Knowing something about Gluten Intolerance

Gluten sensitivity

Gluten intolerance is one of the wheat-related disorders. These are symptoms that some people have after they eat foods that contain gluten. Wheat has high gluten content. Barley and rye also contain it.

Researchers often give gluten intolerance the name non-celiac gluten sensitivity. The reaction to eating gluten is not the same as that for people who have celiac disease, even though the symptoms are similar.

Celiac disease happens to people who are genetically at risk, whereas gluten intolerance is not so well understood.

In celiac disease, the body's immune system attacks its own tissues, triggered by gluten in the diet. It only happens in people who have a genetic vulnerability. Scientists have evenidentified certain genes that may be behind celiac disease.

The third wheat-related disorder is wheat allergy. This disorder can produce very serious signs and symptoms.

Some people have gut symptoms when eating foods with ingredients containing gluten, ie wheat, barley and rye, even if they don’t have coeliac disease. This is sometimes called non coeliac gluten sensitivity.

The symptoms of non coeliac gluten sensitivity may be similar to those experienced by many people with coeliac disease, but it is not clear how the immune system might be involved and there does not appear to be damage to the lining of the gut.

What is the difference between the conditions?

Coeliac disease is a well defined, serious illness where the body’s immune system attacks itself when gluten is eaten. This causes damage to the lining of the gut and means that the body cannot properly absorb nutrients from food. Coeliac disease is not a food allergy or intolerance, it is anautoimmune disease.

Wheat allergy is a reaction to proteins found in wheat, triggered by the immune system and usually occurs within seconds or minutes of eating.

Non coeliac gluten sensitivity is when symptoms similar to coeliac disease are experienced, but there are no associated antibodies and no damage to the lining of the gut.

Research into non coeliac gluten sensitivity

Non coeliac gluten sensitivity is something that is being recognised as a problem in many countries across the world. This is a new area and there is a need for more research to understand the condition and who is at risk.
The exact role of the immune system in non coeliac gluten sensitivity is unclear and further research is needed. There are no specific diagnostic tests for non coeliac gluten sensitivity.

Some researchers define non coeliac gluten sensitivity as an improvement in symptoms when following a gluten-free diet. However, it is difficult to rule out the possibility of a placebo effect.

There is also some debate around whether gluten is the cause of the sensitivity or if other components are to blame, which are also removed from the diet when gluten-containing ingredients are removed, such as Fermentable Oligo- Di- Mono-saccharides and Polyols (FODMAPs) and other non-gluten proteins found in wheat.

What should you do if you think you may be non coeliac gluten sensitive?

If you are experiencing symptoms when eating foods that contain wheat, barley, rye or oats and think you have a sensitivity to gluten, it’s important to first rule out coeliac disease.

We do not recommend trying a gluten-free diet as a first option if you are experiencing symptoms related to eating gluten. We recommend continuing to eat gluten and to see your GP as soon as possible to undertake a test for coeliac disease. It’s essential to keep eating gluten in order for the tests to be accurate.

If you have confirmed test results that indicate that you do not have coeliac disease and other causes of your symptoms have been ruled out, you might wish to discuss the possibility of non coeliac gluten sensitivity with your healthcare team.