Gluten Free Or Not Gluten Free?

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Celiac disease can begin to develop at any age. Although it is most often diagnosed during childhood, in developed countries more and more adults are being diagnosed with this chronic disease, which causes alterations in the mucosa of the small intestine, the main consequence of which is that the small intestine is unable to absorb the nutrients necessary for the rest of the body.

What Is Celiac Disease?

Celiac disease is a disease that affects digestion. Contrary to the beliefs of many, celiac disease is not an allergy or an intolerance. It is what is known as an “autoimmune” condition, which along with type 1 diabetes, rheumatoid arthritis and lupus, means that the immune system accidentally attacks healthy tissue, and the body is not therefore properly protected against infection. In the case of celiac disease, it’s gluten that causes the problem.


Some people have instructions in their genetic makeup which make their body react to gluten as if it were an unwelcome invader.

This means that celiac disease is an autoimmune disease. It is caused by a reaction of the immune system to gluten – a protein found in wheat, barley and rye. When someone with celiac disease eats gluten, their immune system reacts by damaging the lining of the small intestine.

The small intestine is between the stomach and the large intestine (the colon). In a healthy small intestine, there are small, finger-like projections (villi) that allow the body to absorb nutrients from food into the blood. If you have celiac disease, these villi become flat and you have difficulty absorbing nutrients.

We know from research that people with the condition have genes which mean they may develop celiac disease but we don’t yet know why. It is important to understand that people with untreated celiac disease will most likely be experiencing problems from additional ailments which can be caused by a lack of the crucial nutrients your body needs to keep you healthy.

Untreated celiac disease

In untreated celiac disease, villi become inflamed and flattened. In some cases, they can even disappear. This is called villous atrophy. When the gut is damaged in this way, it means the body can’t absorb all the nutrients from food properly. This is called malabsorption.

This damage causes many of the symptoms of celiac disease and adds to the health risks and complications found with celiac disease such as anemia and osteoporosis. The way the body’s immune system reacts to gluten can affect other parts of the body as well. For example, the skin rash called dermatitis herpetiformis may develop.

The good news is that once someone with celiac disease follows a gluten free diet, their small intestine will begin to repair and  absorb nutrients again.

What Is Gluten?

Gluten is the collective name for the proteins that are found in wheat, barley, spelt, rye and triticale (a hybrid of wheat and rye). When combined with water, these proteins act as a glue, making dough elastic, allowing bread to rise, and helping food to keep its shape. This is what gives “glu-ten” its name.

When gluten is ingested by someone who has celiac disease, the immune system mistakes gliadin, a substance that makes up gluten, as a threat and attacks it. This damages the lining of the small intestine, specifically the million finger-shaped growths called villi, which become inflamed and flattened (this is known as villous atrophy). As the villi are in charge of absorbing nutrients, this then leads to malnutrition, illness or deficiencies.

The Painful Bit…

At Triborough GI we know that the reactions to eating gluten when you have celiac disease differ from person to person, and also range in intensity from mild to possibly severe. Symptoms include:

  • Bloating and flatulence
  • Diarrhea, constipation or a combination of both
  • Nausea
  • Abdominal pain
  • Weight loss
  • Iron, folate, zinc or vitamin D deficiency
  • Mouth ulcers or dental defects
  • Tiredness due to malnutrition
  • Slowed growth (in children)

Although unpleasant, these symptoms can be helpful in diagnosing the condition initially.  It is not in fact known why certain people have celiac disease, but it affects one in every hundred people.

How Is Celiac Diagnosed?

If you are sure you have symptoms that are listed above or are at a very high risk of developing them, you might like to go for a celiac screening. There is a two-stage process when diagnosing celiac disease. First, a sample of your blood will be tested for the presence of the common antibodies related to the condition. It is important that in the time between deciding on a blood test and having blood taken, you continue to eat your regular diet containing gluten so that your blood can be accurately monitored.

It is possible to not have these antibodies in your bloodstream but still have celiac disease, so in both cases, your doctor is likely to recommend you for a biopsy, as a way of confirmation. This will be like an endoscopy, but small samples of your small intestinal lining will be taken and analyzed as well. If the biopsy comes back positive, you may also have to carry out a test to see how the condition has affected you already, which may include more blood tests for vitamin and mineral deficiencies.

It is recommended that you go for a screening if your parents, siblings or children have celiac, as there are high chances of the condition being hereditary.


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