Gluten-free diet

gluten-freegluten freegluten free diet
Following a lifelong gluten-free diet is the only medically-accepted treatment for people with coeliac disease. Non-coeliac gluten sensitivity (NCGS) is described as a condition of multiple symptoms that improves when switching to a gluten-free diet, after coeliac disease and wheat allergy are excluded. People with NCGS may develop gastrointestinal symptoms, which resemble those of irritable bowel syndrome (IBS) or a variety of nongastrointestinal symptoms. Gastrointestinal symptoms may include any of the following: abdominal pain, bloating, bowel habit abnormalities (either diarrhoea or constipation), nausea, aerophagia, gastroesophageal reflux disease, and aphthous stomatitis.

Gluten-related disorders

gluten intolerancegluten-sensitive enteropathygluten sensitivity
Non-celiac gluten sensitivity (NCGS), or gluten sensitivity (GS), is a syndrome in which patients develop a variety of intestinal and/or extraintestinal symptoms that improve when gluten is removed from the diet, after coeliac disease and wheat allergy are excluded. NCGS, which is possibly immune-mediated, now appears to be more common than coeliac disease, with a prevalence estimated to be 6–10 times higher. Gastrointestinal symptoms, which resemble those of irritable bowel syndrome (IBS), may include any of the following: abdominal pain, bloating, bowel habit abnormalities (either diarrhea or constipation), nausea, aerophagia, gastroesophageal reflux disease, and aphthous stomatitis.

Wheat allergy

Wheatallergic to wheatbaker's asthma
While gluten is also the causative agent of celiac disease (CD), celiac disease can be contrasted to gluten allergy by the involvement of different immune cells and antibody types (See Comparative pathophysiology of gluten sensitivities), and because the list of allergens extend beyond the classic gluten category of proteins. Prolamins and the closely related glutelins, a recent study in Japan found that glutenins are a more frequent allergen, however gliadins are associated with the most severe disease. A proteomics based study found a γ-gliadin isoform gene. Glutenin (wheat glutelin) is a predominant allergen in wheat.

Glutamic acid

glutamateGluglutamate metabolism
The substance was discovered and identified in the year 1866, by the German chemist Karl Heinrich Ritthausen who treated wheat gluten (for which it was named) with sulfuric acid. In 1908 Japanese researcher Kikunae Ikeda of the Tokyo Imperial University identified brown crystals left behind after the evaporation of a large amount of kombu broth as glutamic acid. These crystals, when tasted, reproduced the ineffable but undeniable flavor he detected in many foods, most especially in seaweed. Professor Ikeda termed this flavor umami. He then patented a method of mass-producing a crystalline salt of glutamic acid, monosodium glutamate.


diarrhoeadiarrheal diseaseschronic diarrhea
These include lactose intolerance, irritable bowel syndrome, non-celiac gluten sensitivity, celiac disease, inflammatory bowel disease, hyperthyroidism, bile acid diarrhea, and a number of medications. In most cases, stool cultures to confirm the exact cause are not required. Diarrhea can be prevented by improved sanitation, clean drinking water, and hand washing with soap. Breastfeeding for at least six months and vaccination against rotavirus is also recommended. Oral rehydration solution (ORS)--clean water with modest amounts of salts and sugar—is the treatment of choice. Zinc tablets are also recommended.


winter ryerye flourLargest rye producer
Like wheat, barley, and their hybrids and derivatives, rye contains gluten, which makes it an unsuitable grain for consumption by people with gluten-related disorders, such as celiac disease, non-celiac gluten sensitivity, and wheat allergy, among others. Nevertheless, some wheat allergy patients can tolerate rye or barley. Ergotism is an illness that can result from eating rye and other grains infected by ergot fungi (which produce LSD-25-like toxins in infected products).


Low-FODMAP dietdiet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyolslow-FODMAP diets
A low-FODMAP diet can ameliorate and mask the digestive symptoms of serious diseases that usually present digestive symptoms similar to those of irritable bowel syndrome, such as celiac disease, inflammatory bowel disease and colon cancer. It is crucial to conduct a complete medical evaluation before starting a low-FODMAP diet to ensure a correct diagnosis and that the appropriate therapy can be undertaken. This is especially relevant in the case of celiac disease.


exhaustionOverexertionfeeling tired
Irritable bowel syndrome. Leukemia or lymphoma. Liver failure. Lyme disease. Neurological disorders such as narcolepsy, Parkinson's disease and post-concussion syndrome. Physical trauma and other pain-causing conditions, such as arthritis. Sleep deprivation or sleep disorders. Spring fever. Stroke. Thyroid diseases. Uremia, which is caused by kidney disease. Cancer-related fatigue. Combat stress reaction. Directed attention fatigue. Effects of fatigue on safety. Gaucher's disease. Heat illness. Malaise. Microsleep. Museum fatigue. Presenteeism. Sleep-deprived driving. Danish edition: Træthedssamfundet. Møller, 2012, ISBN: 9788799404377.


headacheschronic headacheheadach
More serious causes of secondary headaches include: Gastrointestinal disorders may cause headaches, including Helicobacter pylori infection, celiac disease, non-celiac gluten sensitivity, irritable bowel syndrome, inflammatory bowel disease, gastroparesis, and hepatobiliary disorders. The treatment of the gastrointestinal disorders may lead to a remission or improvement of headaches. The brain itself is not sensitive to pain, because it lacks pain receptors. However, several areas of the head and neck do have pain receptors and can thus sense pain.

