Celiac disease? Non-celiac gluten sensitivity? With all you hear about gluten these days, it is reasonable to wonder if you have celiac disease or a gluten sensitivity. Is going gluten free right for you?

Let’s start with some definitions. celiac disease is an autoimmune disease in which a very small piece of a protein found in wheat, rye, and barley triggers a reaction damaging the small intestine. That damaged intestine cannot absorb nutrients normally, especially iron, vitamin B12, calcium, and vitamin D. The nutrient deficiencies lead to symptoms anywhere in the body. Celiac disease goes beyond the classic digestive symptoms to include early onset osteoporosis, anemia, neurological problems, liver problems, and skin rashes, among many others. Long thought to affect about one percent of Canadians, recent data suggest the true rate may be between two and three percent of the population.

Non-celiac gluten-sensitivity (NCGS) affects about five to seven percent of the general population. Sensitivity reactions do not damage the small intestine and do not trigger nutritional deficiencies. NCGS is not well understood, but some recent research suggests that there might be several problems being lumped into a single diagnosis.

The first thing to do if you think you have a problem with gluten is to get blood screening tests for celiac disease through your family doctor. These tests can only be done if you are eating gluten every day. If you have already gone gluten free, you have to eat gluten again for several weeks to several months before you can be tested.

If the screening test is positive, you will be referred to a gastroenterologist for a small bowel biopsy so tissue from your small intestine can be examined for damage. If the screening test is negative, you may or may not be referred for biopsy, depending on your symptoms and nutritional status.

The treatment for both celiac disease and NCGS is a strict gluten-free diet. This means absolutely no gluten from wheat, rye, or barley. Not even one bite. Besides baked goods and cereal, you will find gluten in unexpected places: soy and BBQ sauce, soup, processed meat, and even chocolate bars and potato chips.

Thankfully, the labelling regulations for food in Canada require that gluten added to a product must be listed as an ingredient or identified in a “contains” warning using its common name — wheat, rye, or barley.

The other thing you need to know is that the internet is full of rumors and old, discredited information about gluten. There are well-meaning bloggers who pass along incorrect information. It is important to find information backed by research and monitored for correctness. In Canada, this is the Canadian Celiac Association (www.celiac.ca), an advisory council of physicians, dietitians, and food scientists that reviews information and publications.