A new study from Sweden suggests that an enzyme found in an over-the-counter supplement can stop gluten from reaching the small intestine, acting as a safeguard against gastrointestinal distress for gluten-sensitive people.
The findings were presented at Digestive Disease Week 2017, an international conference for gastroenterologists and other specialists in related fields.
Lead researcher Julia König, Ph.D. is from the School of Medical Sciences at the University of Örebro. She and her colleagues tested the enzyme, called AN-PEP, on patients who reported themselves to be gluten-sensitive. The participants consumed porridge and wheat cookies – both of which contained gluten – and were then given either AN-PEP or a placebo. The team then monitored the levels of gluten in the stomach and small intestine over a three-hour period.
The results showed that those participants given AN-PEP had 85 percent less gluten in their stomachs than the placebo group; this was regardless of whether they had received a high or low dose of the enzyme. Earlier research had shown that AN-PEP broke down gluten when ingested as part of a liquid meal, but this is the first study to confirm the results using solid foods.
Alejandro Perez, D.O., who is board-certified in gastroenterology and practices as part of the
Sebastian River Medical Group, believes the findings of this study are intriguing but should not be considered conclusive, as the number of participants was low. He says, “The study opens the conversation as to what may be possible in the near future for patients suffering from gluten-associated symptoms. Critical in understanding these study findings is that even a small amount of gluten – equal to the amount of a half-slice of bread – can be enough to cause symptoms in gluten-sensitive people.”
Gluten is a protein occurring naturally in wheat, rye and barley, and may often be found in processed foods. Gluten-sensitive people usually learn to eat a gluten-free diet, but occasions may arise when they are not sure if what they’re eating contains gluten. The University of Örebro’s Dr. König says, “AN-PEP allows gluten-sensitive patients to feel safer, for example, when they are out with friends at a restaurant and cannot be sure whether something is 100 percent gluten-free.”
Some estimates indicate that up to 18 million people in the United States – about 6 percent of the population – have some degree of gluten-sensitivity, but celiac disease only affects about 1 percent of the population. For those with celiac disease, eating gluten causes an immune system reaction which damages or destroys the villi, the microscopic projections lining the small intestine that allow for the absorption of nutrients into the body. The classic symptom is diarrhea; other symptoms include bloating, gas, fatigue and low blood count (anemia).
Additionally, osteoporosis – weakened bones – can be a complication of untreated celiac disease. Vero’s Dr. Perez says “the damage to the small intestine prevents the proper absorption of nutrients such as calcium and vitamin D, which can eventually lead to bone loss and osteoporosis.”
The government has made it a little easier to buy gluten-free food at the supermarket; as of August 2014, any food labeled “gluten-free” must comply with the FDA definition (less than 20 parts-per-million of gluten). Additionally, there are many foods that are naturally gluten free, including fresh fruits and vegetables, eggs and dairy, unprocessed meats and poultry, fish and seafood, beans, nuts, rice, corn and potatoes.
Dr. Perez says there is greater awareness of gluten sensitivity now than there was a decade ago, which had led to an increase in the number of diagnosed cases. He cautions, “patients should not jump to a quick diagnosis without an appropriate work-up. Symptoms of gluten-sensitivity commonly overlap with other conditions, such as irritable bowel syndrome. And often, a wide array of gastrointestinal symptoms will improve on a gluten-free diet due to its overall healthier dietary composition.”
AN-PEP is available in a supplement called Tolerase G. It is intended for people who are gluten-sensitive but not for those with celiac disease. “Patients who suspect they may have gluten sensitivity or celiac disease should seek the care of a specialist for an appropriate evaluation,” says Dr. Perez.
Dr. Perez’s practice is located at 920 37th Place, Suite 105 in Vero Beach; the phone number is 772-567-4825.
