What is it?
Individuals who experience distress when eating gluten-containing products and show improvement when following a gluten-free diet may have gluten sensitivity, instead of celiac disease. These individuals are unable to tolerate gluten and develop an adverse reaction when eating gluten. Gluten sensitivity has not been well researched, but there is a significant amount of clinical evidence supporting the existence of this condition. In early 2012 gluten sensitivity was classified by an international group of recognized celiac experts as a distinct condition. It is also referred to as Non-Celiac Gluten Sensitivity (NCGS).
Symptoms seen in gluten sensitivity may resemble those that are associated with celiac disease. In gluten sensitivity there is no indication that gluten causes the same type of damage to the intestine as it does in celiac disease.
There are no agreed upon medical tests that can be performed to confirm gluten sensitivity. However, having an antibody reaction to gluten or gliadin is highly suspicious. To diagnose gluten sensitivity, both celiac disease and wheat allergy should be ruled out. Antibody testing and small intestine biopsy would rule out celiac disease. Immune-allergy tests to wheat would also be negative. Finally an elimination diet is most often used to evaluate whether health improves with the elimination or reduction of gluten from the diet. Symptoms improve when gluten is removed from the diet and reappears when it is reintroduced.
FODMAPS is another recently documented syndrome that can mimic the same symptoms. For more information, visit our FODMAPS page.
Although there are currently no scientific studies that support specific treatment of GS, large numbers of people have discovered that avoiding gluten dramatically changes their health. The recommended course of action is to follow a gluten-free diet. It may or may not be possible for some individuals with gluten sensitivity to tolerate a low-gluten diet instead of a gluten-free diet. Consult an expert in gluten sensitivity for dietary guidelines.
Frequently Asked Questions
Will gluten damage my intestines?
If you have an intestinal biopsy or celiac blood testing which shows that you do not have celiac disease then you will not have villous atrophy. This does not guarantee that you are not experiencing some other type of intestinal damage, but this area is poorly understood.
If I have gluten sensitivity now, will I develop celiac disease later?
There is no research that shows whether or not individuals with gluten sensitivity will develop celiac disease. Continue to be checked by your doctor regularly if you continue to eat gluten.
Why does a gluten-free diet work for some persons with autism, multiple sclerosis or chronic fatigue, even when they do not have celiac disease?
It is possible that they have gluten sensitivity. This may be one reason why eliminating gluten from their diets results in improvement of some symptoms.
My doctor says that I have some elevated blood tests but do not have celiac disease. What do I have?
You may have a form of gluten sensitivity. Avoiding gluten may help you to feel better. Talk to your doctor or consider a trial elimination of gluten to determine whether or not gluten is negatively affecting you.
I avoid wheat, but I am still having symptoms. What is wrong with me?
A wheat allergy is different from gluten sensitivity. If your symptoms are due to celiac disease or gluten sensitivity, you need to avoid all gluten-containing foods: wheat, rye and barley, as well as any hybrids or products derived from these grains.
￼￼￼Updated 8/2012. Reviewed for accuracy by Dr. Fasano, a member of the GIG Medical Advisory Board, and Dr. Wangen, a member of the GIG Board of Trustees.