Gluten Sensitivity and Celiac Disease

The Difference Between GLUTEN SENSITIVITY and CELIAC DISEASE

 

At Essential Health Solutions in Chicago, we provide state-of-the-art testing for Gluten Sensitivity (or Gluten Intolerance) and Celiac disease -- two medical conditions involving gluten.

Here you'll learn what gluten is and what the basic difference is between Gluten Sensitivity or Gluten Intolerance and Celiac Disease.

WHAT IS GLUTEN?

Gluten is a protein found in some grains such as wheat, barley, and rye. Known more fully as an “elastic protein”, it is made up of a mixture of two smaller proteins:

• Gliadin – a glycol-protein made up itself of a mixture of a smaller protein and a carbohydrate

• Glutenin – a protein that activates when bread is kneaded to create the stable bonds that comprise the structure responsible for the firmness of bread.

Both gliadin and glutenin also contain certain amino acids named proline and glutamine. The high levels of proline in particular make gluten resistant to being digested. This is true for everyone, whether they are Gluten Sensitive or not.

GLUTEN SENSITIVITY and CELIAC DISEASE BOTH INVOLVE RESPONSES TO GLUTEN -- 
BUT THEY ARE DIFFERENT RESPONSES.

According to current scientific understanding:

  • Gluten Sensitivity - is an allergy to gluten that causes the immune system react as it does to any other allergen -- by attacking the ingested gluten directly through inflammation of both the inner and outer portions of the digestive tract
  • Celiac Disease - is an autoimmune disease that causes the small intestines to get inflamed when digesting gluten, which in turns causes the immune system to attack its own intestinal lining.

Unfortunately, because the symptoms of Gluten Sensitivity and Celiac Disease are so similar, it's difficult to tell which one a person has without a Gluten Sensitivity test or Celiac Disease test. Additionally, someone who has undergone testing for Celiac Disease and was found not to have Celiac Disease may undergo testing for Gluten Sensitivity and be found to have a positive reaction (or visa versa).

ESSENTIAL HEALTH SOLUTIONS: COMPREHENSIVE GLUTEN ALLERGY TESTING and TESTING FOR CELIAC DISEASE

Call us today to set up gluten food allergy testing appointment for Gluten Sensitivity or Celiac Disease. The labs we work with use the latest techniques and technologies to provide fast and accurate Celiac Disease testing and Gluten Intolerance testing.

We then follow up all Gluten Food Allergy Testing with our nutrition counseling service in Chicago however we can accommodate out-of-area patients.

Our phone number is 773.878.7330. We are located in Andersonville, just off Lincoln Square, and serve the greater 60640 area.

CELIAC DISEASE TESTING  

WHAT IS CELIAC DISEASE?

According to the National Foundation for Celiac Awareness, 3 million Americans suffer from Celiac Disease, and 95% of these sufferers are either undiagnosed or misdiagnosed with another condition. These Americans are at risk for developing serious complications that can be avoided with simple dietary changes.

When a person with Celiac Disease (also known as Celiac Sprue) consumes anything with gluten in it, their immune system attacks the surface of their small intestines which causes it to get inflamed. When this happens repeatedly enough, it starts to damage microscopic parts of the small intestine called the villi. The villi are small fingerlike projections on the surface of our small intestine that are vital to the absorption of nutrients from the food we eat. They get the nutrients we need into our bloodstream. With damaged or flattened villi, Celiac patients can not get the nutrition they need from food and they become under-nourished no matter how healthy the food they eat is.

CELIAC DISEASE FACTS

Celiac Disease is classified as a permanent acquired hereditary autoimmune disease which means several things:

  • There is a genetic component which is passed down through family lines.
  • It involves an abnormal immune response.
  • There is an environmental component, or a “trigger”. In this case it is gluten.

