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Doctor's Diagnosis: Gluten intolerance

There are now millions of Americans avoiding gluten

There are now millions of Americans avoiding gluten and a multibillion-dollar food industry trying to accommodate their needs. Credit: Jeremy Bales

Years ago my good friend Tim starting experiencing a significant weight loss when he began having severe abdominal pain after meals. It took several physicians a long time to figure out the problem was that he could not tolerate gluten. At the time, this was a relatively unusual diagnosis for an adult. There was not much information available on the subject, and even the food labels were of no help. Through lots of research and much trial and error, he eventually developed a gluten-free diet that he could follow.

There are now millions of Americans avoiding gluten and a multibillion-dollar food industry trying to accommodate their needs.

Why are they avoiding gluten?

Gluten is not a toxic substance, but rather a combination of proteins commonly found in certain plants, such as wheat, barley and rye. Not only is consuming gluten perfectly healthy for most people, it’s also very useful. For example, when baking bread it enables the dough to rise and helps maintain the bread’s final shape and texture.

But many individuals who suffer from celiac disease or other related problems, such as "gluten sensitivity," respond negatively to gluten. Gluten damages the lining of their small intestines, interfering with absorption of nutrients. Exposure to gluten may result in immediate problems such as diarrhea, abdominal distention, heartburn and bloating. Long-term problems such as anemia, weight loss and weakening of the bones may also develop.
Recently, for unknown reasons, there has been a tremendous increase in the number of people who have been diagnosed with gluten related difficulties.

In the past, people like my friend Tim were on their own in dealing with their situation. Now there are gluten-free products everywhere, which makes the process easier but still challenging. The list of foods to avoid is lengthy and includes most traditional cereals, pastas, breads, bagels and even beers. Constant vigilance and much label-reading are required. Supplemental vitamins and minerals are often needed. A dietician can help create an appropriate diet plan.

Interestingly, many people without gluten problems have taken it upon themselves to adapt a gluten-free diet, but there is no real medical evidence showing this is of any benefit.

Living a gluten-free life may be challenging, but it is certainly possible. Tim’s been doing it a lot longer than most people, and he’s doing just fine. He just never expected so much company.

Dr. Stephen Picca of Massapequa is Board Certified in both Internal Medicine and Anesthesiology. He is retired from practice. Questions and comments can be sent to Dr. Picca at