Is gluten really Public Enemy #1? Many seem to regard it as a toxin. . Restaurants and supermarkets offer a wide variety of gluten-free foods. Years ago, physicians advised a gluten-free diet only for individuals who had celiac disease (CD), which is an autoimmune disease that largely affects the small intestine. If a celiac patient wades back into Glutenland, his or her intestine will start an internal uprising. I care for a few of these folks, but they are but a slim fraction of my patients who are shunning gluten. Gluten are proteins contained in wheat and other grains. Many adherents of a gluten-free diet believe that this is a more healthful dietary choice. For most of them, there is no supportive evidence for this contention. Why should it matter if an individual chooses to avoid gluten? After all, there’s no risk here? In fact, avoiding gluten can lead to vitamin deficiencies and increased exposure to arsenic and mercury. I’m not suggesting that
You might think that gastroenterologists like me are conversant with food allergies. You would be wrong. Here is a second misunderstanding you likely harbor. Most individuals who believe or suspect that they are suffering from a food allergy have no allergic condition at all. A true allergic reaction involves the firing off of one’s immune system in response to an external stimulant resulting in a rash, wheezing and other characteristic allergic responses. Poison ivy, for example, is an allergic reaction. Nausea resulting from an antibiotic is not an allergic reaction. Physicians, of course, appreciate this distinction. This is why when you tell us you are ‘allergic’ to a medication, we will ask you specifically what the reaction was. In my experience, most of these ‘allergic reactions’ are routine non-allergic side effects. Often enough, a patient will claim to have a penicillin allergy, for example, but has no clue what the reaction might have been.