Non Celiac Gluten Sensitivity

While Celiac Disease represents an immune reaction to gluten in genetically predisposed individuals, Non-Celiac Gluten Sensitivity remains the subject of considerable debate. It appears Non-Celiac Gluten Sensitivity may represent a subset of the Irritable Bowel Syndrome. Rather than being specifically related to gluten, it may represent a collection of disorders all with similar manifestations.

Non-Celiac Gluten Sensitivity may respond to elimination of gluten, however this removes a variety of proteins including gluten, gliaden, amylase trypsin inhibitor and wheat germ agglutinin. Not all people who self-identify as gluten sensitive react to double blind reintroduction of gluten to an otherwise gluten free diet.

Other culprits may be in the starch family most prominent among them the so-called fodmaps. This acronym identifies fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Included in this group are lactose, fructose and a variety of other carbohydrates that escape digestion by the body’s enzymes only to be fermented by intestinal bacteria.

Symptoms of Non-Celiac Gluten Sensitivity include abdominal bloating, excessive upper or lower intestinal gas, abdominal pain, heartburn and altered bowel habits. Extra-intestinal manifestations include headaches, fatigue, inability to concentrate and a “foggy mind.”

Treatment of Non-Celiac Gluten Sensitivity may require more than simply avoiding gluten in wheat, rye and barley.