Micah Stanley
Gluten sensitivity has long been thought of as something of a conceit. Those affected have just read that gluten is unhealthy. And when they then ate foods containing gluten, they showed relevant symptoms – not because gluten is actually harmful, of course, but only because people firmly believed it.
Scientifically proven: gluten sensitivity
Those who cannot tolerate gluten have celiac disease. But if you don’t have celiac disease, you have to tolerate gluten – that’s roughly the opinion of conventional medicine so far. So-called gluten sensitivity, where you develop symptoms after eating gluten without having celiac disease, was viewed as an esoteric construct, something that was not taken seriously and only mildly smiled at.
It is true that since the 1970s there have been reports of patients who reacted to gluten, even though they did not have celiac disease. But the phenomenon was not given a name, so it was simply ignored.
However, it now has its own name: non-celiac gluten sensitivity or non-celiac gluten sensitivity – NCGS for short.
The symptoms of non-celiac gluten sensitivity
The NCGS is inconsistent, i.e. with very unspecific, individual symptoms. On the one hand, these include digestive problems:
- Diarrhea
- constipation
- nausea
- gas
- a stomach ache
On the other hand, there can also be completely different, sometimes very unspecific symptoms, such as B.
- malaise
- anxiety states
- Foggy head
- headache
- fatigue
- Chronic states of exhaustion up to
- fibromyalgia
- Frequent respiratory infections
- Sinus infections (incl. nasal polyps)
Diagnosing gluten sensitivity: anything but easy
The symptoms of celiac disease are very similar, with the difference that celiac disease can be clearly diagnosed, but NCGS cannot. In celiac disease, specific damage to the lining of the small intestine is seen (biopsy) and certain antibodies can be detected in the blood.
If someone reacts to gluten with the symptoms described, but without showing the diagnostic features typical of celiac disease, then NCGS is the obvious choice. NCGS is therefore mainly diagnosed by ruling out celiac disease with almost identical symptoms.
Gluten Sensitivity: No longer imagination
So it’s almost understandable that conventional medicine doesn’t really believe in the existence of gluten sensitivity (also called gluten intolerance) due to the vague situation and categorizes it as “It’s all just imagination!” packed.
From there, however, it can now be officially removed again, because in recent years scientists have repeatedly provided proof that gluten sensitivity independent of celiac disease exists and thus also proof that all those affected are by no means imaginary sick people, but suffer from very real ailments.
Scientific studies prove the existence of gluten sensitivity
As early as 2011, Biesiekierski et al. reported in the American Journal of Gastroenterology on their double-blind study in which they were able to observe NCGS in people diagnosed with IBS.
In 2012, Carroccio et al. showed that about 30 percent of all patients with digestive problems reacted with symptoms when challenged with wheat. The authors of the study thus spoke of NCWS patients, i.e. of wheat sensitivity.
In 2015, Di Sabatino et al. found in a double-blind crossover study that 20 percent of gastrointestinal patients definitely responded to gluten without having celiac disease.
The GLUTOX study
The Italian so-called GLUTOX study, the results of which were presented in the specialist journal Nutrients in 2016, is very current. This research was carried out in 15 different ambulatory health centers in Italy over a period of one year (from autumn 2013 to autumn 2014). 140 adults who suffered from chronic gastrointestinal complaints were involved.
- 40 had a diagnosis of irritable bowel with diarrhea,
- 14 an irritable bowel with constipation diagnosis,
- 20 suffered from irritable bowel syndrome with alternating symptoms (sometimes diarrhea, sometimes constipation),
- 12 had chronic stomach problems with symptoms mainly after eating,
- 10 suffered from upper abdominal pain and burning (epigastric pain syndrome) and
- 41 had other undiagnosed gastrointestinal complaints.
Strikingly, the symptoms always occurred particularly when those affected had eaten something that contained gluten. Celiac disease, chronic inflammatory bowel diseases (ulcerative colitis, Crohn’s disease, etc.), mental disorders, systemic autoimmune diseases and a wheat allergy could be ruled out.
Gluten-free diet: 75 percent of patients experience an improvement
The investigation was carried out in two phases. Phase 1 looked at how those involved reacted to a three-week gluten-free diet. 75 percent experienced an improvement with the gluten-free diet. No side effects of this diet were observed.
In phase 2, those who had improved on the gluten-free diet continued on a strict gluten-free diet. In addition, they were given 7 capsules a day for 7 days containing either gluten or a placebo – 4 with lunch and 3 with dinner. The amount of gluten in the capsules (5.6 g) corresponded to the amount of gluten in 80 g of pasta.
They then took a 7-day break without capsules before swapping the gluten and placebo groups. Now those who had previously received the gluten capsules received the placebo capsules and vice versa. Phase 2 lasted a total of three weeks.
The doctors performing the treatment knew just as little as the patients, which capsules were the gluten capsules and which were the placebo capsules. Only the capsule supplier knew.
Of the 101 patients who responded so well to the gluten-free diet, only 98 entered Phase 2. The 3 dropouts were so happy about the improvement in their symptoms that they feared suffering a relapse due to the gluten they had to eat in phase 2, which they wanted to avoid at all costs.
Other grain substances that can lead to gluten sensitivity
A third of the remaining patients could be divided into two groups after phase 2. Half could actually have succumbed to a so-called nocebo effect, so the gluten sensitivity seemed only to be imagined. On the other hand, these patients could also react to other cereal substances with symptoms. After all, wheat and other cereals not only contain gluten as a substance to which people with intolerances can react.
Cereals also contain the so-called ATIs (amylase trypsin inhibitors), which can also be the cause of gluten-independent gluten sensitivity. The so-called FODMAPs can also lead to digestive problems after eating the corresponding foods. Fodmap is the abbreviation for “fermentable oligo-, di- and monosaccharides and polyols”.
These are multiple sugars, double sugars and simple sugars as well as certain alcohols (polyols). These substances are known to occur in many foods, but especially in grain products. So if you avoid foods containing gluten, you automatically reduce the amount of FODMAP in your diet. And his complaints – if they are FODMAPs-related – will decrease.
If you are gluten-sensitive: a gluten-free diet is worth a try!
However, the other half (14 percent of the original 101 patients) could be diagnosed as clearly gluten-sensitive. They did worse when they ate gluten (even if they didn’t know if they had gluten in the capsules or a placebo) and far better when they went gluten-free. They suffered from a celiac disease-independent gluten sensitivity.
So anyone who suffers from chronic gastrointestinal complaints, is sent home with an irritable bowel diagnosis and is only treated purely symptomatically, often only gets prescribed antidepressants, should simply live gluten-free for a few weeks.
There is a good chance that the symptoms will improve significantly or even disappear completely.
