Should I Avoid Gluten?

Gluten-free products are appearing on more and more grocery shelves, and many people are confused about whether they need to avoid gluten. The answer is…maybe.

Gluten is the name of the proteins found naturally in wheat, barley and rye. It holds the food together and provides the elastic texture in dough. It is safe for most people to consume. However, some people have an autoimmune disease or sensitivity that makes it necessary for them to avoid gluten.

Celiac Sprue

About one in 100 people have an inherited condition known as celiac sprue, which causes damage to the small intestine when gluten is consumed. Celiac sprue may be difficult to recognize because the symptoms can be linked with many other issues. Symptoms can include bloating, diarrhea, constipation, weight loss, abdominal pain, skin rash, elevated liver enzymes and others.

Celiac sprue can develop at any age, and left untreated, can lead to serious health concerns including diabetes, multiple sclerosis, skin rash, osteoporosis, heart disease and gastrointestinal cancer. The only treatment for celiac sprue is a strict gluten-free diet. If you have been diagnosed with this condition, you should avoid consuming foods that contain gluten.

Gluten Sensitivity

Some people do not have the blood marker for celiac disease but find that they experience GI discomfort when they consume products that contain gluten.

“If you experience symptoms when you consume gluten, stop eating it,” said Raj Mariwalla, MD, of Island Gastroenterology Consultants. “We don’t know if you will develop celiac at some point, but gluten is not an essential nutrient and it is safe to avoid it if it causes you discomfort.”

Genetic Marker

Some people are born with a genetic marker for celiac disease, as detected by a blood test, but do not experience symptoms.

“It is not known if these people should avoid gluten to avoid developing celiac later in life,” Dr. Mariwalla said. “But I would recommend that they avoid gluten.”


Dr. Mariwalla says that the incidence of celiac disease is increasing and that increasing numbers of people are developing the disease later in life.

“We are diagnosing people in their 60s and 70s with celiac,” he said.

Diagnosis may be made through a simple blood test. If you have a family history of celiac sprue, or have difficulty digesting foods containing wheat, rye or barley, Dr. Mariwalla recommends that you be evaluated by your gastroenterologist for gluten sensitivity. Contact his office at 631-669-1171 to schedule an appointment.

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