SYMPTOMS OF CELIAC DISEASE

Celiac Disease presents itself differently in different people. Only a small portion of patients with Celiac Disease present with clinically overt symptoms; they are therefore easy to identify. In the vast majority of cases, however, Celiac Disease testing is necessary to determine whether or not a person has Celiac Disease or a Gluten Sensitivity/Gluten Intolerance, or to rule out both of these possibilities altogether.  Even when a person shows overt symptoms of Celiac Disease a Celiac Disease Blood Test is still one of the best ways to be certain that Celiac Disease is actually responsible for these symptoms.

Celiac symptoms as once formerly understood by physicians were confined to gastrointestinal disturbance and/or malabsorption. And in fact, still the most common symptoms for Classic Celiac Disease are usually gastrointestinal, such as:

  • Abdominal pain
  • Gas and recurrent bloating
  • Diarrhea or constipation
  • Pale / yellow stool

However recent research has provided more insight on other forms of Celiac Disease. Celiac Disease that only affects the gastrointestinal system has now been reclassified to Classic (Typical) Celiac Disease. The term Celiac Disease is mostly used to refer to those patients with Gluten-Sensitive Enteropathy (abnormal small intestine histology including villous atrophy, crypt hyperplasia, and an increase in intraepithelial lymphocytes).

Patients with these classic manifestations of Celiac Disease are usually diagnosed by the age of 2 or 3, with concurrent symptoms including:

  • Chronic diarrhea or constipation
  • Vomiting
  • Irritability
  • Anorexia
  • Short stature
  • Weight loss
  • Abdominal distension.

HOW DOES CELIAC DISEASE OCCUR?

Some of the way that gluten affects the development of Celiac Disease is understood, some of it has been hypothesized about, and other areas of research yet to be understood. It has been suggested that the gliadin component of gluten can go through one of two competing pathways to be metabolized by the cell. Current research in the Journal Gut suggests that in patients with Celiac Disease the gliadin might be attracted to the exogenous pathway thus initiating an immune response whereas in healthy individuals it chooses the endogenous pathway.

The precise way this occurs is not fully understood and research is on-going. This hypothesis may account for the degree of severity experienced by Celiac patients. The more severe the symptoms, the more gliadin is going to the exogenous pathway.

It is thought that the abnormal immune reaction occurs when the “gluten” is exposed to the HLA molecule and becomes attached. It is then presented to the CD4+T cells (immune system cells that recognize it as a threat and mount an attack) in the small intestine. This shouldn’t happen.

The general consensus is that this occurs because the glutamine component of gliadin is broken down by a calcium dependant enzyme called tissue transglutaminase (normally released by the intestine during injury) into glutamic acid. This is not it’s primary role, it should be involved in tissue repair by forming bonds with the glutamine and lysine.

The initial activation of the immune system causes damage and inflammation to the small intestine, particularly the surface which is covered by the vili we discussed above. Unfortunately, the damage triggers more tissue transglutinase to be released to heal the damage but it is tricked by the HLA molecule that has binded with the gluten and it doesn’t heal – it just causes more damage to occur.

Celiac Disease appears to be associated with genes that code for human leukocyte antigens DQ 2.5 for the majority of Celiac patients and human leukocyte antigen DQ8 for the remainder. These genes belong to a family of genes called the HLA genes that code for human leukocyte antigens (HLA). Our immune system function revolves around HLA molecules and HLA genes are linked to several of the immune disorders including Celiac Disease, Type 1 Diabetes, and Rheumatoid arthritis.

CELIAC DISEASE RISK FACTORS

Current scientific understanding on the subject is that Celiac Disease is multigenic, meaning more than one gene is involved. The other genes involved in Celiac Disease have yet to be identified.

Because Celiac Disease is genetic, the first – and second-degree relatives of people with a known sensitivity (children and grandchildren) are at risk for acquiring it themselves. However, just because you carry a gene does not necessarily mean that you will go on to develop Celiac Disease. In fact, less than 2% of the population that carries this gene goes on to develop the disease.

