Ask a Specialist: Gluten: Friend or Foe?

It seems like everywhere you turn, you hear about gluten-free products- there’s gluten-free baked goods, pastas, chicken nuggets. You find them in stores, on the menu in restaurants, even pizza places.

What exactly is gluten and who does it affect? Is gluten something you should avoid? We “Ask A Specialist,” Dr. Traci Murakami, gastroenterologist at The Queen’s Medical Center.

Dr. Murakami defines gluten as a protein found in wheat, barley and rye, and says there are three distinct clinical problems worsened by gluten:

  1. Celiac disease is an autoimmune condition where gluten causes inflammation and flattening of the villi that make up the absorptive surface of the small intestine. Celiac disease can be diagnosed with blood tests which check for antibodies against gluten, a blood test to check for genetic susceptibility to celiac disease, and a biopsy of the small intestine.
  2. Wheat allergy is a very rare condition that can resemble allergy to peanuts or to cats.  It can result in sneezing, hives and, in rare cases, anaphylaxis.
  3. Gluten intolerance is when a person has feelings of bloating or experiences bowel changes after eating gluten. There is no specific test for this condition.

Celiac disease is known to affect about 1% of people. The incidence of celiac disease is higher in those of white or northern European ancestry – it may be as high as 1:100 or 1:250. One in 4,700 Americans have been diagnosed with celiac disease.

If you have symptoms which include chronic or recurrent diarrhea, malabsorption (low iron or low vitamin B12, low folate levels) or anemia, or if you have bloating or abdominal distention, you should be tested. This can include people who have “irritable bowel syndrome” or severe lactose intolerance. Routine screening of the general population is not recommended.

The cornerstone of treatment is the elimination of gluten in the diet, however, “gluten-free” should not be mistakenly confused with “healthy,” advises Dr. Murakami.

“Not only are gluten-free foods more expensive, but studies found increased risk of becoming overweight as a result since gluten-free foods contain less fiber and other nutrients, and often have added sugar.  There can be harm in blindly going gluten-free and you should not start a gluten-free diet on your own without consulting your physician.”

Dr. Murakami is part of the team at Queen’s Gastroenterology Services. To find out more about the gastroenterology physicians and the types of services offered, go to: or call (808) 691-8955.

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