QuestionQUESTION: Hello! I have a family history of celiac disease (gluten allergy). I have GI problems myself, but they are not too severe as of yet. I went for a month without eating wheat at all, and now it seems as if when I eat wheat my digestive system cannot tolerate it at all. I did not have these problems with wheat with this severity before the wheat-free month. I understand that in persons with celiac disease, the gluten in wheat destroys the lining of the intestine. So, I began to wonder...since I do seem to have a mild intolerance to wheat, and if I were to eat only a small amount of wheat or gluten in my diet, would my intestine still be in danger of being damaged, even in small amounts?
So, here is my question for you: Are there levels of intolerance per gluten intolerant person in which some persons can eat varying amounts of wheat without risk of damaging their intestinal lining, or does every gluten intolerant person need to totally exclude wheat from their diet the rest of their lives?
Thanks so much for your help! I so appreciate you!
--Mariah
ANSWER: hi mariah,
certain individuals can be intolerant to foods in which they cease to eat and restarted weeks or months later. however, it generally can be resolved from a slow reintroduction to the product. your case, on the other hand, is a bit more tricky as celiac disease can present at any age. it is more common in children. however, it can occur in a 30 or 80 year old as well. it is more common in adults after 60 year old on average.
as of my knowledge, there is no facts supporting a small gluten meal which will not risk some sort of damage in an intolerant person. so excluding gluten for the rest of their lives may be the only effective and appropriate measure.
my only advise would be to adopt a gluten-free lifestyle which may reverse the damage associated with celiac disease. my second advise would be to obtain blood tests (transglutaminase IgA, endomysial IgA, and reticulin IgA) to rule out celiac disease. up to 10% of patients with celiac disease, however, may turn up negative for these blood tests.
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QUESTION: Dr. Thai,
I just wanted to thank you personally for your answer. It was so nice to receive such a knowlegable, carefully articulated response to my question. It really helped me sort this whole thing out, and I really appreciate the time you took to read my question carefully, then craft a response that would be so helpful to me...all at no cost to me. It really touched me, and I so appreciate it!
Best wishes on your world travels...I have traveled some myself, and the memories are priceless! Just try to keep some sort of journal everyday about your activities and feelings...you will want it afterwards!
Thanks again! You are wonderful!
--Mariah
Answerhi mariah,
thank you very much for your kind words. it is very much appreciated. as with all physicians, we tend to overlook the patient as a human being and their will for knowledge. poor interpersonal communication skills inadvertently cause inappropriate responses due to lack of physician-patient interaction and increases the risk of physician mistakes.
today, i find that more and more physicians are changing the way they approach patients, mainly the older physician generations. spending a few more minutes listening and explaining can definitely be positive. i know a few who are taking further steps to educate the public like having live weekly or monthly small group discussions about diseases and health prevention at local university hospitals hosted by different guest speakers. a colleague of mine, who is a well respected professor and physician specializing in women's health, is in the process of creating an online live discussion site. she's hoping that all of these wonderful technologies will connect everyone to taking control of their health. all are for free!
please do not hesitate to ask me questions regarding your health in the future.
best wishes to you and your family
