Giving up wheat, rye may help beat that mystery illness but don’t try it at home

New Delhi: Muralidharan spent 18 years wondering why doctors couldn’t cure his skin disorder and gastrointestinal problems. It was gluten allergy, but most doctors weren’t aware of it in the late 1990s. Two years ago, Sharad Kumar began suffering a low haemoglobin count. He took iron supplements and changed his food habits, but there was no improvement, and doctors put him on anti-tuberculosis medication. Recently, he consulted another doctor regarding the problem. A biopsy revealed that his intestinal villi, which absorb nutrition from digested food, had been damaged by consumption of food containing gluten to which he was intolerant. Just proves awareness about gluten allergy continues to be low both among the masses and the medical fraternity.

The Indian Journal of Medical Research described allergy to gluten, a protein found in wheat, rye and barley, as an impending epidemic in 2011. Dr Ishi Khosla, clinical nutritionist and founder of Celiac Society of India, said every week she came across patients who have gastrointestinal problems that refuse to respond to medicines. “When going off food items that contain gluten helps, we conduct tests and usually confirm celiac disease,” she said. Khosla revealed that one of every 140 persons in India is estimated to have celiac disease, a chronic inflammation of the small intestine caused by intolerance to gluten and usually present in genetically predisposed individuals.

Patients suffering from celiac disease, also called wheat allergy, suffer from recurrent diarrhoea, failure to gain weight, weakness, anaemia, irritability and behavioural issues. “The first case of celiac disease I diagnosed was in 1997. The patient was the son of doctors. They didn’t believe the diagnosis, but were ecstatic when his health improved six months after going gluten-free. These days, I come across at least four such cases among children every week,” said Dr Anupam Sibal, paediatric gastroenterologist and group medical director of Apollo Hospitals.

A 60-year-old woman was recently diagnosed with celiac disease in Medanta Medicity in Gurgaon after having taken periodic iron shots for years to treat her anaemia, little realising that the culprit was gluten. Celiac disease calls for the complete avoidance of food containing gluten, but, according to doctors, even those not diagnosed with the condition are giving up cereal grains for perceived benefits such as weight loss and better digestion. “Many patients claim to have benefitted from going gluten-free. But more research is needed to establish the facts,” said Dr Randhir Sud, chairman of Medanta’s Institute of Digestive and Hepatobiliary Sciences.

Experts, however, warn against keeping off food containing gluten without medical consultation because wheat is a source of dietary fibre and is needed for the bowels to work properly. “It is also the source of a protein that most Indians lack,” said a doctor. A recent study published in British Medical Journal added that going gluten-free might increase the risk of heart disease because whole grains containing gluten are associated with cardiovascular benefits.

AIIMS is now conducting a study to assess the benefits of gluten-free diet in patients suffering from irritable bowel syndrome, said Dr Govind Makharia, professor of gastroenterology. “Nearly 250 patients have been enrolled for the project. Some of them did benefit from the dietary changes, but it is too early to correlate the introduction and benefits of a gluten-free diet,” he said.

The internet, of course, is already demonising the protein, with people going off gluten testifying to relief from irritable bowel syndrome to autism spectrum disorders and many other medical conditions. “I get 50-60 samples to test for gluten sensitivity every week, some referred by doctors, others on their own. Nearly 10% of the samples test positive,” said Dr Navin Dang, founder of Dr Dang’s Lab. A decade ago the pathology lab got just 8-10 requests a day for gluten testing. In some cases, blood tests reveal sensitivity to gluten without celiac disease.

While increased awareness is one of the reasons for the rise in diagnosis of celiac disease, many researchers say the incidence of the condition may have also gone up due to a change in the variety of wheat grown. The modern wheat is hexaploid, rather than diploid, and it is more antigenic, meaning it stimulates the production of antibodies when introduced in the body.