avoidance of gluten. ALETRIS Naturopathic physicians can diagnose and treat gluten sensitivities.