Treatment of celiac disease involves avoiding gluten in the diet, but it’s a difficult task. Gluten is in many processed foods, including meats (canned and cold cuts), salad dressings, condiments, soups, flavored yogurt, and even herbal teas. The WHO defines “gluten free” as foods having a maximum of 200 PPM.
Thirty-five studies were reviewed by researchers to help clarify how gluten affects those with celiac disease. Thirteen were included for review. The authors concluded that individual foods with concentrated levels of gluten were less important than the total amount of gluten ingested on a daily basis. The studies were more focused on changes seen in the intestine, rather than patient symptoms, finding that consumption of gluten at levels of 200 mg/ day resulted in intestinal abnormalities.
According to the study results, 20 PPM, or 6 mg of total gluten daily should be the standard to prevent intestinal abnormalities in patients with celiac disease until further investigation. The review hopes to provide guidelines for anyone diagnosed with celiac disease until more research is available. The study authors noted inconsistencies during their research, writing that “more than half of subjects consuming only 10 mg of gluten per day experienced worsening of their villous height/crypt ratio, (meaning the healthy structure of the intestines changed). “However, another study demonstrated no histologic abnormalities among a group of patients who consumed an average of 34 mg of gluten daily,” making precise conclusions difficult
Celiac disease is an often misdiagnosed disease. Those fortunate enough to obtain a diagnosis often suffer before finding the cause of symptoms such as fatigue, diarrhea, weight loss, and excessive gas and bloating. The symptoms of celiac disease mimic other common gastrointestinal disorders, making diagnosis difficult. After a diagnosis is made, controversy exists about how much gluten, if any, can be consumed. Most people with celiac disease avoid gluten, but given its prevalence in foods, many patients end up consuming some gluten on a daily basis.
According to estimates, 1% of people are affected with celiac disease, thought to be the result of an immune reaction in the mucosal lining of the small intestine. The result is inflammation and other abnormalities.
Testing for tTG antibody in the blood can give some clue as to whether celiac disease exists, but biopsy is often necessary if symptoms are suspicious and the test is negative. Genetic testing is more sensitive. The presence of HLA-DQ8 gene, found in the lining of the intestine in patients with celiac disease, provides a more definitive diagnosis.
Resource: Medscape.com
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