A substance called gluten is found in barley, bulgur, durum, farina, Graham flour, malt, rye, semolina, spelt, triticale, and wheat. There are also grains it’s not found in, such as rice, maize, and sorghum. This is an important distinction for bakers, because wheat gluten is what makes dough feel like dough and helps bread rise.
It’s also an important distinction to the nearly one percent of Americans who have a condition called celiac disease, in which a protein called gliadin that is part of gluten causes an allergic reaction. Celiac is particularly common in people with conditions such as type 1 diabetes, lupus, thyroid disease, Down syndrome, and colitis. Medical experts believe that more than three in four people with celiac disease don’t realize that they have it. Celiac patients who eat gluten get inflamed bowels, damaging the small intestine and reducing absorption of nutrients.
Now researchers have found that the intestinal damage sometimes means an elevated risk of lymphoma. Lymphoma is a type of blood cancer involving the white blood cells. If the patient is put on a gluten-free diet, the intestinal damage generally heals over the course of a few months. When it doesn’t, the patient’s lymphoma risk is higher. It’s not always obvious why some people heal and others don’t. Adherence to the dietary restrictions is an important factor, but some patients who report scrupulous adherence to gluten-free eating nonetheless don’t fully heal from the intestinal damage. Severity of the damage at the time of diagnosis may have some bearing on healing.
Symptoms of celiac only occur when someone with the condition eats gluten. They may experience abdominal cramping, bloated stomach, fatty or greasy stool, chronic diarrhea, and constipation. Celiac disease also means malabsorption, which can lead to various symptoms of malnutrition, such as unexplained weight loss, fatigue, weakness, anemia, osteoporosis, and infertility. In some cases, the disease manifests as irritability or depression; in others, joint pain and muscle cramps. However, many people with the condition seem perfectly fine, the inflammation not being severe enough to cause any discomfort or noticeable effects.