Eight facts about gluten sensitivity.

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Gluten sensitivity is still being researched. Here is a little information about what is known and still unknown about this condition.

 

1.The medically accepted term for what was previously known as gluten intolerance is Non Coeliac Gluten Sensitivity (NCGS).

2. NCGS is characterized by symptoms that usually occur soon after gluten ingestion, disappear with gluten withdrawal and relapse following gluten challenge, within hours or few days (1).

3. Symptoms experienced include a combination of IBS-like symptoms, including abdominal pain, bloating, bowel habit abnormalities (either diarrhoea or constipation), and systemic manifestations such as “foggy mind”, headache, fatigue, joint and muscle pain, leg or arm numbness, dermatitis (eczema or skin rash), depression, and anemia (1).

4. In NCGS there are no coeliac-specific antibodies in response to gluten, and gluten ingestion does not result in the atrophy of the villi (damage to the small intestine lining) like in coeliac disease (1).

5. Diagnosing NCGS. Since there are still no validated tests to diagnose gluten sensitivity, currently the only way to diagnose this condition is by elimination. It is important to keep eating gluten until coeliac disease and wheat allergy are tested for. If these are negative, gluten can be eliminated for a few weeks and then re-introduced to observe the response under a doctor’s guidance.

People with negative coeliac blood tests who also lack clinical evidence of malabsorption (weight loss, diarrhoea, and nutrient deficiencies) and coeliac disese risk factors (including a personal history of other autoimmune diseases and a family history of CD) are highly likely to have NCGS (2).

Some doctors are offering saliva, blood or stool testing. However, these tests have not been validated and are therefore not accepted. Due to the lack of biomarkers or diagnostic measures,  it is difficult to differentiate between gluten sensitivity and conditions that are not gluten related (1).

6. The overall prevalence of NCGS in the general population is still unknown. This is mainly because many people self-diagnose and start a gluten free diet without medical advice or consultation (1). It has been estimated to be six to ten-times more prevalent than that of coeliac disease (CD) (3). However, more research is needed to determine the true prevalence of this condition.

7. It is still unknown if NCGS is permanent or transitory (1).

8. It is also unknown if everybody who has NCGS has the same sensitivity to gluten, and if sensitivity in the individual changes over time (1).

 

References:

1. Carlo, C., Bai, J.C., Bonaz, B.,  Bouma,G., Calabrò, A., Carroccio, A.,….Fasano, A. (2013)Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders. Nutrients. National Center for Biotechnology Information. Web. 07 Apr. 2014.
2. Kabbani, T. A., Vanga, R.R.,Leffler,D.A., Villafuerte Galvez, J.,Pallav,K.,  Hansen, J. … Kelly, C.P. (2014) Celiac Disease or Non-Celiac Gluten Sensitivity? An Approach to Clinical Differential Diagnosis.American Journal of Gatroenterology, Nature.com Web. 07 Apr. 2014.
3. Molina Infante, J., S. Santolaria, M. Montoro, M. Esteve, & M. Fernandez Banares. Non-celiac Gluten Sensitivity: A Critical Review of Current Evidence. (2014) Unbound MEDLINE. N.p., Web. 07 Apr. 2014.

 

 

 

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