An increasing number of people are opting for gluten-free diets, believing it will change their lives for the better. Proponents of these diets claim it can “cure” or eradicate a plethora of conditions anything from a runny nose to eczema, to irritable bowel syndrome. Some parents even go so far as to place their toddlers on gluten-free diets. Proponents of gluten-free foods are often categorised as People Who Avoid Gluten (PWAG).

There seems to be a pervasive belief that gluten is harmful, but nobody is really sure why. On the other hand, there also is scientific evidence that following a long-term gluten-free diet can lead to obesity and heart disease. The expenses associated with gluten avoidance also is a factor to consider.

What is gluten?

Gluten is a protein found in wheat, rye and barley. Gluten and Gliadin (see wheat allergy) make up between 65 and 70 per cent of the protein in wheat. While many people opt to go gluten-free in pursuit of a healthier lifestyle, there also are people who have to avoid gluten because it can have a dire impact on their lives.

One of the conditions that can be aggravated by gluten is irritable bowel syndrome. There also is a group of people who are non-Coeliac disease patients. Symptomatically, these patients respond well to a gluten-free diet. This condition is referred to as Non-Coeliac gluten hypersensitivity.

Autoimmune conditions

An autoimmune disease is where our bodies recognise its own cells as foreign and harmful and attack these cells. There are many examples of autoimmune disease, one of which is the very common rheumatoid arthritis.

Coeliac disease is another autoimmune disease and is only activated when patients with this condition eat gluten. When Coeliac patients are exposed to gluten, antibodies form against the cells in their small bowels, which then damage the cells that line their intestines. This leads to diarrhoea, cramping and poor absorption of food, which in itself can lead to a chain-reaction of other health problems, like affected growth and development in the case of children with Coeliac disease. It can also lead to a skin condition called Dermatitis Herpetiformis, which is often mistaken for eczema. Long term, uncontrolled coeliac disease is associated with osteoporosis and lymphoma.

What is wheat allergy?

Wheat allergy is when we develop a different antibody to wheat, which is aggravated by the Gliadin protein. It triggers a catastrophic release of biochemical markers, of which the most well-known marker is Histamine.

The release of Histamine can lead to a severe allergic reaction called an Anaphylaxis where the reaction starts within a couple of minutes with hives and swelling to your chest closing. This can be life-threatening. Many wheat allergic patients will use gluten-free products as alternative sources of grains.

The consequences of wheat

When a person with irritable bowel syndrome eats a product with gluten, they can eat the entire product and not feel ill. The following day or 2 they might be tired, bloated, constipated or have a bit of diarrhoea.

A patient with Coeliac disease might be able to finish the product, but some might not. Very soon after consuming gluten, they will develop severe diarrhoea, cramping and will need to rush to the bathroom to relieve themselves. This diarrhoea can last hours, days, weeks or even months if the Coeliac disease is reactivated. The severity of immediate symptoms varies among patients. Even limited amounts of gluten can send them into a spiral of severe bowel symptoms.

When an unsuspecting wheat allergy patient consumes a gluten-free product that contains wheat, he or she is likely to taste that something is wrong and spit it out. Depending on the amount of gluten they have consumed, they may develop hives and swelling of the eyes, or tongue. Within minutes their throat can close, or their chest can close.

In a nutshell

Avoiding gluten can be a lifestyle choice or – in in the case of coeliac disease or wheat allergy – a lifesaving decision. The availability of more gluten-free options has improved the quality of life of many patients with debilitating conditions.

That said, it’s essential to draw a clear distinction between people who genuinely need gluten-free products to stay alive, and those who not. If you suspect you are sensitive or allergic to gluten, it’s best to seek advice from a medical professional. Who knows? Either your health or your bank balance might just thank you in the long run!

  • The purpose of this article is to raise awareness of allergies , their psychological impact and the treatment options that are available for it. This article should by no means be used, or viewed, as a primary source for medical or other professional advice – please arrange for a personal consultation with your medical practitioner or psychologist before taking any decisions that could affect the wellbeing of you or your loved ones. Read our medical disclaimer for more information.

Marinda McDonald

Dr Marinda McDonald has offered specialised treatments for allergies for most of her professional career. Read more about her on the home page of this website (allergydoc.co.za).