There is also a portion of patients with Gluten Sensitivity who have "Latent Celiac Disease" which means that they have the potential to develop the disease if the threshold of reactivity is reached. This term has also been proposed to include patients with normal pathology or subtle immune changes which indicate they are at high risk of developing Celiac Disease.

TESTING FOR CELIAC DISEASE

Celiac Disease Testing and Gluten Allergy Testing is one of our specialties at Essential Health Solutions in Chicago where we perform expert Celiac Disease Testing for Chicago area residents using the most current and cost effective techniques and technologies.

A diagnostic test for Celiac Disease is vital for those suffering from the disease because it is the only way to know what action to take to eliminate your current symptoms and prevent new Celiac symptoms from occurring. Moreover, it can help prevent serious digestive damage.

Once a person is diagnosed with Celiac Disease, subsequent Celiac Disease testing can be used to monitor the patient's diet and make sure they're not unknowingly consuming gluten from hidden gluten sources (such as some of the so-called “Gluten-Free Foods” that still may legally contain 20 parts per million of gluten and be called “Gluten-Free”) or gluten mimicking foods, also known as cross reactive foods, which contain a protein similar in structure to gluten that the body of some people with Celiac Disease may react to as though it were gluten.

For more details, see our article The Gluten-Free Diet  about foods with gluten, foods without gluten, and these gluten mimicking foods/cross reactive foods.

ESSENTIAL HEALTH SOLUTIONS: CELIAC DISEASE TESTING

Call now at 773.878.7320 to schedule Celiac testing. The labs we work with such as Cyrex labs,  use the most current methods to provide fast and accurate Celiac Disease Testing.

All Celiac Disease Testing is followed-up with individualized nutrition counseling.

We are located in Chicago right off Lincoln Square in the Andersonville neighborhood of Chicago, with free parking in the street outside our building and in a small lot at our building's north end. We serve the 60640 and surrounding area.

For a brief explanation of what gluten is and the basic difference between gluten intolerance or gluten sensitivity and Celiac Disease, please refer to our article that explains the difference between Gluten Sensitivity and Celiac Disease.

Below you'll find out all about allergies to gluten also referred to as gluten intolerance and gluten sensitivity which is what we will refer to it as. If you are looking for information on Celiac Disease, please click over to our companion article on Celiac Disease.

What is Gluten Intolerance/Gluten Sensitivity?

When people who have an allergy to gluten ingest it, the immune system reacts as though to a harmful invader by causing the small intestines to inflame, inside and out.

In terms of any difference between gluten sensitivity and gluten intolerance, some doctors consider gluten intolerance a more severe condition than gluten sensitivity, although the distinctions between the two are still widely debated. For simplicity, we will use the terms gluten sensitivity and gluten intolerance interchangeably .

There is also a portion of patients with gluten sensitivity who have "Latent Celiac Disease" which means that, if the threshold of reactivity is reached, they have the potential to develop Celiac disease -- a different condition from gluten sensitivity described in depth in our companion article on [Celiac Disease]. This term has also been proposed to include patients with normal pathology or subtle immune changes which indicate they are at high risk of developing Celiac Disease.

Symptoms of Gluten Intolerance/ Gluten Sensitivity

While gluten sensitivity involves the digestive system, the majority of patients with gluten sensitivity (like other food sensitivities) may have no gastrointestinal symptoms at all, but rather a tremendous range in the gluten intolerance symptoms, severity, and onset of symptoms that may be entirely outside of the gastrointestinal system, including:

• Fatigue

• Weight loss or weight gain

• Bone pain

• Joint pain

• Easy bruising

• Muscle cramps

• Numbness or tingling

• Seizures

• Irritability or other behavioral changes

• Dermatitis herpetiformis (skin disorder)

• Hyperpigmented dermatitis (skin disorder)

• Dental enamel hypoplasia (defective development of tooth enamel)

