Gluten Made Simple

Is my peanut butter and jelly sandwich gluten-free, and does that matter? What’s the deal with gluten anyway?

So what is the deal with gluten? You know, you look at the restaurant menu and things are labeled as gluten-free and the question is, is gluten bad or what’s the story with this? Do I need to be worried about gluten? Do I need to avoid gluten? So here’s the deal in a quick take-home nutshell: Gluten is found in wheat and many grain products and it can cause two GI issues: One of them is something called celiac disease and the other one goes by a variety of different names but sometimes it’s called gluten sensitivity or non-celiac gluten sensitivity.

Celiac disease

First, celiac disease is a condition where the immune system is sensitized to gluten using the same immune system tools that the immune system uses when it is sensitized to poison ivy. Not an instant reaction like if you’re allergic to penicillin and you accidentally take penicillin, you break out in hives, your throat closes up, not that kind of reaction, but more of the slow onset and long-lasting reaction like you get with poison ivy.

Second is gluten sensitivity and this is kind of a GI distress from gluten, so things like bloating and gas and potentially diarrhea and discomfort and pain. Now with celiac disease, like with poison ivy, a person needs to very strictly, rigorously avoid gluten. It’s kind of like if you had poison ivy and you had a leaf of it and you wiped it across your arm, well, guess what? 24 hours later you’ve got a big red rash on your arm from even a little exposure. Same thing with gluten if you have celiac disease.

Gluten sensitivity

Now with gluten sensitivity, this one is more the way that lactose intolerance occurs where there’s a threshold amount above which you start to get problems. If you stay below the threshold, all as well; it’s not an immune system condition, but if you go over that threshold, then you start to have problems. Like with lactose intolerance, if somebody has a little bit of milk and a little cream in their coffee they may be fine, but if they have a bowl of cereal, then it’s very bad.

Interestingly, with gluten sensitivity, a very interesting study by a research group in Australia where they divided people up and assigned them to two different diets that were very carefully designed to where people didn’t know if they were in the high gluten versus the low gluten category. They switched people over after a couple of weeks and had people keep symptom diaries. A subset of people within these groups had more digestive symptoms like gas and bloating on the high gluten diet and then had many fewer symptoms on the low gluten diet; so it reflects this difficulty with digestion and absorption.

Putting all this together, with gluten you’ve got celiac disease in which case you need to be strict in avoiding gluten and then there is gluten sensitivity in which case you don’t need to strictly avoid gluten but you need to stay below a threshold at which gluten or some associated carbohydrates begin to cause problems.

I hope that’s helpful and interesting to you. For more videos, check out the website at sentinelprimarycare.com.