Allergic to Wheat?

By MICHAEL D. LEMONICK

If you come down with celiac disease this week, you might not know it until 2015. It's not that the illness is symptom free. Caused by a severe allergy to gluten (a protein found in wheat and other grains), the disease can cause diarrhea, gas, cramping and weight loss--which is why doctors often mistakingly assume it's irritable bowel syndrome. Or it might show up instead as joint pain, or fatigue, or a skin rash.

No wonder celiac disease is known as the great pretender, and why it takes an average of 11 years to diagnose. An expert panel convened by the National Institutes of Health last month estimated that some 3 million Americans may suffer from the illness--10 times as many as doctors once thought. The disease is not just discomforting; gluten from wheat, rye, barley and several other grains triggers an immune response that attacks the lining of the intestines, cutting down on the absorption of calcium, iron and other nutrients.

Over time, says Dr. David Elliott, director of the Celiac Clinic at the University of Iowa medical center, celiac disease can lead to osteoporosis, anemia and severe weight loss. There is also an increased risk of diabetes, thyroid disease, liver disease and arthritis. Fortunately, celiac disease has become a lot easier to diagnose in the past few years, thanks to more reliable blood tests. If the results are positive, a quick biopsy of the small bowel provides a definitive verdict. The trick now, say experts, is to teach primary-care doctors to recognize the symptoms and test for the disease.

Unfortunately, there's no cure for celiac disease, which seems to be caused by a genetic defect. But there is a remedy that's 100% effective: stay away from gluten. That isn't as easy as it sounds. Breads and cereals are obvious sources of the offending protein, but it's also used--and not always labeled--as an additive in cold cuts, soups, soy sauce, malt vinegar and even jelly beans.

Finding hidden ingredients could get easier if Congress passes the new labeling bill that's scheduled to come to a vote this week. The law would require manufacturers to identify wheat and other troublesome grains on product labels. And although it wouldn't require a label for gluten per se, it does instruct the Department of Health and Human Services to define what it means by "gluten free." Meanwhile, says Elliott, if you have received a diagnosis of celiac disease, you should consult a professional dietitian about how to rid your diet of gluten.