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Y O U R T I M E / H E A L T H

Allergic to Wheat?

Millions are without knowing it ­ but a simple test can help you find out

By MICHAEL D. LEMONICK

Monday, Jul. 19, 2004

If you come down with celiac disease this week, you might not know it until

2015. It's not that the illness is symptom free. Caused by a severe allergy to

gluten (a protein found in wheat and other grains), the disease can cause

diarrhea, gas, cramping and weight loss ­ which is why doctors often mistakingly

assume it's irritable bowel syndrome. Or it might show up instead as joint pain,

or fatigue, or a skin rash.

No wonder celiac disease is known as the great pretender, and why it takes an

average of 11 years to diagnose. An expert panel convened by the National

Institutes of Health last month estimated that some 3 million Americans may

suffer from the illness--10 times as many as doctors once thought. The disease

is not just discomforting; gluten from wheat, rye, barley and several other

grains triggers an immune response that attacks the lining of the intestines,

cutting down on the absorption of calcium, iron and other nutrients

Over time, says Dr. Elliott, director of the Celiac Clinic at the

University of Iowa medical center, celiac disease can lead to osteoporosis,

anemia and severe weight loss. There is also an increased risk of diabetes,

thyroid disease, liver disease and arthritis. Fortunately, celiac disease has

become a lot easier to diagnose in the past few years, thanks to more reliable

blood tests. If the results are positive, a quick biopsy of the small bowel

provides a definitive verdict. The trick now, say experts, is to teach

primary-care doctors to recognize the symptoms and test for the disease.

Unfortunately, there's no cure for celiac disease, which seems to be caused by a

genetic defect. But there is a remedy that's 100% effective: stay away from

gluten. That isn't as easy as it sounds. Breads and cereals are obvious sources

of the offending protein, but it's also used ­ and not always labeled ­ as an

additive in cold cuts, soups, soy sauce, malt vinegar and even jelly beans.

Finding hidden ingredients could get easier if Congress passes the new labeling

bill that's scheduled to come to a vote this week. The law would require

manufacturers to identify wheat and other troublesome grains on product labels.

And although it wouldn't require a label for gluten per se, it does instruct the

Department of Health and Human Services to define what it means by " gluten

free. " Meanwhile, says Elliott, if you have received a diagnosis of celiac

disease, you should consult a professional dietitian about how to rid your diet

of gluten.