• Iron-deficient anemia resistant to iron supplementation

• Hepatitis

• Arthritis

• Delayed puberty

• Impotence

• Short stature

• Osteopenia / osteoporosis

• Peripheral neuropathy

• Rickets (children - weak bones / slowed growth)

• Tetany (sharp spasm of wrist and ankle joints)

• Acrodermatitis (skin disorder)

• Coagulopathy (blood disorder)

• Night blindness

• Cheilosis (dryness and cracking of and around the lips)

• Glossitis (inflammation of the toungue)

• Stomatitis (inflammation of the mouth)

• Purpura (small hemorrhages in skin)

• Follicular hyperkeratosis (hypertrophy of skin)

• Edema (swelling due to fluid retention)

• Ascites (fluid in abdomen)

• Low Vitamin A, D, E, K, Thiamine, Folate, Niacin, Beta-Carotene, or Zinc

• Essential fatty acid deficiency

• Prolonged PT

• Hypocalcaemia (low levels of calcium in blood)

• Elevated PTH

• Increased alkaline phosphatase

• Hypophosphatemia (low levels of phosphate in blood)

• Hypomagnesaemia (low levels of magnesium in blood)

• Hypoalbuminemia (low levels of albumin in blood)

• Re-feeding syndrome (moderate to severe electrolyte shift during re-feeding)

• Ataxia (irregular muscular coordination)

Some people may show any number or combination of these gluten intolerance symptoms, while others may show no overt symptoms at all. This contributes greatly to why gluten sensitivity is so often misdiagnosed. Regardless of the symptoms, however, this abnormal immune response causes damage whether you feel it or not, which is why gluten sensitivity testing is so imperative.

What's more, symptoms of gluten intolerance or sensitivity sometimes appear in early youth, while in other cases symptoms may not appear until adulthood. Sometimes gluten intolerance symptoms are triggered by stress, surgery, or childbirth. Some people experience symptoms of gluten intolerance in concert with another disease or autoimmune disorder. And still other people with an allergy to gluten don't experience any symptoms at all.

Even asymptomatic patients, however, are still at risk of developing conditions related to the nutrient deficiency a gluten sensitivity can cause (such as osteoporosis), and should particularly undergo gluten intolerance testing if they fall into the risk group of patients with a parent with a gluten sensitivity, autoimmune thyroiditis, type 1 Diabetes, selective IgA deficiency, Down Syndrome, Turner Syndrome, or Williams Syndrome.

Only a small portion of patients with gluten sensitivity present with clinically overt symptoms of Celiac Disease. As such, gluten sensitivity is sometimes referred to as "silent Celiac disease".

How does Gluten Sensitivity Occur?

Gluten Sensitivity appears to be associated with genes that code for human leukocyte antigens DQ 2.5 for the majority of Celiac patients and human leukocyte antigen DQ8 for the remainder. These genes belong to a family of genes called the HLA genes that code for human leukocyte antigens (HLA). Our immune system function revolves around HLA molecules and HLA genes are linked to several of the immune disorders including Celiac Disease, Type 1 Diabetes, and Rheumatoid arthritis.

Gluten Sensitivity Risk Factors

Because a gluten sensitivity is genetic, the first – and second-degree relatives of people with a known sensitivity (children and grandchildren) are at risk for acquiring it themselves.

• One out of every 133 people in the general population (approx) has a gluten sensitivity

• If you have a grandparent with a gluten sensitivity, your odds of having one yourself are 1 in 24-39 people.

• If you have a parent with a gluten sensitivity, your odds of having one yourself are 1 in 18-22 people.

It is important to undergo gluten sensitivity testing if you fall into one of these risk categories or if your doctor suspects that you may have it. Proper treatment can prevent or delay major complications, such as dermatitis herpetiformis, fertility problems, osteoporosis, intestinal lymphoma, gluten ataxia, and other neurological disturbances.

