Gluten sensitivity

Several screening studies in Europe, South America, Australasia, and the USA suggest that approximately 0.5–1% of these populations may have undetected coeliac disease.<a href="http://en.wikipedia.org/wiki/Wheat#cite_note-VanHeelWest-38">[39]</a> <a href="http://en.wikipedia.org/wiki/Coeliac_disease" title="Coeliac disease">coeliac</a> (also written as celiac) <a href="http://en.wikipedia.org/wiki/Disease" title="Disease">disease</a> is a condition that is caused by an adverse <a href="http://en.wikipedia.org/wiki/Immune_system" title="Immune system">immune system</a> reaction to <a href="http://en.wikipedia.org/wiki/Gliadin" title="Gliadin">gliadin</a>, a <a href="http://en.wikipedia.org/wiki/Gluten" title="Gluten">gluten</a> protein found in wheat (and similar proteins of the <a href="http://en.wikipedia.org/wiki/Tribe_%28biology%29" title="Tribe (biology)">tribe</a> <a href="http://en.wikipedia.org/wiki/Triticeae" title="Triticeae">Triticeae</a> which includes other species such as <a href="http://en.wikipedia.org/wiki/Barley" title="Barley">barley</a> and <a href="http://en.wikipedia.org/wiki/Rye" title="Rye">rye</a>). Upon exposure to gliadin, the enzyme <a href="http://en.wikipedia.org/wiki/Tissue_transglutaminase" title="Tissue transglutaminase">tissue transglutaminase</a> modifies the protein, and the immune system cross-reacts with the bowel tissue, causing an <a href="http://en.wikipedia.org/wiki/Inflammation" title="Inflammation">inflammatory reaction</a>. That leads to flattening of the lining of the <a href="http://en.wikipedia.org/wiki/Small_intestine" title="Small intestine">small intestine</a>, which <a href="http://en.wikipedia.org/wiki/Malabsorption" title="Malabsorption">interferes with the absorption</a> of nutrients. The only effective treatment is a lifelong <a href="http://en.wikipedia.org/wiki/Gluten-free_diet" title="Gluten-free diet">gluten-free diet</a>.

Gluten sensitivity (GS) belongs to a spectrum of disorders in which <a href="http://en.wikipedia.org/wiki/Gluten" title="Gluten">gluten</a> has an adverse effect on the body. It can be defined as a non-allergic and non-autoimmune condition in which the consumption of gluten can lead to symptoms similar to those observed in <a href="http://en.wikipedia.org/wiki/Coeliac_disease" title="Coeliac disease">coeliac disease</a> or <a href="http://en.wikipedia.org/wiki/Wheat_allergy" title="Wheat allergy">wheat allergy</a> (other conditions which fall under the gluten-related disorders spectrum).

Gluten sensitivity is thought to affect approximately 6% of the general population <a href="http://en.wikipedia.org/wiki/Gluten_sensitivity#cite_note-0">[1]</a>. Symptoms of gluten sensitivity include bloating, abdominal discomfort, pain or diarrhoea; or it may present with a variety of extraintestinal symptoms including headaches and migraines, lethargy and tiredness, attention-deficit disorder and hyperactivity, autism and schizophrenia, muscular disturbances as well as bone and joint pain <a href="http://en.wikipedia.org/wiki/Gluten_sensitivity#cite_note-1">[2]</a> <a href="http://en.wikipedia.org/wiki/Gluten_sensitivity#cite_note-2">[3]</a> <a href="http://en.wikipedia.org/wiki/Gluten_sensitivity#cite_note-3">[4]</a> <a href="http://en.wikipedia.org/wiki/Gluten_sensitivity#cite_note-4">[5]</a> <a href="http://en.wikipedia.org/wiki/Gluten_sensitivity#cite_note-5">[6]</a>

Until recently, the terms gluten sensitivity and coeliac disease were used interchangeably in literature. However, emerging research is beginning to identify the differences that exist between coeliac disease and gluten sensitivity. If the medical history of a patient, along with clinical tests, rule out coeliac disease and wheat allergy, a diagnosis of gluten sensitivity can be considered. However, certain criteria need to be met before a diagnosis of gluten sensitivity can be confirmed (see diagnosis section). Treatment for all three conditions is a gluten-free diet; the difference being that with wheat allergy the interruption is temporary and drugs may be administered; in the case of coeliac disease the diet is lifelong and even ingesting very small amounts of gluten-containing food could damage their health and, in the case of gluten sensitivity the withdrawal of gluten from the diet may only be temporary.

Gluten is a <a href="http://en.wikipedia.org/wiki/Protein" title="Protein">protein</a> composite found in foods processed from wheat and related species, including barley and rye. It gives elasticity to dough helping it to rise and to keep its shape. It is found in many staple foods in the Western diet. Gluten is composed of a gliadin fraction (alcohol soluble) and a glutenin fraction (only soluble in dilute acids or alkali).

The estimate for people in the <a href="http://en.wikipedia.org/wiki/United_States" title="United States">United States</a> is between 0.5 and 1.0 percent of the population.<a href="http://en.wikipedia.org/wiki/Wheat#cite_note-39">[40]</a><a href="http://en.wikipedia.org/wiki/Wheat#cite_note-40">[41]</a><a href="http://en.wikipedia.org/wiki/Wheat#cite_note-41">[42]</a>

While the disease is caused by a reaction to wheat proteins, it is not the same as <a href="http://en.wikipedia.org/wiki/Wheat_allergy" title="Wheat allergy">wheat allergy</a>.