What is Gluten Sensitivity?


Picture insert is an enlarged view of the cross section of small intestine micro villi.

The term gluten sensitivity has been used to refer to a variety of clinical complaints caused by the ingestion of gluten.  What is gluten?  Gluten is defined as a cohesive elastic protein left behind after the starch is washed away from the grain of the wheat plant.  Gluten is found in the grain of the wheat, barley and rye plants, and possibly oats.  It is a fairly long protein molecule, that is for some, is difficult to digest, or ignites a cascade of reactions.

The most commonly known gluten sensitivity is celiac disease or gluten sensitive enteropathy (GSE).  GSE is a genetic auto immune disease of the small intestines whereby the ingestion of gluten results in inflammation and loss of villous structure.

Some terms defined

  1. Auto immune; comes from the root word auto meaning self, relating to the the immune response of the body against substance normally present in the body.  Or in other words the body attacks itself, as it would any other foreign invader.
  2. Enteropathy is defined as a disease of the intestinal tract.
  3. Villous structure refers to the area of the small intestine that is responsible for the digestion and assimilation of our food and nutrients.  Without the micro villi (Villous structure), we will lose our ability to absorb nutrients.  Damage of the Villous structure can continue for years, accumulating until near total loss of the micro villi.

How much surface area is the small intestine?  Healthy micro villi gives us an area of about two tennis courts in absorption area.  Therefore you can imagine that if we lost any of that surface area, our ability to absorb nutrients would decrease substantially.

“Diagnosis (of Celiac Disease) is based on the finding of villous atrophy in the small bowel”, states the British Medical Journal Vol. 330.  Atrophy is a weakening or degeneration, in the size of an organ caused by disease or disuse.

Gluten sensitivity without enteropathy:

A second type of gluten sensitivity is known as gluten sensitivity without enteropathy.  This type of sensitivity also involves an inappropriate immune response to gluten.

Gluten sensitivity without enteropathy is typically induced by intestinal barrier distress and enhandced by intestinal permeability.

What is intestinal permeability?  Intestinal permeability of the intestinal barrier refers to substances crossing from inside our intestines to outside our intestines.  This is commonly referred to as leaky gut.  The American Journal of Pathology vol. 169 reports that “an intact intestinal barrier is therefore, critical to normal physiological function and prevention of disease.”

leaky gut anime

Explaining leaky gut.  Picture a soaker hose in your flower bed.  This soaker hose as you know is made to drip out very small amounts of water along its length, however if it becomes damages in some way, large amounts of water escape.  “Intestinal permeability is increased in patients with food allergy, thus uptake of food antigens is elevated in food allergic patients.” States the Gastroenterology journal from 2005.  

The medical journal just quoted (Gastroenterology journal) is linking intestinal permeabliity with food allergies.  An antigen is any subtance that stimulates an immune response in the body, expecially the productions of antiboides.

In both types of gluten sensitivity, the immune system overreacts to the presence of gluten, resulting in the production of antibodies to gliadin and tissue transglutaminase.  Are there blood tests to measure this response?  Blood tests for gluten will be discussed.