Gluten-free diets are popular, but unless a person suffers from coeliac disease or gluten intolerance, there is no scientific evidence that indicates a connection between better overall health and avoiding gluten-containing foods.

Gluten intolerance isn’t the same as a wheat allergy or coeliac disease. A wheat allergy may be severe and life-threatening, and coeliac disease, which affects 1-2% of the Australian population, causes damage to the digestive system (1).

The terms gluten intolerance and gluten sensitivity may be used interchangeably, and the condition may also be referred to as non-coeliac gluten sensitivity (NCGS).

Coeliac disease vs. gluten intolerance

Coeliac disease and gluten intolerance or gluten sensitivity cause different responses in affected people. In both groups of people, ingesting gluten-containing foods triggers a series of common gastrointestinal symptoms.

If you suspect that you are sensitive to gluten or have coeliac disease, it’s important to seek the advice of your primary care physician right away. Your physician can administer a blood test or a skin prick test to determine whether you test positive for coeliac disease. Intestinal damage and certain antibodies are hallmarks of coeliac disease.

People who begin a gluten-free diet before seeking the advice of their doctor risk producing a false negative, because their body will stop making the antibodies that indicate a misfire in their immune system.

When people experiencing symptoms indicating a possibility of coeliac disease seek treatment and test negative, they may receive a diagnosis of gluten intolerance or gluten sensitivity. People who don’t show clinical signs of coeliac but experience occasional upset stomach, gas, bloating or diarrhea may have an intolerance to gluten.  Gluten intolerance is defined by a study posted on BMC Medicine as “not accompanied by the concurrence of tTG or autoimmune comorbidities.”

Gluten consumption and symptoms

For people with gluten sensitivity, a flare-up of symptoms can be painful and inconvenient, but symptoms may disappear when the affected person stops eating gluten-containing foods.

In a scientific study conducted in 38 Italian medical facilities, 486 patients with symptoms of gluten sensitivity indicated that their symptoms appeared between one hour and 24 hours after ingesting gluten.

The most common complaint among people who believe they are sensitive to gluten-containing foods is bloating and stomach discomfort. Other specific gastrointestinal symptoms of gluten sensitivity identified in the study include:

  • Diarrhoea
  • Constipation
  • Nausea
  • Discomfort in the upper abdomen
  • Occasional Heartburn

Some symptoms of gluten intolerance identified by people included in the study aren’t digestive-related problems. These systematic symptoms can be more difficult for sufferers to identify and communicate to health practitioners.

  • Feeling sad or blue
  • Foggy mind
  • Fatigue
  • Itchy skin
  • Joint or muscle discomfort

Diagnosing gluten sensitivity or gluten intolerance

While no non-coeliac gluten sensitivity biomarker test is available, there is a standardized procedure that leads to a confirmed diagnosis of gluten sensitivity that’s widely accepted in the medical community.

The Salerno Experts’ Criteria calls for an assessment of the clinical response to a gluten-free diet (2). Using a symptom rating scale of one through ten (one being mild and ten being severe), patients rate their symptoms before and after beginning a gluten-free diet. Clinicians look for a 30% change in symptoms before making a positive diagnosis of non-coeliac gluten sensitivity.

Gluten intolerance relief

Many symptoms can be attributed to gluten intolerance. Many of them have several common causes, however. Experimenting with a gluten-free diet and noting any changes in symptoms is an option that many people choose, to learn more about what’s causing their discomfort.

Many people who believe they suffer from gluten intolerance note that their discomfort is temporary and that symptoms may be inconsistent or worse with certain types of gluten-containing foods. The easiest way to find out if gluten-containing foods cause symptoms of gluten intolerance is to simply stop eating them. (However, as noted above, if you plan to see a doctor to confirm your suspicion that you don’t tolerate gluten well, wait until after any diagnostic tests to change your diet).

If gluten containing food has been consumed and is causing discomfort certain enzymes such as proteases and DPP-IV can be consumed to support the  breakdown of gluten which may result in reduced symptoms overall.

The gluten-free diet isn’t as mysterious as it was even a few years ago. If you decide to embark on a gluten-free diet, be aware that you must make an effort to replace gluten-containing foods with plenty of B vitamins and fibre like beans, fruits and vegetables. It may be beneficial to add a gluten-free supplement that contains B vitamins if you are contemplating a gluten-free diet.

References

  1. Walker M, Ludvigsson J, Sanders D. Coeliac disease: review of diagnosis and management. The medical journal of Australia 2017; 207(4).  https://www.mja.com.au/journal/2017/207/4/coeliac-disease-review-diagnosis-and-management (accessed 4 September 2019).
  2. Catassi C, Elli L, Bonaz B, Bouma G, Carroccio A, Castillejo G et al.. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients 2015; 7(6). https://www.ncbi.nlm.nih.gov/pubmed/26096570 (accessed 4 September 2019).
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