What is it with Gluten?

Lately I have been diagnosing more and more Coeliac Disease in my patients. Whilst bowel symptoms are the commonest presentation,many patients simply present with fatigue or thinning hair and eyebrows and other less known symptoms. According to Coeliac New Zealand, upto 80% of people may not be aware they have Coeliac disease. The current rate in New Zealand is 1 person in 70, and this has mushroomed from the 1960's when the incidence was 1 in 8000. A study in Finland in 2000 found that the incidence of Coeliac disease had doubled from 1 to 2% of the population in just 2 decades.

Gluten sensitivity is far more common nowadays too, with 13% of people feeling better on a gluten free diet, and the gluten free market is booming- apparently 60% of us purchase gluten free products. It is of course more difficult to be scientific about gluten sensitivity, as we are unable to test and quantify it at the moment. My clinical experience shows that many people improve their bowel symptoms when they cut gluten out of their diets, but not always; sometimes there are other forces at work such as dairy intolerances or disease in the gut which needs further investigation.

I am interested in exploring the reason for this increased sensitivity to gluten. Partly, we clinicians are becoming more adept at spotting Coeliac disease and more readily advocating gluten -free diets.But I wonder if there is a bigger picture of mass-produced food which is sensitising us? Hybridisation of wheat has been implicated, as has generally overusing gluten as a preservative in food to increase shelf life. Perhaps we are simply being exposed to more concentrated gluten products? The western lifestyle revolves around excess gluten and dairy foods, often at the expense of vegetables and fruit.This perhaps sets up an inflammatory state in our bodies and heightens our sensitivity, even maybe switching on the genes? We know that HLA DR2 and DR8 are involved in Coeliac disease and seem to activate at a certain point in life in some people.

So if you have any symptoms which you are struggling with- bowel symptoms, fatigue, nausea, recurrent skin rashes, it may be worth asking your doctor for a Coeliac test. You can read more about Coeliac disease on www.coeliac.org.nz/coeliac-disease/what-is-coeliac-disease. It is important to continue eating gluten until you have been tested.Even if your test is negative , it may be worth trialling a 4-6 week gluten -free diet to see if your symptoms improve. Some propose gluten should become a public health issue with a limit on daily intake for everyone, similar to salt and sugar. That would be interesting.