A gluten-free diet is a diet that is completely free of gluten, which is a generic term for storage proteins found in grains. In celiac disease (also referred to as celiac sprue), persons develop an inflammatory immune system response to gluten that results in damage to the small intestine, which inhibits the absorption of nutrients. Some persons also develop dermatitis herpetiformis, an itchy and blistering skin condition. Because of gluten intolerance, affected persons must completely avoid foods that contain gluten.
The gluten-free diet is the prescribed medical treatment for gluten intolerance diseases, including celiac disease and dermatitis herpetiformis. Celiac disease is a genetically inherited, chronic digestive disease that results in damage to parts of the small intestine that are responsible for absorption of nutrients. Celiac disease affects almost three million people in the United States, about one percent of the population. Celiac disease is found among North American and European populations, where wheat is a staple food, but is found infrequently among descendants of China and Japan and persons with an African-Caribbean background, where wheat is not as widely consumed.
When a person with celiac disease consumes gluten, the villi of the small intestine, where absorption of key nutrients takes place, become damaged, resulting in nutrients passing through the digestive system without being absorbed. The person exhibits gastrointestinal distress and eventually malnutrition. In infancy, the celiac disease manifests itself as failure to thrive, diarrhea, abdominal distention, developmental delay, and in some infants, as severe malnutrition.
After infancy, the symptoms of celiac disease are less dramatic. Older children may be short or exhibit dental enamel defects. Women compriseabout75%of newly diagnosed adult cases of celiac disease. Symptoms of celiac disease include diarrhea, constipation alternating with diarrhea, intestinal gas, fatty, greasy, foul-smelling stools, bloating, nausea, vomiting, skin irritation, weight loss, anemia, neurological effects (including seizures, and possibly migraine headaches), fatigue, concentration and memory problems. In some cases, there may be intestinal damage without significant gastrointestinal symptoms. Celiac disease is diagnosed by blood tests for certain antibodies and small intestine biopsy. A positive small intestine biopsy, followed by an improvement in health after following a gluten-free diet, is confirmation of celiac disease. A gluten-free diet should not be started before the diagnosis is confirmed.
A gluten-free diet may also be helpful for persons with multiple sclerosis and other autoimmune disorders, as well as for persons with autism spectrum disorders, Attention Deficit Hyperactivity Disorder (ADHD), and some behavioral problems.
Benefits of Gluten-free diet
A gluten-free diet has been shown to greatly reduce the risk for cancer and overall mortality for individuals with symptomatic celiac disease.
For many people with celiac disease, following a gluten-free diet will stop the symptoms of the disease and result in improved health, usually within several months(for some persons, recovery may take up to one year) However, the health of some people with extensive damage to their small intestines may not improve. Refractory coeliac disease (RCD) is a rare syndrome with a poor prognosis, defined by malabsorption due to gluten-related enteropathy after the initial or subsequent failure of a strict gluten-free diet and after exclusion of any other disease or disorder mimicking celiac disease. Other treatments may be necessary to treat the RCD, such as the use of corticosteroids and immunosuppressant drugs, but data on their effectiveness is lacking.