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  NIDDK

Pamphlet describing CD/DH

 

The Intestinal System

As you fill your plate and sit down to eat a meal you may thinking that you are feeding yourself. Actually, your intestines feed YOU. Most of the foods we eat would be deadly poisons if they got directly into our bloodstream. Your small intestines act as very elaborate food "dis-assembly" plant. Except for dietary fiber - nut husks, bran, celery strings and such - your small intestines disassemble virtually everything we eat into very tiny molecular components. Your intestine converts the crisp fat in your breakfast bacon into smaller fatty acids. It turns the protein in your dinner lamb chop into smaller amino acids. It changes the large carbohydrates in your mashed potatoes into sugary glucose. Then these much smaller and simpler nutrients can be passed through the intestinal wall to be ciruclated in the blood stream throughout your body. These components are used to build tissue, have energy to function, fight disease, etc.

To maximize absorption of nutrients into your bloodstream,                     

the walls of your small intestine are normally covered with

microscopic hair-like projections called villi and even

smaller microvilli. Villi contain special cells which enable

absorption of nutrients into your body. Each square inch of

intestine contains about 10 billion microvilli. This increases the

surface area for food absorption dramatically. In fact, if

your intestinal interior were smooth, it would present only

about 6 square feet of absorptive surface. Instead, because

of these villi, it presents about the same surface as a football field!

 

 What is Gluten Sensitive Enteropathy ?

"Gluten" as it is commonly referred to is the protein found in wheat, rye and barley. Any reaction in which the body responds to a particular food in a negative way is referred to as a "sensitivity". Many food sensitivities manifest as allergies and some as autoimmune responses. Consequently "Gluten Sensitive Enteropathy" includes a wide range of symptoms and conditions which encompass any reaction to gluten.

At one end of the GSE scale is an autoimmune reaction (IGg/IgA). Diseases such as Celiac Disease (CD) and Dermatitis Herpetiformis (DH) are the "classic", well-known gluten sensitivities and are considered to be the most serious health condition due to the damage incurred in the small intestine. Current estimates place the number of individuals with CD/DH at 1 in 133. About 97% of these individuals remain undiagnosed ! This is a genetic condition, you must have the genes and be consuming gluten to develop.

Current research indicates that there are many more individuals who have a "gluten response" which is not detectable through testing for CD or DH. These individuals have found that a gluten-free diet improves their health and sense of well-being. Recent genetic testing appears to indicate that these individuals share a "genetic propensity" for this sensitivity with those individuals who develop CD/DH.

At the other end of the scale is an "allergic reaction" (IgE), an individual can suffer from a sensitivity to gluten and/or wheat, rye or barley individually.  Your reaction will range from no "noticeable" symptoms to "mildly" noticeable symptoms all the way to the extreme end of the scale causing anaphylic shock - an immediate respiratory reaction, as in a severe peanut allergy. Typically, this histamine reaction can be controlled by using antihistamines, though avoidance of the offending food is preferred.

To make matters even more confusing, estimates up to 50% of those individuals who test positive for CD do not experience any of the "classic" symptoms. Making diagnosis even more difficult until more serious conditions and/or complications develop.

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