Intolerance gluten

In either coeliac disease or gluten intolerance there is a need for products that do not contain gluten. In the case of special dietary needs the ordinary food laws are set aside. This is of course an entirely logical position to take. 

As already mentioned, it is difficult to assess the effect of reintroduction of gluten into patients that are only partially recovered, since there are commonly large daily fluctuations in the fecal fat level. For the present it seems wise to retain the term idiopathic steatorrhea to cover these patients and to accept the view that they may exhibit varying degrees of gluten intolerance. 

Two types of patient will be considered first, those that are suffering from gluten-induced enteropathy as already defined second, those that do not conform to the criteria required for the diagnosis of gluten-induced enteropathy, but are gluten-intolerant in that they show some improvement on a gluten-free diet. 

There is some tolerance in the immune system, otherwise it could react unnecessarily to any foreign, large molecule such as those in food or the air (there are people who do indeed show hypersensitivity reactions to such things, hence hay fever, gluten intolerance, and peanut allergy). If only the antigen is present, the T cell may well ignore it. 

Flax seed contains gluten (a protein in wheat, rye, and barley), so it can be eaten by people with celiac disease, or gluten intolerance. 

Celiac disease is the result of the development of inflammatory-allergic condition due to gluten intolerance. The disease occurs both in adults and in children in a number of countries all over the world. Its occurrence is fairly frequent, it is estimated that approximately 1% of the population suffers from it. Patients manifest not only gastrointestinal symptoms, but also symptoms which are the consequence of malabsorption syndrome, such as osteoporosis, hypochromic anemia, hypoproteinaemia, hypocalcemia, short stature in children, vitamin deficiency, secondary polysensibilization, and emotional disturbances. Moreover, it has been observed that the occurrence of autoimmunological diseases and neoplasms in patients who are not treated with gluten-free diet doubles (Swinson et al., 1983 Ventura et al., 1999). 

Di Cagno, R., De Angelis, M., Atfonsi, G., De Vincenzi, M., Silano, M., Vincentini, O., Gobbetti, M. 2005. Pasta made from durum wheat semolina fermented with selected lactobacilli as a tool for a potential decrease of the gluten intolerance. J Agric Food Chem 53 4393-4402. 

Shan, L., Molberg, O., Parrot, I., Hausch, F., Filiz, F., Gray, G.M., Sollid, L.M., Khosla, C. 2002. Structural basis for gluten intolerance in celiac sprue. Science 297 2275-2279. 

Normally there is very little fat in the feces. However, fat content in stools may increase because of various fat malabsorption syndromes. Such increased fat excretion is steatorrhea. Decreased fat absorption may be the result of failure to emulsify food contents because of a deficiency in bile salts, as in liver disease or bile duct obstruction (stone or tumor). Pancreatic insufficiency may result in an inadequate pancreatic lipase supply. Finally, absorption itself may be faulty because of damage to intestinal mucosal cells through allergy or infection. An example of allergy-based malabsorption is celiac disease, which is usually associated with gluten intolerance. Gluten is a wheat protein. An example of intestinal infection is tropical sprue, which is often curable with tetracycline. Various vitamin deficiencies may accompany fat malabsorption syndromes. 

Shan L, Molberg O, Parrot I, et al. (2002). Structural basis for gluten intolerance in celiac sprue. Science, 297 225. 

In a study introducing oats into the diets of patients with celiac disease, the addition of 50 g of oats daily for 12 weeks was generally well tolerated, although one patient developed partial villous atrophy and a rash after the introduction of oats. Several other patients showed positive levels of interferon gamma mRNA after introduction of oats (Lundin et al. 2003). Other studies have indicated that moderate quantities of oats are safe for persons with gluten intolerance (Janatuinen et al. 1995, 2002 Picarelli et al. 2001 Storsrud et al. 2003). 

Production of aerated products from nonwheat cereals has been a goal for a long time. Utilization of nonwheat cereals such as sorghum would be enhanced if they could produce breads with consumer acceptance close to that of wheat breads. This would also create a niche market for the fraction of the population that is gluten intolerant (see Chapter 14). Success has been limited. 

Gluten intolerance and the question cf viscoelastic properties for nonwheat cereals... 

Beers especially brewed for gluten-intolerant people. They are made from sorghum malt and/or microbial enzymes and gluten-free brewing adjuncts such as rice, maize, or soighum grits. The beer should be made avoiding barley malt and adjuncts or starches from wheat, rye, triticale, and oats. 

What is gluten intolerance What kind of cereals are the most used to produce gluten-free products ... 

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