Gluten Intolerence-What Do We Do

Most of the India’s population (about 75%) are lactose intolerant and can’t consume milk or milk products without feeling ill. This is because they lack the enzyme lactase, which digests the milk sugar lactose.

Lactose intolerance is inability to digest sugar in milk – lactose. Ability to digest lactose is significantly reduced among most individuals already from age two. When an organism ceases to digest lactose efficiently then consuming milk, dairy products, and other products that contain even a trace of lactose (e.g. bread, cereals, instant soups, nibbles…) can cause various symptoms in individuals such as abdominal pain, cramps, bloating, nausea, flatulence and diarrhoea. Lactose intolerance causes digestive problems that can significantly affect quality of life. If these symptoms occur in children they should not be ignored. About 20% of people consider themselves lactose intolerant because of related symptoms, although they have never been formally tested for the intolerance. It is important to distinguish between milk allergy and lactose intolerance. Milk allergy is an immune system response to milk, while lactose intolerance is a digestive disorder. Symptoms of lactose intolerance become evident in early childhood or in adolescence.

Lactose intolerance occurs when the lactase enzyme is not present in sufficient quantity to break down lactose. Genetic studies have shown that mutation at a single position in MCM6 gene is associated with decrease in lactase activity which may lead to lactose intolerance. Cytosine (C) or thymine (T) may be found at that position of gene, where C is associated with lactose intolerance and T is associated with lactose tolerance.

Genetic test (DNA test) for lactose intolerance is based on detection C or T variant in gene MCM6. Although this detection can be performed using several different methods, most of methods are technically demanding and expensive and some of them are also insufficiently precise.

Gluten: Some people experience symptoms found in celiac disease, such as “foggy mind”, depression, ADHD-like behavior, abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, and chronic fatigue when they have gluten in their diet, yet do not test positive for celiac disease. The terms non-celiac gluten sensitivity (NCGS) and non-celiac wheat sensitivity (NCWS) are generally used to refer to this condition, when removing gluten from the diet resolves symptoms.

Until now it was thought that people with NGCS/NCWS only experienced symptoms and did not have any intestinal damage. However, in July 2016, a team of researchers at Columbia University Medical Center, published a study confirming that wheat exposure in this group is, in fact, triggering a systemic immune reaction and accompanying intestinal cell damage. It is estimated that the impacted population is equal to or even exceeds the number of individuals with celiac disease (the vast majority of whom remain undiagnosed).

At this point, research has not confirmed that gluten is the culprit triggering the immune reaction as is the case with celiac disease. According to head researcher of the study, Dr. Armin Alaedini, “there is some ambiguity there, which is why we are referring to it as non-celiac wheat sensitivity for now.” He explains that “more studies are needed to understand the mechanism and identify the molecular triggers responsible for the breach of the intestinal barrier and the associated symptoms in affected patients.”

Genetic testing for celiac disease which is an autoimmune disorder requires a swab sample from the mouth or a blood sample. This testing can accurately predict the risk probability of the celiac disease along with the statistical probability of the individual’s offspring inheriting the same risk. A severe celiac disease is found to occur if both the parents are carriers of this gene. The testing also includes gluten sensitivity.

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