Essential Health Solutions: Gluten Food Allergy Testing Chicago

At Essential Health Solutions, we are experts in food intolerance testing in Chicago. We specialize in Gluten Sensitivity and Celiac Disease testing and counseling using the latest state-of-the-art methods to screen for or support diagnosis of gluten sensitivity as well as monitor treatment progress.

Diagnosis of an allergy to gluten is essential because it will make you more compliant with the diet you will need to undertake if you are to alleviate and prevent symptoms and further digestive damage. Once diagnosed, food intolerance testing can then continue to be used to monitor your diet and determine whether you are unknowingly ingesting gluten from hidden sources or gluten mimicking foods.

These gluten mimicking foods, also known as cross reactive foods, contain a protein that is similar in structure to gluten, and therefore some people with an allergy to gluten may react to as though it were gluten.

See our convenient companion [Gluten-Free Diet Chart] to see a full list of these gluten mimicking foods/cross reactive foods.

Gluten Allergy Testing Types

There are different testing options available and the one that is best for you depends on your personal history, health history, and goals. We will discuss your options and our recommendations with you to choose the best testing option for your circumstance that provides you with answers while conserving health care dollars and resources.

1. Salivary Testing

For the first time, reliable salivary testing for gluten intolerance testing is now available. We are proud to offer our patients this simple saliva test that can be used to check for gluten sensitivity long before digestive damage has already occurred. It is also an easier type of gluten intolerance test to give to children.

2. Blood Gluten Testing

Blood gluten intolerance testing that detect the presence of various antibodies (discussed above) that are known to be associated with a gluten sensitivity primarily used for screening.

• Antigliadin antibodies (AGA) test for IgG and IgA antibodies to the gluten protein

• Antiendomysial antibodies (EMA) tests for the IgA based antibody against reticulin connective tissue around smooth muscle fibers

• Anti tissue transglutaminase antibodies (TTG or tTGA) tests for IgA antibody against tissue transglutaminase

3. Stool Test

Tissue transglutaminase stool test (test for the autoimmune reaction inside your small intestine). The stool test portion of the testing can be collected in the privacy of your home and is not affected if you are currently eating gluten or are on a gluten free diet. These tests can be more sensitive than saliva and blood tests with proven accuracy in both children and adults.

4. DNA / Gene Test  

The genetic testing is done by swabbing the inside of your cheek. These tests are looking to see if you carry the DQ 2.5 and DQ 8 HLA genes that predispose you to Gluten Sensitivity or Celiac Disease. You may have one copy or two copies of the genes. We will provide counseling to you so you understand what this means. It is important to note that just because you have one or two copies of the gene does not necessarily mean you will develop a disease as genes can be turned on and off in this instance by removing the trigger (gluten). These tests can be more sensitive than saliva and blood tests with proven accuracy in both children and adults.

Essential Health Solutions: Gluten Intolerance Testing Chicago

For all gluten allergy testing Chicago, we at Essential Health Solutions use fully accredited and registered clinical laboratories that specializes in analyzing intestinal specimens for food sensitivities, such as Cyrex Labs. When indicated, we may also use one or several of these tests to monitor a patient’s ability to comply with a gluten free diet – an effective method to safely manage one’s Gluten Sensitivity or Celiac Disease.

The doctor may also refer you for a more invasive test that requires a small intestine biopsy. This is required in order to get a definitive diagnosis of Celiac Disease.

To schedule gluten sensitivity testing in Chicago, call us at 773.878.7330. The labs we work with use the latest techniques and technologies to provide fast and accurate gluten intolerance testing. And with our nutrition counseling service, all gluten food allergy testing Chicago area residents receive from us is followed-up with individualized nutrition counseling from one of our Chicago nutrition experts.

We serve the greater 60640 area of Chicago, our office located in Andersonville, right off Lincoln Square. Call or visit us today. Free parking is available in the lot at the north end of our building and on the street.