Is celiac disease an allergy to gluten?

[Hari_Seldon]

Is it possible for a person who has a negative skin test to gluten suffer nonetheless from celiac disease?

This really belongs in GQ since I want facts not opinions, but the mods do not permit medical questions in GQ.

[MLS]

According to the Mayo Clinic,

Definition
By Mayo Clinic staff

Celiac (SEE-lee-ak) disease is a digestive condition triggered by consumption of the protein gluten, which is primarily found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye. People with celiac disease who eat foods containing gluten experience an immune reaction in their small intestines, causing damage to the inner surface of the small intestine and an inability to absorb certain nutrients.

It’s not exactly an “allergy,” like poison ivy, peanuts or shellfish.

Normally, your small intestine is lined with tiny, hair-like projections called villi. Resembling the deep pile of a plush carpet on a microscopic scale, villi work to absorb vitamins, minerals and other nutrients from the food you eat. Celiac disease results in damage to the villi. Without prominent villi, the inner surface of the small intestine becomes less like a plush carpet and more like a tile floor, and your body is unable to absorb nutrients necessary for health and growth. Instead, nutrients such as fat, protein, vitamins and minerals are eliminated with your stool.

[Qadgop_the_Mercotan]

When one eats gluten, the body produces a protein that digests gluten.

In a person with celiac disease, their body produces an antibody to the protein that digests gluten. Since this protein is in the intestinal wall, the antibodies attach to the protein in the intestinal wall, signal the rest of the immune system to come and help attack, and the intestinal wall is damaged in the process, impairing absorption of nutrients, causing pain and malabsorption.

But someone with celiac would not react on an standard allergy test to gluten, because they have no antibodies to gluten.

[Hari_Seldon]

@Qadgop_the_Mercotan

When one eats gluten, the body produces a protein that digests gluten.

In a person with celiac disease, their body produces an antibody to the protein that digests gluten. Since this protein is in the intestinal wall, the antibodies attach to the protein in the intestinal wall, signal the rest of the immune system to come and help attack, and the intestinal wall is damaged in the process, impairing absorption of nutrients, causing pain and malabsorption.

But someone with celiac would not react on an standard allergy test to gluten, because they have no antibodies to gluten.

That’s what I wanted to know. Here is the full story. A woman I know suffers constant nausea and now weighs under 80 lb. She is around 5’3" and, as you can imagine, looks like a concentration camp victim. Her doctor gave her a skin test for gluten allergy and it was negative. Some of her symptoms resemble those of my aunt’s who has diagnosed celiac disease and is fine so long as she avoids gluten. I have suggested to my friend avoid gluten for a month to see what happens. She refuses, citing the results of the allergy test. I figure she has nothing to lose by trying. Armed with this, I might try again. She needs, according to her cardiologist, a heart valve replacement, but is too weak to have the operation.

One similarity of her case and my aunt’s is that in both cases the problems began with a serious case of food poisoning. In my aunt’s case, the conclusion is that the same antibodies that reacted to the bacteria involved also caused the celiac disease. I guess these infections are common causes of auto-immune disorders. My mother had a serious, never diagnosed (as to cause) infection when she was near 70. Within a year or two, she developed Parkinson’s and died of it several years later.

[MLS]

I think she should see a different doctor. When I started having some digestive issues several years ago, I went to a gastroenterologist. He told me the only 100% proof of celiac was to actually biopsy the intestine, which was done. In my case, a different cause for the issue was found – Lymphocytic (AKA microscopic) Colitis.

IANAD, but I’d bet that there are probably dozens of conditions that could cause constant nausea. A friend of mine who has celiac tells me that one of the major symptoms of it for her is abdominal cramping, not nausea.

She may be resistant to trying out your suggestion because gluten free diets are not trivial, even today when more gluten-free foods are available. It is in stuff you’d not instinctively suspect, such as OTC medicines, soy sauce, salad dressings and chocolate candy.