Gluten is a nutrient protein found in wheat and grains like barley. Many people are being diagnosed with gluten intolerance. This increase in gluten intolerance might be result of increased amount of wheat used in everyday diet and use of pesticides in farms. Many forms of gluten intolerance exists the most common ones are celiac disease, wheat allergy and non-celiac gluten sensitivity.

Celiac disease

Celiac disease is a chronic, immune-mediated process which mainly involves intestinal mucosa. Ingestion of wheat, barley, and other gluten containing products begins an immune response in part of the intestine in which gluten is absorbed. This reaction can results in abdominal pain, flatulence, nausea, malabsorption and diarrhea. Celiac disease is not limited to intestinal manifestation and as an immune problem can involve many organs. Skin manifestation of the disease is common and includes skin blisters known as dermatitis herpertiformis. Celiac disease can develop in all age groups but is most commonly seen in young persons. The diagnosis of celiac disease is based on the history of sensitivity to gluten, relief of symptoms following a gluten free diet and might require intestinal biopsy and running of blood tests. If celiac disease is left untreated, complications can ensue which include weight loss and malabsorption, iron deficiency, osteoporosis and even lymphoma (type of blood malignancy).

Wheat allergy

Like any type of allergy, wheat allergy includes an abnormal body response to wheat which is sensed as a threatening foreign body. The immune system responses to the wheat in a way that is different with celiac disease. The resulting symptoms are similar to celiac disease and include abdominal discomfort and diarrhea but the symptoms occur much faster in wheat allergy than celiac disease. It might take only couple of hours for gastrointestinal symptoms to manifest themselves. People with wheat allergy might experience other forms of allergy as well.

Non-celiac gluten sensitivity

Non-celiac gluten sensitivity (NCGS) is a new diagnosis introduced in 2010. NCGS is described as a condition of multiple symptoms that resolves with a gluten-free diet. The tests for celiac disease and wheat allergy should be negative before diagnosis of NCGS is made. NCGS up to 10 times more prevalent than celiac disease itself. Like celiac disease, manifestation of NCGS is not limited to gastrointestinal symptoms of abdominal pain, diarrhea, malabsorption and include fatigue, headache, neurologic and psychiatric symptoms.

The main stay of treatment in all gluten sensitivity diseases is to keep gluten away. There are many nutritional products that are labeled gluten free and patients are encouraged to use such nutrient instead.

If you get a cramp after drinking milk, you should read this one.

Lactose is a sugar found in milk. Humans need to breakdown lactose to its backbone structures of galactose and glucose before it can be absorbed. The enzyme responsible for this job is known as lactase. The activity of gene responsible of production of lactase decreases with age. The activity of this gene is also very variable among different population such that Native Americans and Asians have much less lactase production. A reduction in formation of lactase results in accumulation of lactose inside the intestines when a lactose containing product is consumed. The lactose inside the intestines works an absorbing substance and keeps water and solutes inside the intestines which results in abdominal discomfort, bloating, flatulence, vomiting and diarrhea.

In addition to age related decrease in lactase production, babies may lack lactase after a short period of diarrhea. Diarrhea causes damages to the absorptive layer of mucosa inside the intestine and brush border enzymes including lactase become deficient. Zinc preparations have shown to help reproduce absorptive cell of intestines following diarrhea in babies, and are recommended for babies following a diarrhea episode.

Lactase deficiency should not be confused with milk allergy in which the patient develops allergic symptoms following consumption of milk. The distinguishing feature is that patients with milk allergy develop similar symptoms even after drinking lactose-free products, but lactase deficient patient do not.

The diagnosis of lactase deficiency can be made by relieve of symptoms after removing lactose from the diet or it can be diagnosed clinically with hydrogen breath test. In hydrogen breath test the patient is asked to swallow a solution of lactose with water, the breath is assessed for formation of hydrogen products. If lactose is absorbed, no hydrogen product is detectable in the breath but if lactose is remained inside the intestine, bacteria of the intestine start to use lactose as a nutrient and produce methane and other hydrogen products.

Lactase intolerance does not requires treatments in forms of taking medication and performing surgeries. Patients should avoid dietary products that contain lactose, although the amount of lactose that can be tolerated by each patient varies largely. Lactose free dietary products are great option for patients who cannot tolerate smallest amount of lactose.