Read the article, “Gluten-Related Disorders: Celiac Disease, Gluten Allergy, Non- Celiac Gluten Sensitivity,” by Patricia Jackson Allen (listed in the learning materials) and answer the following questions.
- What is the difference between the three gluten-related disorders discussed?
- How are they diagnosed and treated?
- Have you had any personal experience with either of these conditions?
What is the Difference between the Three Gluten-related Disorders Discussed?
Celiac disease refers to a group of intestine pathologies that are immune-mediated and are caused by ingestion of dietary gluten among genetically susceptible individuals. The immune pathologies include loss of tight junction barrier, elevated IgA antibodies to tissue transglutamines, and atrophy of the duodenal mucosa villa. Over time the daily threshold for gluten consumption is reduced to 10-50mg. Gluten allergy is an adaptive immune response in the GI mucosa and is linked with IgE, which triggers the basophils and mast cells to release histamine. This results in systemic reactions in the gastrointestinal tract, respiratory tract such as rhinitis, and on the skin, for example, atopic dermatitis. Non-celiac gluten hypersensitivity is characterized by systemic and intestinal symptoms associated with the intake of gluten-containing products among individuals with no diagnosis of wheat allergy or celiac disease (Allen, 2015).
How are they Diagnosed and Treated?
Diagnosis for celiac disease involves serological testing. Anti-tissue transglutaminase immunoglobulin A and anti-endomysium immunoglobulin A are identified as markers for celiac disease. For individuals with IgA deficiency, testing for deaminated gliadin peptide antibodies is required to avoid a false negative. All these tests have to be conducted while the patient is still on a gluten diet. Once the serologic test is positive, endoscopic examination of the small bowel is recommended for diagnosis confirmation (Sabenca et al., 2021). Gluten allergy is mainly diagnosed using in vitro IgE serum assay and skin prick test. Oral gluten challenge, where the patient is placed on a gluten-free diet for at least three weeks to observe symptom patterns and then return to a normal diet. Return of the symptoms is considered a positive challenge and confirms gluten allergy. Diagnoses for non-celiac gluten sensitivity involve excluding the possibility of celiac disease and wheat allergy. The existing form of treatment for gluten-related disorders involves the initiation of a gluten-free diet (Allen, 2015).
Have you had any Personal Experience with Either of these Conditions?
I have encountered patients with gluten-related disorders. The main challenge is compliance with a gluten-free diet since gluten-free products are usually expensive and are not widely available, limiting individuals’ choices concerning diet (Sabenca et al., 2021).
Allen, P. J. (2015). Primary Care Approaches. Gluten-Related Disorders: Celiac Disease, Gluten Allergy, Non-Celiac Gluten Sensitivity. Pediatric nursing, 41(3).
Sabença, C., Ribeiro, M., Sousa, T. D., Poeta, P., Bagulho, A. S., & Igrejas, G. (2021). Wheat/Gluten-Related Disorders and Gluten-Free Diet Misconceptions: A Review. Foods, 10(8), 1765. https://www.mdpi.com/2304-8158/10/8/1765