Lactose intolerance

lactose intolerantlactose-intolerantlactase deficiency
Secondary lactose intolerance is due to injury to the small intestine such as from infection, celiac disease, inflammatory bowel disease, or other diseases. Developmental lactose intolerance may occur in premature babies and usually improves over a short period of time. Congenital lactose intolerance is an extremely rare genetic disorder in which little or no lactase is made from birth. Diagnosis may be confirmed if symptoms resolve following eliminating lactose from the diet. Other supporting tests include a hydrogen breath test and a stool acidity test. Other conditions that may produce similar symptoms include irritable bowel syndrome, celiac disease, and inflammatory bowel disease.

Fructose malabsorption

fructose intolerancefructoseDietary fructose intolerance
Occurrence in patients identified to be suffering symptoms of irritable bowel syndrome is not higher than occurrence in the normal population. However, due to the similarity in symptoms, patients with fructose malabsorption often fit the profile of those with irritable bowel syndrome. In some cases, fructose malabsorption may be caused by several diseases which cause intestinal damage, such as celiac disease. Fructose malabsorption is not to be confused with hereditary fructose intolerance, a potentially fatal condition in which the liver enzymes that break up fructose are deficient.

Anti-gliadin antibodies

AGAanti-gliadin IgGAntibodies to α-gliadin
It is also associated with coeliac disease and non-celiac gluten sensitivity. Anti-gliadin antibodies are frequently found with anti-transglutaminase antibodies. The IgE antibodies are more typically found in allergy-related conditions such as urticaria, asthma, and wheat-dependent exercise-induced anaphylaxis. The target of the most allergenic antibodies is ω-5 gliadin, which is encoded by the Gli-1B gene found on the B haplome (Aegilops speltoides derived) of wheat. What is the relationship of gluten and anti-gliadin antibodies?. In gluten-sensitive individuals AGA testing is a routinely used blood test for possible presence of coeliac disease, allergies or idiopathic phenomena.

Mental disorder

mental illnessnervous breakdownmentally ill
Psychotic disorders in this domain include schizophrenia, and delusional disorder. Schizoaffective disorder is a category used for individuals showing aspects of both schizophrenia and affective disorders. Schizotypy is a category used for individuals showing some of the characteristics associated with schizophrenia but without meeting cutoff criteria. Personality—the fundamental characteristics of a person that influence thoughts and behaviors across situations and time—may be considered disordered if judged to be abnormally rigid and maladaptive.


gluten ataxiaataxicloss of coordination
Non-hereditary causes of cerebellar degeneration include chronic ethanol abuse, head injury, paraneoplastic and non-paraneoplastic autoimmune ataxia, high altitude cerebral oedema, coeliac disease, normal pressure hydrocephalus and infectious or post-infectious cerebellitis. Ataxia may depend on hereditary disorders consisting of degeneration of the cerebellum and/or of the spine; most cases feature both to some extent, and therefore present with overlapping cerebellar and sensory ataxia, even though one is often more evident than the other.

Food intolerance

intolerancefood sensitivityFood Intolerances
GIT symptoms include mouth ulcers, abdominal cramp, nausea, gas, intermittent diarrhea, constipation, irritable bowel syndrome (IBS), and may include anaphylaxis. Food intolerance has been found associated with irritable bowel syndrome and inflammatory bowel disease, chronic constipation, chronic hepatitis C infection, eczema, NSAID intolerance, respiratory complaints, including asthma, rhinitis and headache, functional dyspepsia, eosinophilic esophagitis and ENT illnesses. Reactions to chemical components of the diet are more common than true food allergies. Although, there is no evidence to support this.

Autoimmune disease

autoimmune diseasesautoimmune disorderautoimmune
Some common diseases that are generally considered autoimmune include celiac disease, diabetes mellitus type 1, Graves' disease, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, and systemic lupus erythematosus. The diagnosis can be difficult to determine. Treatment depends on the type and severity of the condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) and immunosuppressants are often used. Intravenous immunoglobulin may also occasionally be used. While treatment usually improves symptoms, they do not typically cure the disease. About 24 million (7%) people in the United States are affected by an autoimmune disease.

