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Going gluten-free means missing out on chewy pizza, but is necessary in certain instances. / www.jupiterimages.com/thinkstock

Gluten-free seems to be popping up everywhere. We see it on countless items at the grocery store, on the menu at our favorite restaurant, even at the gas station on candy bars. If you’re wondering what gluten is or why people suddenly want to avoid it, you’re not alone.

Gluten is a protein found in grains such as wheat, barley and rye. Most pasta, cakes and processed foods contain gluten. It gives bread and pizza dough that chewy, stretchy quality we love. It also shows up in places you wouldn’t expect: medication, toothpaste and deli meats to name a few. Most of us have unknowingly been enjoying it for years.

So why give it up now? Unfortunately, gluten can cause serious digestive problems in some people. A gluten-free diet should be followed only after diagnosis of the following three conditions:

Celiac disease: Ingesting trace amounts of gluten can make people with celiac disease very sick. Their immune system attacks gluten, which in turn damages the lining of the intestines. This can lead to health problems ranging from diarrhea to the inability to absorb nutrients. Symptoms include abdominal pain or cramping, rashes, nausea, vomiting, unexplained weight loss, diarrhea or constipation. Over time, a lack of nutrients can lead to depression, anxiety, hair loss, muscle and joint pain, anemia and infertility.

Celiac disease can develop at any age and symptoms vary from person to person, making it hard to diagnose. Knowing the risk factors can lead to early diagnosis and intervention. Celiac disease runs in families and is more prevalent in women and Caucasians. Blood tests can detect antibodies and determine genetic risks, and a biopsy will detect any intestinal damage.

There is no way to prevent celiac disease because its exact cause is unknown. About one in 133 people suffers from celiac disease. If you are not diagnosed with celiac disease you do not need to eat a completely gluten-free diet.

Gluten sensitivity or intolerance: This condition produces many of the same symptoms as celiac disease but does not damage the intestines. Easing symptoms does not require a gluten-free diet, but it is a good idea to eliminate gluten for about one month and gradually reintroduce it. This will allow you to assess which foods produce noticeable symptoms and how much gluten your digestive system can tolerate.

Gluten allergy: Allergies are a histamine reaction in response to contact with a specific substance the body perceives as harmful, even if it isn’t. Allergies generally produce symptoms of rash, hives and inflammation of the sinuses, airways or digestive system. This reaction to gluten is completely different and is not a digestive disorder like celiac disease or gluten intolerance.

These conditions were only recently recognized by medical professionals; and as awareness increases, food manufacturers are taking advantage of this new market. Once you are diagnosed with a gluten-related condition it’s important to seek the help of a registered dietitian who can determine if you suffer from any deficiency.

— Phyllis Neef, M.D., is board certified in internal medicine. She is a primary care physician with Lee Physician Group and can be reached by calling 992-0558.

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