So-called intolerance to wheat, and/or other cereals and dairy produce is so common that few patients who seek advice leave a consultation without being told to cut them out. Research is still being carried out to find a test that will show any intolerance.

There is an hereditary disorder known as coeliac disease, often called gluten enteropathy. It affects a number of people depending on their race – between one in 300 to one in 1,500. With coeliac there is a sensitivity to one fraction of gluten, the wheat protein. This is the gliadin fraction, found in wheat, rye, barley and oats.

The antibodies and gliadin act together as an antigen. The immune response set up by the antigen reaction promotes lymphocytes that damage the mucosal wall of the small intestine. Because of damage to the gut wall and poor absorption of nutrients, patients suffer from gross fatigue, anaemia, weight loss, skin diseases and bone pain. Patients’ bowel movements are disturbed. In other conditions (some forms of arthritis, ankylosing spondylitis, Crohn’s disease and other inflammatory bowel diseases) it is possible that wheat or other cereals may trigger symptoms.

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