We live in a culture of trends, and somehow, the inexplicable and capricious fads of fashion seep into the domain of health, especially for those who follow celebrity doctors, whose bland assertions often have very little value for any given individual.
The trending topic of today seems to be gluten intolerance. Gluten is a protein ubiquitous in wheat, barley, and rye. Our species has been enjoying it for millennia.
There are individuals who should avoid gluten, most of all those with celiac disease, a serious autoimmune disorder that affects nearly 1 in 100 people of Northern European ancestry. Celiac disease is correlated with other autoimmune afflictions such as Crohn’s disease, thyroid disorders, and diabetes mellitus among others.
For patients with celiac disease, gluten triggers an autoimmune response primarily affecting the small intestine, causing malabsorption of nutrients. But this damage is not limited to the intestine, it can also affect the skin, the skeletal and nervous systems. In fact, untreated celiac is linked to cancer of the small intestine.
Typical symptoms of celiac disease include bloating, abdominal pain, chronic diarrhea or constipation, an itchy skin rash, arthritis, fatigue and irritability. If you have symptoms that may suggest celiac disease, or suspect you might, please see your doctor and get tested. A simple blood test for Tissue Transglutaminase Antibodies (tTG-IgA) is a commonly performed and highly accurate test to make the diagnosis. In an individual with celiac disease, the immune response to gluten produces tTG-IgA antibodies.
To accurately test for these antibodies, the patient must be consuming gluten. If you test positive for tTG-IgA, this will be followed with a simple endoscopic biopsy performed by a gastroenterologist to confirm the diagnosis. This procedure takes around one hour from arrival to departure, and is well worth your time if you or your doctor suspect you may have celiac disease.
Those who have celiac disease, with careful monitoring of the diet to ensure complete avoidance of gluten, can live healthy and normal lives. For the rest of us however, without this serious food allergy, the gluten free craze may not make much sense. The problem with some of these dietary trends is that they can cause needless complication and concern for folks who have no problem tolerating a substance like gluten. Moreover, a gluten-free diet can be costly.
It should be noted, however, that some people do have sensitivity to gluten. Sensitivity is not a true allergy; it’s more akin to the way some of us react to beans, spicy, or acidic foods.
This is in no way to say gluten is great for you, only that the current trend is stirring irrational fear on the topic. If you experience any of the symptoms we discussed, or others that raise concern about celiac disease, or if you have a history of related autoimmune disorders or a sibling or parent who has celiac disease, then comprehensive diagnostic testing by a gastroenterologist is highly indicated.
Dr. Yousif A-Rahim, M.D. Ph. D.
Chief Medical Officer: Covenant Surgical Partners
Dr. A-Rahim works with our Medical Advisory Boards, our Medical Directors, and our quality assurance programs to oversee improvement of clinical outcomes for our patients. He also organizes and leads Company efforts to measure and improve clinical outcomes for all centers and the Company as a whole. Dr. A-Rahim earned his medical and doctorate degrees from the Pennsylvania State University and completed a residency in Internal Medicine and fellowship in Gastroenterology at Beth Israel Deaconess Medical Center, Harvard Medical School. As a physician, he is known for his expertise in interventional endoscopy and minimally invasive treatments for gastrointestinal disease. He has authored several articles published in medical journals and has delivered presentations to fellow physicians around the country, including at his alma mater, Harvard Medical School.
Dr. A-Rahim is currently a Lecturer in Medicine at Harvard Medical School and practices gastroenterology at the VA Boston Healthcare System West Roxbury Campus in Massachusetts, and at Pacific Endoscopy Center, an ASC he co-founded in 2008 in Pearl City, Hawaii.