Gluten is a naturally occurring protein found in some grains, such as wheat, barley, and rye. Many popular foods, including baked goods, cereals, and pizza, are commonly made with these grains. The digestive system cannot completely break down gluten, although that is not a problem for most people.
But if you’re sensitive to gluten, your immune system overreacts in a big way. The result is inflammation, which can lead to serious side effects.
This article discusses what the research says about the connection between gluten and inflammation. It also covers what you need to know about going gluten-free.
The Science Behind Gluten-Induced Inflammation
Gluten is mostly composed of gliadin and glutenin proteins and is part of the prolamin superfamily of proteins. In susceptible people, these proteins trigger an inflammatory response from the immune system. Some people have a genetic or environmental predisposition to have gluten issues.
For example, your risk of developing celiac disease (a gluten-related immune disorder) is higher if you carry certain variants of the HLA-DQA1 and HLA-DQB1 genes. They are part of a family of genes called the human leukocyte antigen (HLA) complex that help the immune system distinguish between foreign invaders and the body’s own proteins.
In people who are sensitive to gluten but do not have celiac disease, it may be that gluten proteins, combined with other parts of wheat, trigger an inflammatory immune response.
Types of Gluten Intolerance
Many conditions are linked to gluten. The symptoms are similar, but there are distinct differences among them.
Celiac disease is a serious autoimmune disorder that affects about 1% of the world’s population. In celiac disease, the body sees gluten as a foreign invader. It produces antibodies that, while trying to attack gluten, attack healthy tissue, especially the small intestines. That makes it difficult to absorb nutrients from food.
Symptoms may include:
- Diarrhea, constipation
- Abdominal pain, bloating, vomiting
- Migraines, joint pain
- Chronic fatigue
In addition to malnutrition, long-term complications can include:
- Anemia (a low number of healthy red blood cells)
- Neurological conditions
- Osteoporosis (chronic bone thinning)
- Skin problems
- Development of other autoimmune diseases
The diagnosis of celiac disease is reached through blood tests and endoscopy (a tube with a camera is inserted into the throat to look for damage caused by the condition) with biopsy (a sample is removed and analyzed by a pathologist in the lab). .
There is no cure for celiac disease. Since gluten is the trigger, people who have it must be careful to avoid foods that contain gluten.
People with gluten sensitivity also have an adverse reaction to gluten. They may have some of the symptoms of celiac disease. However, gluten sensitivity does not include the high levels of antibodies and damage to the intestines seen in celiac disease. Gluten sensitivity is not a true allergy.
Other names for gluten sensitivity are non-celiac gluten sensitivity (NCGS) and gluten intolerance. People with gluten sensitivity should consider a gluten-free diet.
Many things can lead to similar stomach symptoms, and it’s not always gluten. Poorly digestible carbs that ferment in the gut (FODMAPS, short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) can cause the same symptoms. Also some food allergies.
Wheat allergy is a type of food allergy where your immune system overreacts to wheat. It can cause symptoms such as hives, sneezing, or runny nose. You may also have gastrointestinal symptoms similar to gluten sensitivity and celiac disease. Less commonly, wheat allergy can cause anaphylaxis, a severe, life-threatening allergic reaction.
Many foods contain both gluten and wheat. Because symptoms can overlap, it can be difficult to tell whether you’re reacting to gluten or wheat. However, an allergy test can confirm whether you have a wheat allergy.
Dermatitis herpetiformis is an autoimmune disease triggered by gluten. It causes skin symptoms, including an itchy, sore, blistering rash. It can also cause gastrointestinal symptoms similar to celiac disease. Most people who develop dermatitis herpetiformis also have celiac disease. A skin biopsy can determine if you have it.
What Does Inflammation From Gluten Feel Like?
Not everyone experiences a reaction to gluten in the same way. If you have gluten sensitivity, you will likely feel symptoms soon after eating gluten. For those with celiac disease, it can take 48 to 72 hours for symptoms to begin.
After you eat something with gluten, you may experience symptoms such as:
- Bloating, gassiness
- Abdominal discomfort or pain
- Diarrhea, constipation
- Muscle and joint pain
Some people report brain fog (thinking feeling) from gluten.
Over time, you may notice that you lose weight. Atypical signs of gluten intolerance are:
- Hair loss
- Mouth ulcers
- Failure to thrive and delayed puberty in children
How to Prevent Inflammation From Gluten
The inflammatory response is the body’s way of fending off harmful pathogens. But an exaggerated inflammatory response and chronic inflammation are also harmful.
If gluten is the culprit, eliminating gluten from your diet can prevent the inflammatory response. This is especially important for people with celiac disease because inflammation damages the intestines and other healthy tissues.
Should You Be Gluten-Free?
If you have celiac disease, a strict, lifelong gluten-free diet is the main therapy. People with dermatitis herpetiformis or gluten sensitivity also benefit from avoiding gluten. But for some people with gluten sensitivity, the diet may not need to be as strict or lifelong. If you are allergic to wheat, you should avoid it, but you may have other grains that contain gluten.
Eliminating gluten in these conditions can relieve inflammation, which causes symptoms and complications.
Gluten does not provide essential nutrients. But it is found in many foods that are part of a healthy diet, and there is no need for most people to avoid it. Potential downsides of a gluten-free diet include:
- Low intake of folate, iron, thiamin, riboflavin, niacin, and calcium
- Gluten-free products often have added fat and sugar
- Not getting enough fiber, which can lead to digestive problems like constipation
- Wheat substitutes may have less fiber and protein than wheat and may be higher on the glycemic index (GI) (a measure of how carbohydrates affect blood sugar).
- Decreased number and variety of beneficial intestinal bacteria, which can affect the immune system
Gluten is a protein found in various grains. The digestive system cannot completely break down gluten. For most people, that’s not a problem and there’s no benefit to a gluten-free diet.
If you have celiac disease, gluten causes severe inflammation and damage to the intestines. You should avoid gluten to control inflammation and the potential for serious complications.
If you have gluten sensitivity, you may have many of the same symptoms as someone with celiac disease but without the intestinal damage. Avoiding gluten can help you avoid an adverse reaction.
If you have a bad reaction after eating grains, it’s worth seeing a healthcare provider. Getting the right diagnosis can guide any dietary changes.
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