Gluten and Allergy

May 27th, 2009

Gluten is a protein found in wheat, barley and rye.  In persons with celiac disease (formerly celiac sprue, aka gluten sensitive enteropathy), eating gluten causes an inflammatory response in the bowel leading to abdominal pain, diarrhea, and malabsorption.  The latter may cause anemia.  The presenting symptoms can vary, but GI symptoms are the most common form of presentation.  Celiac disease may affect up to 1% of the population.  Simple blood tests are very good at screening for celiac disease.  In celiac disease, the reaction to gluten is not an allergy, so allergy testing is not a part of the diagnostic workup.

Allergy to wheat should not be confused with gluten sensitivity.  As with all food allergies, individuals with wheat allergy can have GI symptoms, but will lack the small bowel inflammation and malabsorption found in celiac disease.  Most commonly, individuals with wheat allergy will present with a rash.

Lastly, there is nothing inherently bad about gluten.  I have seen many patients who tried to remove gluten from their diets thinking it would help their allergy symptoms.  There is no evidence to support a connection between eating gluten and allergies.

If you have questions about gluten sensitivity or celiac disease, your primary care doc is a good starting point.

Dr. O

Asthma Control Test

May 11th, 2009

During Spring, many people find that their asthma gets worse.  They experience tightness in their chest, shortness of breath, and an increased cough.  Albuterol use increases.  Patients experience this secondary to the increased tree and grass pollen.

If you think your asthma may be poorly controlled, go to www.asthmacontrol.com and take the Asthma Control Test.  There are 5 questions with a max point total of 5, minimum of 0.  If your total score is less than 20 then your asthma may not be controlled and you should call your doctor for further evaluation.  You can print off your test and bring it with you to your appointment.  This saves time and may provide quicker treatment which could result in less ER visits and less aggressive therapies.

Dr. Norvell

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