Intestinal permeability

gut permeabilityIncreased intestinal permeabilitybeing absorbed
Increased intestinal permeability is a factor in several diseases, such as Crohn's disease, celiac disease, type 1 diabetes, type 2 diabetes, rheumatoid arthritis, spondyloarthropathies, inflammatory bowel disease, irritable bowel syndrome, schizophrenia, certain types of cancer, obesity, fatty liver, atopy and allergic diseases, among others. In the majority of cases, increased permeability develops prior to disease, but the cause–effect relationship between increased intestinal permeability in most of these diseases is not clear.


farinaceouswhite flourmeal
When gluten-free flours are free from contamination with gluten, they are suitable for people with gluten-related disorders, such as coeliac disease, non-celiac gluten sensitivity or wheat allergy sufferers, among others. Contamination with gluten-containing cereals can occur during grain harvesting, transporting, milling, storing, processing, handling and/or cooking. Flour also can be made from soybeans, arrowroot, taro, cattails, acorns, manioc, quinoa, and other non-cereal foodstuffs.

Food additive

food additivesadditivesadditive
Preservatives also reduce spoilage from sources such as air, bacteria, fungi, and yeast. ISO has published a series of standards regarding the topic and these standards are covered by ICS 67.220. Many food additives absorb radiation in the ultraviolet or visible regions of the spectrum. This absorbance can be used to determine the concentration of an additive in a sample using external calibration. However, additives may occur together and the absorbance by one could interfere with the absorbance of another.

Triticeae glutens

Triticeae'' glutensglutenglutens
This renders gluten soluble enough without alcohol to mix with other products like milk. Individuals who suffer from gluten-sensitive enteropathy/coeliac disease have an adverse reaction to the gluten in cultivars of Triticeae when eaten. In addition to bread wheat, rye and barley (which have similar glutens) are known to cause symptoms in coeliacs. Between 2 and 10% of gluten sensitive individuals are also sensitive to oats, but it is not clear how much of this is due to contamination of triticeae seeds in oats or allergic responses (versus intolerance).


breadsbreadmakingleavened bread
Non-wheat cereals including rye, barley, maize (corn), oats, sorghum, millet and rice have been used to make bread, but, with the exception of rye, usually in combination with wheat flour as they have less gluten. Gluten-free breads have been created for people affected by gluten-related disorders such as coeliac disease and non-coeliac gluten sensitivity, who may benefit from a gluten-free diet. Gluten-free bread is made with ground flours from a variety of materials such as almonds, rice, sorghum, corn, or legumes such as beans, but since these flours lack gluten they may not hold their shape as they rise and their crumb may be dense with little aeration.


buckwheat flourLargest buckwheat producerbuck wheat
As buckwheat contains no gluten, it may be eaten by people with gluten-related disorders, such as celiac disease, non-celiac gluten sensitivity or dermatitis herpetiformis. Nevertheless, buckwheat may have gluten contamination. Cases of severe allergic reactions to buckwheat and buckwheat-containing products have been reported. Buckwheat contains fluorescent phototoxic fagopyrins. Seeds, flour, and teas are generally safe when consumed in normal amounts, but fagopyrism can appear in people with diets based on high consumption of buckwheat sprouts, and particularly flowers or fagopyrin-rich buckwheat extracts.


durum wheathard wheatT. durum
The dough is mixed with yeast and lukewarm water, and then fermented for hours. The quality of the bread produced depends on the viscoelastic properties of gluten, the protein content and protein composition. Containing about 12% total protein in defatted flour compared to 11% in common wheat, durum wheat yields 27% extractable, wet gluten compared to 24% in common wheat. Because durum wheat contains gluten, it is unsuitable for people with gluten-related disorders such as celiac disease, non-celiac gluten sensitivity and wheat allergy. * Durum Wheat Research, Grain Research Laboratory, Canadian Grain Commission


communionLord's SupperHoly Communion
The gluten in wheat bread is dangerous to people with celiac disease and other gluten-related disorders, such as non-celiac gluten sensitivity and wheat allergy. For the Catholic Church, this issue was addressed in the 24 July 2003 letter of the Congregation for the Doctrine of the Faith, which summarized and clarified earlier declarations. The Catholic Church believes that the matter for the Eucharist must be wheaten bread and fermented wine from grapes: it holds that, if the gluten has been entirely removed, the result is not true wheaten bread. For celiacs, but not generally, it allows low-gluten bread.


cornTriticumdwarf wheat
Coeliac disease affects about 1% of the general population in developed countries. There is evidence that most cases remain undiagnosed and untreated. The only known effective treatment is a strict lifelong gluten-free diet. While coeliac disease is caused by a reaction to wheat proteins, it is not the same as a wheat allergy. Other diseases triggered by eating gluten are non-coeliac gluten sensitivity, (estimated to affect 0.5% to 13% of the general population), gluten ataxia and dermatitis herpetiformis. The following table shows the nutrient content of wheat and other major staple foods in a raw form. Raw forms of these staples, however, are not edible and cannot be digested.