Written by Greg Arnold, DC, CSCS. Gluten sensitivity includes wheat allergy, Crohn’s Disease, and non-celiac gluten sensitivity. Non-celiac gluten sensitivity is hard to determine and food withdrawal and re-introduction seems best at present.
The term ‘Gluten sensitivity’ comprises three different conditions, 2 of which are commonly known (wheat allergy, Crohn’s Disease) but the third which is still being developed (1), called non-celiac gluten sensitivity. This new classification is needed as patients with this condition do not have problems with the celiac region of their digestive system as is seen with those suffering from wheat allergy and Crohn’s Disease (2).
Estimates of non-celiac gluten sensitivity is thought to be as high as 6% but varying definitions of the disease, poorly conducted studies, and the fact that many patients are currently self-diagnosed and start a gluten-free diet without medical advice leave the exact data in question. The “classic” presentation of non-celiac gluten sensitivity includes abdominal pain, bloating, bowel habit abnormalities (diarrhea/constipation) but also “foggy mind”, headache, fatigue, joint and muscle pain, leg or arm numbness, skin rashes, depression, and anemia (3, 4).
Although risk factors have not yet been identified, non-celiac gluten sensitivity seems to be more common in females and in young/middle age adults.
Because no specific blood tests are known to definitively diagnose non-celiac gluten sensitivity, the current best way to suspect the condition is symptom observation with food withdrawal and introduction.
For the researchers, “the role of non-celiac gluten-free sensitivity in conditions affecting the nervous system remains a highly debated and controversial topic that requires additional, well-designed studies to establish the real role of gluten as a triggering factor in these diseases” and that “So far no specific biomarker of non-celiac gluten sensitivity has been identified.”
Source: Catassi, Carlo, Julio C. Bai, Bruno Bonaz, Gerd Bouma, Antonio Calabrò, Antonio Carroccio, Gemma Castillejo et al. “Non-celiac gluten sensitivity: the new frontier of gluten related disorders.” Nutrients 5, no. 10 (2013): 3839-3853.
Posted July 8, 2014.
References:
- Catassi C. Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders. Nutrients 2013 Sep 26;5(10):3839-53. doi: 10.3390/nu5103839.
- Sapone, A.; Bai, J.C.; Ciacci, C.; Dolinsek, J.; Green, P.H.; Hadjivassiliou, M.; Kaukinen, K.; Rostami, K.; Sanders, D.S.; Schumann, M.; et al. Spectrum of gluten-related disorders: Consensus on new nomenclature and classification. BMC Med. 2012; 10:13.
- Sapone, A.; Lammers, K.M.; Mazzarella, G.; Mikhailenko, I.; Cartenì, M.; Casolaro, V.; Fasano, A. Differential mucosal IL-17 expression in two gliadin-induced disorders: Gluten sensitivity and the autoimmune enteropathy celiac disease. Int. Arch. Allergy Immunol. 2010;152:75–80
- Volta, U.; Tovoli, F.; Cicola, R.; Parisi, C.; Fabbri, A.; Piscaglia, M.; Fiorini, E.; Caio, G. Serological tests in gluten sensitivity (non celiac gluten intolerance). J. Clin. Gastroenterol. 2012; 46:680–685
