Gluten Sensitivity And Coeliac Disease
Dr. Henry Cheng
If you read supplement labels, often times you see “No wheat, no gluten” mentioned in the fine print. This is for the benefit of people with Coeliac Disease. Even a little bit of gluten in the fillers may trigger an attack of abdominal pain and diarrhoea in these individuals. Coeliac Disease is also called non-tropical sprue or gluten-enteropathy. The patient is sensitive to gluten, which interacts with the individual’s abnormal immune response to form immune complexes that damage the intestinal mucosa leading to diarrhoea, flatulence, nausea, malabsorption, anaemia, osteoporosis, depression, general asthenia, etc.
Our normal intestinal mucosal surface is made of convoluted folds like steeples projecting into the lumen. These “steeples” are called villi (pleural for villus). This architecture increases the surface area available for absorption. When gluten gets into the intestine of Coeliac patients, the gluten interacts with an enzyme called tissue transglutaminase to form complexes that destroy these “steeples” so the villi become truncated and nutrient absorption is impaired. It is estimated that one in 133 Canadians may have gluten sensitivity. The only effective management is for these individuals to completely exclude gluten in their diet.
Gluten is a collective name given to the various proteins found in wheat, rye and barley. In the case of wheat, the protein is called gliadin. This is the substance that gives flour its binding properties and is widely used in processing commercial foods and even supplements. Hence Coeliac patients have to be very careful in reading labels. In addition to being sensitive to gluten, Coeliac patients usually develop secondary lactose intolerance. As a result they have to exclude dairy products from their diet as well. In natural medicine, repair of the mucosa can be facilitated by supplements like N-acetyl-glucosamine, RR Formula and probiotics, which also shrink and soothe the mucosa.
As an adjunct to gluten exclusion, enzymes can be used in Coeliac Disease to digest away unpredicted or accidental contamination in the food. This will be useful when a Coeliac patient dines out. There are specific enzyme preparations designed for this purpose and the patient takes a couple of pills just before consuming the meal. One such preparation is called Gluten Defense® made by Enzymatic Therapy. This supplement helps gluten sensitive individuals dine out more freely. A specific enzyme called DPP IV specifically for digesting gluten and casein is included in this preparation. This protease enzyme works under a wide range of pH conditions so it works both in the stomach and the intestine. In addition, Gluten Defense also contains amylase, lipase, phytase, lactase, cellulase, and sucrase. The lactase helps the secondary lactose intolerance and the other enzymes help the general digestive weaknesses. The source of all these enzymes is from plants so it is suitable for vegetarians.
Henry Cheng is a medical graduate of the University of London, England, and is now Natural Health Products Consultant at Pharmasave Downtown Cloverdale.