Gluten sensitivity symptoms and diagnosis

gluten-sensitivityGluten sensitivity is condition in which certain individuals experience adverse reactions to eating foods containing gluten, such as wheat. (1)

Health professionals find the problem highly controversial, since 1% or less of the population suffers from celiac disease, a severe form of gluten intolerance classified as an autoimmune and digestive disorder that damages the small intestine. (2)

Many people who don’t have full-blown celiac disease have problems with eating gluten, and a 2013 survey indicates a full third of Americans actively avoid or try to cut back on gluten. (3)

Wheat is the most common source of gluten in the diet, along with other cereal grains like barley, rye, and spelt. Gluten is made up of a family of proteins, the two most prominent of which are gliadin and glutenin.

Researchers believe gliadin is the protein most people have problems with. (4)

The word gluten originated from descriptions of how these proteins affect the texture of foods containing them: adding water to flour causes proteins to cross-link and create a sticky texture much like glue. (5)

This is what holds bread together, as well as allowing it to rise when heated due to trapped gas molecules inside the dough.

Let’s take a look at what gluten sensitivity is, and whether or not you need to be concerned about it.

Gluten sensitivity diagnosis

Recent research has separated and classified a number of disease conditions related to wheat and gluten, the best-known of which is celiac disease. (6)

When celiac patients consume gluten, their immune systems mistake the proteins for invaders and mount an attack; structures of the gut wall are also targeted, and the resulting damage is what makes the issue an autoimmune disorder. (7)

Severe cases are on the rise, and most people who have celiac disease don’t realize it. (8)

Those who suffer from gluten sensitivity don’t experience this autoimmune reaction, but symptoms can be similar, with problems of a digestive nature as well as non-digestive reactions. (9, 10)

A small number of people estimated at less than 1% are actually allergic to wheat, which is a different issue than gluten sensitivity. (11)

A bad reaction or sensitivity to gluten has been associated with a number of diseases and disorders; some of these are cerebral ataxia, schizophrenia, depression, autism, type 1 diabetes and Hashimoto’s thyroiditis. (12, 13, 14, 15, 16, 17)

While the links with these disorders don’t mean that gluten intolerance caused them, it appears that the condition may make symptoms worse, and a diet free of gluten often leads to improvements.

All the recent attention to gluten and gluten sensitivity has led to intense research on the subject, but the mechanism is still not clearly understood; scientists believe the immune system is involved, as well as genetics. (18)

Symptoms

A lab test for gluten sensitivity is not available, and it’s usually diagnosed by ruling out other conditions. Here is a proposed protocol for establishing sensitivities: (19)

  1. When people experience negative symptoms after eating foods containing gluten, they are placed on a gluten-free diet.
  2. If symptoms disappear, gluten is added back into the diet.
  3. If symptoms recur, celiac disease and wheat allergies are ruled out with lab tests.
  4. A blinded gluten challenge test can be used to confirm diagnosis.

Common symptoms of gluten sensitivity include:

  • Chronic fatigue
  • Stomach pain
  • Flatulence and bloating
  • Diarrhea
  • Bone and joint pain
  • Headaches
  • Depression
  • Weight loss
  • Eczema and Erythema (skin conditions, including rashes and redness)

Other mysterious symptoms that may not be directly related to digestion also appear to be linked to gluten intolerance, including various neurological disorders and skin conditions besides those mentioned above. (20)

Good data on how prevalent gluten intolerance is doesn’t exist. While some studies estimate the percentage is likely in the low ranges, such as less than 0.5%, others speculate it could be as high as 6%. (21)

Adults, especially those in middle age, and women in all age groups, appear to suffer from gluten intolerance at higher rates. (22)

A recent trial conducted on gluten sensitivity may shed new light on the subject; 37 people diagnosed with irritable bowel syndrome (IBS) who believed they were gluten intolerant ate a diet low in FODMAPs and given isolated gluten. (23)

FODMAPs are Fermentable Oligo- Di-Mono Saccharides and Polpyols; these short chain carbohydrates cause digestive problems for many people, especially in those with IBS.

When people can’t digest FODMAPs, this matter ends up feeding gut bacteria in the intestines, resulting in bloating, gas and diarrhea. An estimated 14% of Americans are affected by IBS. (24)

Foods containing FODMAPS include legumes, some fruits and vegetables, grains, milk and sugar alcohols like mannitol and xylitol.

In this study, participants followed a diet low in FODMAPs and did not experience digestive disturbances when they took isolated gluten, leading researchers to believe the self-reported gluten sensitivity was actually a reaction to FODMAPs.

The results indicate that gluten may not be the biggest offender when it comes to symptoms suffered by patients with IBS; instead, foods containing FODMAPs may be the main issue.

Researchers concluded that “wheat intolerance” or “wheat sensitivity” may be a more accurate label for the problem in some cases. (25) Avoiding wheat is still the best solution for those with this type of sensitivity.

Other recent studies suggest that modern strains of wheat can be much more aggravating than the ancient varieties, such as Kamut and Einkorn. (26)

Recap

Gluten sensitivity is a complex issue that will continue to be the subject of intense study to find clear answers for the question of intolerance.

Despite the fact that some health professionals are skeptical on the subject, many scientists and doctors, some of whom specialize in gastroenterology, are convinced gluten sensitivity is a valid and growing concern.

If you believe you’re sensitive to gluten, waiting for confirmation from ongoing research is certainly not necessary, but keep the results from the FODMAP study mentioned above in mind. You may want to extend your range of experimentation to check out this possibility.

The nutrients found in wheat are available in other foods; you’ll get the best nutritional value if you avoid processed foods when choosing suitable substitutes for wheat, since these are just junk foods even though they’re gluten-free.

Summary: Gluten sensitivity isn’t a problem for everyone, and if wheat doesn’t cause problems for you, there’s no need to avoid it just because it’s trendy to do so. For anyone with established issues related to wheat consumption, going gluten-free can bring considerable relief and improved health.

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