Gluten is a general name for the proteins that are found in wheat, rye, barley and triticale, which is a cross between wheat and rye.
Wheat types include durum, farro (which includes emmer) and wheatberries, while common flours made from wheat are semolina, farina and graham.
Gluten is found in many different foods.
Gluten helps many foods hold their shape together, like glue.
Gluten in wheat is found in the bread that you usually eat; any baked goods like buns, pies and cakes; pasta; and cereals.
It is also found in soups, sauces and salad dressings.
Gluten in barley is found in malt and malted drinks, malted milkshakes, and malt flavouring.
Barley is also present in food colouring, soups, and definitely beer.
Gluten in rye is found in rye bread and cereals.
Triticale is a new genetically-modified grain that combines the best qualities of wheat and rye.
Many breads, pasta and cereal now have it.
No one really knows.
It has been extensively researched and there are theories, but there isn’t an exact answer.
Some research suggests that certain people are not exactly intolerant to gluten, but to another carbohydrate found in the same kinds of foods.
Therefore, their guts don’t absorb carbohydrates like they should.
Other research suggests that gluten (like in wheat) affects the gut lining.
This leads to the gut lining being broken down and allowing bacteria inside your gut to leak out to your liver or blood, and cause infections.
Your gut is supposed to contain everything inside it, especially bacteria.
Things are not supposed to leak out.
No, they are different.
People with gluten intolerance are intolerant to gluten for those not clearly-defined causes above.
People with coeliac disease have a clearly-defined cause, i.e. they have an autoimmune response to gluten.
It is caused by having an abnormal gene.
When gluten enters their bodies, their immune system thinks it is a foreign object that has to be fought against and eradicated, as if it was a bacteria or virus.
Their own bodies then get inflamed and their guts get damaged.
But because both diseases produce the same kind of gut symptoms, a gastroenterologist needs to differentiate it for you.
These two conditions are also different!
An allergy to gluten makes your body overreact to gluten.
Allergies cause itching, vomiting and shortness of breath.
A person with gluten intolerance can experience these symptoms after several hours or days of eating gluten:
- Abdominal pain
- Bloating (feeling of “having gas”)
- Fatigue
- Trouble concentrating (like having a “brain fog”) and headache
- Anxiety or depression
- Constipation or diarrhoea
- Rashes.
You can also have irritable bowel syndrome (IBS).
The doctor will challenge your guts with gluten.
Your blood will be taken (and a skin test can be done) to see if you have wheat allergies or coeliac disease.
Once both diseases are ruled out, you will be asked to exclude all gluten from your diet for six weeks.
You will have to keep a record of everything you eat and your symptoms during this period.
If your symptoms improve during this gluten-free diet, you will be asked to slowly take some gluten back in your diet.
If your symptoms return, then you will be diagnosed to have gluten intolerance.
For coeliac disease, your blood should show tissue transglutaminase (tTG) Ig A antibodies.
It is a very specific test and not available on routine blood testing, so your doctor has to specifically ask for it.
A more definitive test is a gastroscopy and a biopsy from your small intestine.
There is no cure for gluten intolerance.
The only thing you can do is to avoid gluten foods completely.
More and more often in Malaysia, bakeries are offering gluten-free products.
You probably have to be gluten free for the rest of your life.
Eat rice-based products instead, like rice and rice noodles (koay teow and vermicelli).
In Asia, you will have plenty of alternative options.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
