(September 18 , 2014) Cereals such as wheat have long been considered a fundamental food source, yet growing numbers of people are intolerant to them and the list of wheat-related conditions seems to grow daily. Now, experts are calling for a greater awareness of wheat-related disorders in order that gluten-intolerant patients are diagnosed more swiftly and receive the best possible treatment.
Cereals such as wheat have long been considered a fundamental food source, yet growing numbers of people are intolerant to them and the list of wheat-related conditions seems to grow daily. Now, experts are calling for a greater awareness of wheat-related disorders in order that gluten-intolerant patients are diagnosed more swiftly and receive the best possible treatment.
According to a paper, ‘Wheat-related disorders: A broad spectrum of ‘evolving’ diseases,’ published in this month’s UEG Journal,1 experts Professor Giovanni Gasbarrini and Dr Francesca Mangiola suggest that people eating a gluten-free diet may also be at risk of developing new food intolerances, due to excessive substitution of alternative carbohydrates and foods containing nickel which may lead to additional health problems.
They offer the following practical advice to clinicians on how to differentiate between coeliac disease and other gluten-related disorders to diagnose conditions more effectively and ensure sufferers do not follow a gluten-free diet unnecessarily:
· Perform a thorough medical history, with particular attention given to the native gut microbiota.
· Extensively explore the symptoms and assess the presence of any history of allergies.
· Evaluate the genetic background with great care because it is often important to target or confirm the diagnosis and in some cases, make it unlikely.
Gluten: the wheat toxin
Gluten is a substance found in wheat, barley and rye that is composed of the two proteins, gliaden and glutenin. Researchers believe that gliaden is the gluten component people react to when they have wheat-related disorders. A number of distinct medical conditions are now recognised to be gluten-related including coeliac disease, wheat allergy and the newly-defined condition, non-coeliac gluten sensitivity. According to Gasbarrini and Mangiola’s paper, among the problematic disorders related to gluten, around 10% may be wheat allergy, 6% may be non-coeliac gluten sensitivity and only 1% is coeliac disease.1
Commenting on the article, UEG Spokesperson, Professor Antonio Gasbarrini said it is important to raise awareness of wheat-related disorders in order that people are not left undiagnosed and suffering. “Gluten-related disorders, like all food allergies, are extremely disabling and can have a major impact on people’s lives,” he said. “Most of us have heard of coeliac disease, but the other conditions are also very distressing and they are far more common.”
“Many clinicians struggle to differentiate between the wheat-related disorders so practical advice like this is always helpful,” adds Prof. Gasbarrini. “Hopefully, as clinicians and patients become more aware of the range of conditions associated with wheat and gluten, the quicker they can be diagnosed, receive the most appropriate treatment and prevent associated health problems.”
1. Gasbarrini GB, Mangiola F. Wheat-related disorders: A broad spectrum of ‘evolving’ diseases. United European Gastroenterol J 2014;2(4):254-62. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114114/.
Notes to Editors
About UEG Week
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