When your digestive system is running smoothly, you tend not to think about it. Once trouble begins, your gut — like a squeaky wheel — suddenly demands your attention. This Special Health Report, The Sensitive Gut, covers the major sources of gastrointestinal distress: irritable bowel syndrome, gastric reflux, upset stomach, constipation, diarrhea, and excess gas. It also includes a special Bonus Section describing how…Learn More »
Good food means good health. That is the common wisdom. But sometimes even good, fresh food can make a person sick. When fresh strawberries trigger an allergic reaction; when a glass of milk induces stomach cramps; when daily bread induces weight loss and fatigue; then it’s time to work with a health professional to determine whether an ordinary food may be causing your health problems. The most common type of food-related illness by far is caused by food contaminated with infectious microbes. A bowl of cherries can harbor bacteria. A turkey burger can do the same. That’s why this Special Health Report, Food Allergy, Intolerance, and Sensitivity, provides information and advice about the wide range of food-related illnesses — from allergy to food poisoning — and how you can protect yourself and your family.
This report was created by the editors of Harvard Health Publishing in collaboration with Ciaran P. Kelly, M.D., Chief, Blumgart Firm; Director, Celiac Center, Beth Israel Deaconess Medical Center; Professor of Medicine, Harvard Medical School; and Lynda C. Schneider, M.D., Program Director, Allergy, Children's Hospital Boston; Associate Professor of Pediatrics, Harvard Medical School. 44 pages. (2011)
- The digestive and immune systems
- The digestion process
- Contaminated food
- The microbes among us
- Poisonous foods
- If you get sick
- Food intolerance and sensitivity
- Lactase deficiency
- Histamine intolerance
- Impaired complex carbohydrate digestion
- Gluten-triggered conditions
- Celiac disease
- Gluten sensitivity
- SPECIAL BONUS SECTION: Ten steps to safer eating
- Conditions that can be aggravated by foods
- Hot flashes
- Acid reflux
- When foods interact with drugs
- Drugs and meals
- The cytochrome p450 connection
- Food allergies
- Setting the stage for an allergic reaction
- Why you have food allergies
- Diagnosing food allergy
- Reducing the threat of anaphylaxis
- Living with food allergy
- Adult-onset food allergies
- When white blood cells inflame the digestive system
- Diagnosing EGID
- Treating EGID
Gluten sensitivity, a separate condition from celiac disease, is associated with many of the same symptoms as lactose intolerance — gas, bloating, and diarrhea — but also with additional and more troubling symptoms, including fatigue and dizziness. The condition has baffled clinicians and patients alike for years, because it has been difficult to even imagine how gluten could trigger such a host of seemingly unrelated symptoms. One theory is that gluten sensitivity is part of the “undersea” portion of the “celiac iceberg.” However, recent studies of people who do not to have celiac disease but still develop symptoms when they ingest gluten indicate that gluten sensitivity is separate and distinct from celiac disease.
Symptoms of gluten sensitivity
- Abdominal cramps
- Balance problems
In March 2011, a group of researchers in Italy and the United States reported evidence for a potential mechanism to account for gluten sensitivity. Patients with many of the symptoms of celiac disease but no signs of intestinal damage were found to produce an abnormally high number of proteins that play a role in activating inflammation — the immune system’s first line of defense — and an abnormally low number of suppressor T cells, which dampen down inflammation once the “threat” is removed. The inflammatory response, like that brought against the flu virus, can cause fatigue and dizziness. However, because the intestinal villi are not damaged, nutrient absorption isn’t affected.
The new evidence has established gluten sensitivity as a real condition apart from celiac disease, but it hasn’t yet yielded a diagnostic test or new treatment for gluten sensitivity. Thus, gluten sensitivity is still a diagnosis of elimination. Patients in whom celiac disease has been ruled out are asked to eradicate all gluten from their diet. If their symptoms improve, they are deemed gluten sensitive.
Gluten sensitivity can be avoided by excluding all gluten-containing foods and products from your diet. Unlike people with celiac disease, those with gluten sensitivity aren’t risking intestinal injury, defective nutrient absorption and serious complications by eating a little gluten. So if you have gluten sensitivity, you have a little more latitude to experiment than do people with celiac disease. You may want to test whether you can eat foods like soy sauce that have minimal gluten concentrations, or enjoy a bite of cake now and then without repercussions.
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