Gluten Intolerance & sensitivity

Written by Dr Harold Gunatillake, FRCS, FICS, FIACS. AM(Sing), MBBS (Cey)
Health writer

How many people suffer from intolerance or sensitivity to gluten containing foods? In Sri Lanka this condition is unknowingly common due to consumption of processed white bread daily as accepted breakfast, lunch or dinner- a quick way to feed your hunger replacing rice and curry as main meals. In most situations when both bread-winners work, may be compelled to eat bread and curry, which include school-going children, too? The most popular curry that goes well nutritiously with bread is lentil curry. Fortunately lentils are gluten-free
Now what are gluten containing foods? They include foods made from wheat flour, Rye and Barley. Eggs, meat, fish have no gluten. Oats have no gluten but may cause bloating, pain and diarrhea.

Rye and barley do not get included in the traditional Sri Lankan meals. In Sri Lanka, people are affected by wheat gluten disorders and the numbers are increasing.

Gluten is a hard to digest-protein found in certain grains as mentioned earlier, and avoiding it leads to better energy and prevents gastro-intestinal upsets and removes ill-health.

Gluten when eaten damages the inner lining of your gut, if you have an allergy to it.

Novak Djokovic the champion tennis star did suffer from gluten sensitivity and he discovered that, that was the reason for his mid-match collapses.

Novak’s experience reveals the importance of proper health care of the gut. The brain is connected to the gut considered as the second brain through wires. So one could explain why your efficiency drops when there is a gut-disorder.

Gluten is a spongy protein which gives food the gummy elastic ability to glue together. Before gum was manufactured, they used wheat flour and warm water and made into thick paste like dough to paste paper in Sri Lanka. Copper sulphate crystals were added to get a blue colour and as a preservative.
With rice you couldn’t make dough due to lack of gluten, and the watery solution made to make food is referred to as batter, for instance used hoppers making.

Gluten containing foods include pasta, macaroni, spaghetti, shells, spirals hamburgers, buns, muffins, croissants, bread, cookies, pizzas, beverages, pastries, all varieties of rotties. You could pasta made with rice flour, corn or quinoa. Thosai and rice noodles are gluten-free.

Beer contains gluten being made from barley malt. Wine and alcoholic beverages are gluten-free.
In countries like US, UK and Australia there are gluten free products, including an assortment of breads made from rice or potatoes flour.

Morning breakfast cereals popular in Sri Lanka among the rich also has gluten. Read the labels for the list of ingredients and go for gluten free foods. Rice based cereals are gluten-free
The full blown chronic condition due to gluten intolerance is called Celiac Disease, an auto-immune disorder triggered by consuming glutinous foods.

The common symptoms of this disorder are diarrhoea, weight loss, bone softening and a few others. These symptoms are common in other gastro-intestinal disorders like IBD, Ulcerative Colitis, Crohn’s disease, and may not be detected for a while that it is a food disorder.

The gluten-free foods that are allowed to consume are: Rice, Beans, seeds, nuts, fresh eggs, fresh meat, fish and poultry, fruits and vegetables, corn and dairy products.

Doctors find it difficult to diagnose these disorders as it is time-consuming to take a history from the patients. You need to consult a gastro-enterologist for diagnosis such disorders. That too you may have problems, because these days they too do more endoscopies to diagnoses obvious growths, ulcers and inflammations in the oesophagus, stomach and colon they too can miss the diagnosis. The condition is commonest in the small intestines which cannot be diagnosed through endoscopies. Gut biopsy may help in the diagnosis.

You need to evaluate and discover your disorder only by yourself. By avoiding gluten containing foods you clinch the diagnosis. Reading these articles help you to suspect the disorder. Then again how many Sri Lankans have the time to read these articles?

So, most people live with the conditions quite ignorantly and complaining about it to friends and others.
You may present this disorder commonly with gastro-intestinal symptoms, but it can present exclusive neurological disease for many. Dr Alessio Fasano a researcher stated that “Both Celiac Disease and gluten sensitivity may present with a variety of neurologic and psychiatric presentations, complementing the gastro-intestinal symptoms”. Further he stated that the gluten sensitivity may remain under-treated and under recognised as a contributing factor to psychiatric and neurological manifestations.

It is necessary to understand that gluten sensitivity can affect other areas in the body beyond the digestive tract, affecting your bones, mouth, joints, mouth, endocrine glands, skin and more.

With gluten intolerance you tend to lose weight, but occasionally you can put on weight. Then, you need to suspect thyroid deficiency as a complication of gluten intolerance.

So, remember- a common cause of hypothyroidism is gluten intolerance. Get your doctor to do TSH, free T3 and T4 as well as thyroid antibodies including thyroid peroxidase (TPO) and anti-thyroglobulin antibodies.
Behavioural disorders related to gut disorders
Sometimes, a child or an adult may present with behavioural disorders, such as hyperactivity disorders, but many don’t make the connection of their symptoms to gluten containing diets. Dr Charles Parker, psychiatrist states that in his psychiatric practice he first looks at the gut because neurotransmitters are broken down in the digestive system resulting from food sensitivities and intolerance to gluten.

Some children with Autism Spectrum Disorder may be sensitive to gluten foods.

Brain Fog

This is a condition that you cannot concentrate and think clearly. Gluten seems to cause this condition. Researchers in a 2002 study revealed in the Journal of Neurology, Neurosurgery and Psychiatry found that there may be interference of IgG antibodies and react with gluten and other different antibodies that could result in brain fogginess.
There are other conditions that are affected due to gluten sensitivities like

• Hormonal Imbalance and Adrenal Fatigue
• Joint and Muscle Aches
• Extreme Fatigue
• Skin problems
• Migraine headaches
• Dental problems
• Low Immunity

So if you don’t feel normal and have any of the above conditions referred you need to think of gut gluten intolerance or sensitivity as a primary cause of your condition.
Evaluate by yourself, and get your family doctor to do the various blood tests and ultimately give up food containing gluten for a while and feel the difference.
So remember, next time you get a bloat, loose motion, discomfort, burp think what you just ate.
Some ref: article by Dana Trentim-https://hypothyroidmom.com