Hidden and Accidental Gluten Exposure in Celiac Disease

Arefa Cassoobhoy, MD, MPH


July 23, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

Patients with celiac disease may be consuming more gluten than they realize.

A new study analyzed amounts of gluten excreted in stool and urine of people with celiac disease who were following a gluten-free diet.

The researchers found that these adults were still being exposed to an average of 150-400 mg of gluten a day. Up to 10 mg per day is considered safe.

Gluten is found in foods made with wheat, rye, and barley. Some obvious sources of gluten include breads, pastas, beer, and malt vinegar. Patients have to be cautious about not-so-obvious sources and check for gluten in sauces, condiments, meat substitutes, candy, and drinks. Some medicines and supplements have gluten as well.

The study wasn't aimed at identifying sources of accidental gluten exposure but it does encourage us to tell our patients with celiac disease who are symptomatic that they need to re-evaluate their diet for hidden sources of gluten.

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