Gluten allergy is a common and chronic one (permanent) Disease and is also called in medicine gluten sensitive enteropathy designated. In the past, the term “celiac disease” was used for gluten allergy in children and the term “sprue” in adults. The clinical picture is autoimmunological: on the one hand, the body produces antibodies against gluten, i.e. a certain grain protein, and on the other hand against certain endogenous substances in the intestine. This leads to a permanent change in the structure of the intestine. The only effective therapy is a lifelong gluten-free diet.
Signs of a gluten allergy
The signs of a gluten allergy are very individual and variable. In some cases there are almost no symptoms so that the disease is not noticed for a long time. Also, adults and children have different symptoms.
As a result of a gluten allergy, changes in the digestive tract and corresponding symptoms occur in the course of the disease. Abdominal pain, which is often localized in the middle of the abdomen, but can also affect the entire abdomen diffusely, is common. There are also changes in bowel movements. Alternating light diarrhea (diarrhea) and constipation (Constipation), but also flatulence and increased fatty stools. Over time, you experience weight loss, loss of appetite, nausea, and vomiting.
The altered mucous membrane of the small intestine leads to absorption disorders and the body lacks important nutrients, which leads to various deficiency symptoms. This manifests itself especially in children in the form of weight loss and stunted growth.
Furthermore, a pronounced lack of drive is characteristic. For example, a lack of calcium in the body leads to bone pain (this is the first symptom in some cases) and, in older people, to the development or progression of pre-existing osteoporosis.
Other accompanying symptoms
In addition to the mostly dominating symptoms of the digestive tract, there is usually fatigue, tiredness and listlessness. Sick people often have the feeling that they cannot find a restful sleep and suffer from headaches and restlessness as a result. Since the disease changes the immune system, a gluten allergy increases the susceptibility to other diseases, such as thyroid diseases and infections.
The inadequate absorption of important nutrients leads to a wide variety of deficiency symptoms, for example in the form of anemia (due to a lack of vitamin B12 and folic acid) or regression of muscle tissue (Muscular atrophy) can represent.
You may also be interested in this topic: Vitamin deficiency
In some cases, a gluten allergy also changes the skin with rashes. These are often associated with severe itching and occur mainly on the joints, such as the elbows and knees. Skin rashes occur mainly in adults with gluten allergies and can be detected by taking a small sample (biopsy) should be examined more closely.
A gluten allergy can lead to various symptoms, which sometimes also show up in skin changes. By activating the immune system against the own body, the balance of the immune defense is changed and - as with most other allergies - skin rashes and pimples can occur. The latter occur mainly on the face and usually show up on the cheeks or in the area around the mouth (perioral).
In over 90% of all cases, a gluten allergy has its main cause in genetics. This means that there is a so-called genetic predisposition, i.e. a change in the DNA of the person concerned. This is found in a region of the DNA that is responsible for the production of certain factors in the body's immune system (HLA system). However, not every person with this DNA change has a pronounced gluten allergy. This often comes to the fore through additional triggers such as stress, infections or other illnesses.
Due to the genetic predisposition, when the gluten allergy is expressed, the immune system's reaction to the disease against the cereal protein gluten changes: antibodies against gluten are formed. Furthermore, the change in the immune system also leads to the formation of antibodies against a substance (Tissue transglutaminase), which is produced by the body itself and plays a role in the processing of proteins. This leads to an autoimmune reaction, i.e. a reaction of the body's own immune system against the body itself. This in turn leads to changes in the mucous membrane of the small intestine, which means that it can no longer absorb various substances such as iron or vitamins from food.
The therapy of gluten allergy consists primarily in avoiding all foods containing gluten, as these stimulate the reaction of the immune system and worsen the severity. There are currently no tablets that can be taken against gluten allergies.
With the diet, the entire diet of the person concerned must be changed, as gluten is contained in a large number of foods. It is important that the gluten-free diet is consistently adhered to, otherwise over time the increased formation of antibodies against the body's own substances and thus the destruction of the small intestinal mucous membrane.
Some people affected also report an improvement in symptoms after taking Schüssler salts or Bach flowers.
If the disease has progressed further, certain nutrients may also be given that the intestines can no longer absorb in the normal way. These include above all iron and vitamins, as these are required for many important processes in the body and the deficiency can cause various other symptoms.
What do you have to consider when eating?
The diagnosis of gluten allergy means a complete change in diet for the person affected. Gluten can be found in many foods. Therefore, information should be given about all products that are no longer allowed to be eaten. For example, all products that contain wheat, spelled, green spelled, barley or rye must be avoided.
Corn, soybeans, buckwheat, potatoes, millet and rice are recommended as substitutes. Depending on the severity, oats can also be tried, as they only contain a very small amount of gluten. Fortunately, today, with an increase in gluten allergy awareness, more and more products and restaurants indicate whether the products contain gluten or not.
It is crucial that the gluten-free diet is followed consistently, otherwise the disease will progress and the mucous membrane of the small intestine will be further destroyed.
Read more about this under: Diet in Celiac Disease
Unfortunately, gluten allergy is currently not a disease that can be cured by therapy. Therefore, when diagnosing a gluten allergy, it is to be expected that it will last for life. With a consistent gluten-free diet and a change in diet, a relatively symptom-free life can be led despite the gluten allergy. Those affected should see their doctor regularly to prevent other illnesses or infections caused by an increased susceptibility to gluten allergy.
Course of disease
The gluten allergy can take different forms, which are of decisive importance for the quality of life of those affected. In many cases, gluten allergy is associated with pronounced symptoms of the digestive tract and deficiency symptoms, and leads to significant stress in everyday life. But there are also some cases in which there are hardly any problems with digestion and deficiency symptoms only occur as the disease progresses, such as anemia due to insufficient intake of vitamin B12 and folic acid. The time of diagnosis and consistent adherence to a gluten-free diet are always decisive for the course of the disease.
If a gluten allergy is suspected, various diagnostic options can be used to confirm the diagnosis. This includes first of all the anamnesis, i.e. the doctor-patient conversation, and a physical examination to get information about changes in eating and bowel habits.
The most important test is the blood test. For this, a blood sample must be taken and examined in the laboratory. The blood is examined for the presence of certain antibodies. In the case of gluten allergy, the body forms antibodies against certain body structures over time. These include tissue transglutaminase, a substance that plays a role in the processing of proteins, the endomysium, i.e. connective tissue in the digestive tract, and gluten itself. However, these antibodies cannot be detected quickly in all those affected by gluten allergy. Sometimes different types of these antibodies need to be looked for.
In order to be certain about the diagnosis of a good allergy, a small intestinal biopsy should be performed in doubtful cases. For this purpose, a duodenoscopy, i.e. a small intestine specimen, must be performed, in which samples of the damaged mucous membrane are taken and then examined.
Also read: Wheat allergy
Can a gluten allergy lead to infertility?
In recent years there have been more and more cases of infertility related to the diagnosis of a gluten allergy in the mother. The reasons for this have not yet been adequately researched, but it is likely that in the context of the change in the immune system due to the gluten allergy, antibodies are formed that are directed against the structures of the placenta. A doctor should therefore always be contacted in the event of a gluten allergy or suspicion of this and an existing desire to have children.