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32 WWW. UNWLA.ORG “НАШЕ ЖИТТЯ”, ЧЕРВЕНЬ 2013 What’s Up with the Gluten - Free Craze? by Ihor Magun, MD, FACP The label “ gluten - free” is just everywhere — in supermarkets, restaurants and on food pro d- ucts. Is this a new fad? What exactly is gluten and why are we talking so much about it? Gluten is a protein that is found in wheat and wheat products. It is also present in other common grains, such as barley and rye. Gluten and the related substance, glidin, are proteins that produce significant problems in the disorder referred to as “celiac disease” or “sprue.” Celiac disease is an autoimmune disease that can affect individuals from infancy to adul t- hood. It i s caused by a reaction to wheat/ glidin. There is no specific cause of this disease but it is more common in individuals of European d e- scent, individuals with autoimmune t hyroid di s- ease, type - one diabetics (those requiring insulin from a young age), t hose with Down's syndrome or a condition known as microscopic colitis. Cel i- ac disease is more common in women. Many p a- tients go undiagnosed or are told that their cond i- tion is simply IBS — irritable bowel syndrome. The best way to desc ribe the condition is to discuss the changes that happen in the walls of the intestine. Under normal conditions, the walls of the intestine have hair - like projections called “ villi. ” These can be likened to a plush carpet with deep piles. The piles permit the absorption of vitamins, minerals and nutrients. In celiac di s- ease patients, the villi are damaged (by the gl u- ten) and the plush carpet is now more like a smooth floor. The surface cannot absorb the ne c- essary nutrients, v itamins and minerals, which are lost in the sto ol. Symptoms include a b- dominal pain, weight loss, malnutrition, fatigue, anemia and other issues stemming from the inte s- tinal losses. Untreated patients develop malnutr i- tion, despite an adequate diet. It should be e m- phasized that many patients may not p osses s all the intestinal symptoms that suggest this diagn o- sis, but could have unexplained anemia, puzzling bone disease w ith bone pain and osteoporosis — as Vitamin D and calcium are some of the nutr i- ents that are lost. Interestingly enough, the only reas on that the disease is now more openly discussed and a d- dressed is because more individuals know that they carry this diagnosis — thanks to better scree n- ing and knowledge . Certain criteria should be met in order to substanti ate the diagnosis. Blood tests are readily and easily available. They can detect elevated a n- tibodies. The tests should be done with gluten ingested so as to be certain that the antibodies are present. Testing on a limited or gluten - free diet will result in a normal test. Confirmatory tests can include an actual biopsy of the intestine , and they are both highly specific and sensitive. Many individuals actually do a self - confi rmatory pr e- li m inary evaluation: they follow a strict, gluten - free diet for at least one week and see if their sy mptoms improve (diarrhea, blo ating, a b- dominal pain, cramps). Then they resume a gl u- ten diet and see if the symptoms return. There are many resources for gluten - free diets. In fact, man y supermarkets devote a sp e- cial aisle to such resources , mo stly using rice - based products. These tend to be more expensive but work well as substitutes. There has also been a barrage of cookbooks for gluten - free diets, and certainly the I nternet is full of information that is easily available. Finally, decreasing the consu m p- tion of wheat and wheat - derived products many not be a bad idea for everyo ne, as this may help with optimal weight maintenance. ДО УВАГИ МИСТЦІВ І ШАНУВАЛЬНИКІВ МИСТЕЦТВА! Редакція журналу приймає фотографії доброї резолюції (у форматі JPG ) з праць мистців укра ї нського походження , котрі будь - коли малювали або виставляли свої праці в США, для розміщення на обкладинці «Нашого життя». Просимо надсилати Ваші пропозиції та фото електронною поштою до редакції «Нашого життя» ( unwlaourlife@gmail.com ) та до нашого мистецького координатора Уляни Зінич ( uzinych @ comcast . net ).
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