Celiac Disease and Gluten Sensitivity

You have all the symptoms of celiac disease: stomach pain after eating gluten, fatigue, headaches, "brain fog" - but your tests came back negative. What gives? Are you crazy? Is your doctor? Frustrated, you give up and stuff yourself with pizza and beer. It can't hurt, right?

Well, yes and...maybe. Debated about for years, recent research has uncovered a "less severe [than celiac disease] non-specific immune response," according to the National Foundation for Celiac Awareness, called Non-Celiac Gluten Sensitivity (NCGS.) Both conditions are clinically similar, however NCGS does not cause long-term intestinal damage, nor does it seem to be genetic. In his new book, Gluten Freedom, Alessio Fasano, M.D.,world-renowned expert and founder of Massachusetts General Hospital’s Center for Celiac Research, explains the differences between celiac disease, NCGS and wheat allergy. "Celiac disease is not a food allergy. Food allergies, including wheat allergy, are conditions that an individual might outgrow." Celiac disease is an autoimmune disease that never goes away; even with complete avoidance of gluten, sufferers will always have it. NCGS may go away on its own.

Should you be gluten-free?

Celiac disease affects about 1% of the population, or 1 in 133 Americans, while research estimates that 6% of Americans (mostly adults) suffer from Non-Celiac Gluten Sensitivity. Celiac disease can only be diagnosed by blood tests and biopsy. There is no definitive test for NCGS. Sufferers must be sure to first rule out celiac and wheat allergy, then follow an elimination diet and subsequent gluten challenge. Of course, whenever these maladies are suspected, it is important to find a doctor who has experience with gluten issues. This is not the time to self-diagnose.

Dr. Fasano says "Celiac disease is driven by even minimal cross-contamination of gluten. In gluten sensitivity, this is not necessarily so." Some NCGS patients may be able to tolerate a small amount of gluten; their symptoms emerge when they ingest too much wheat, rye or barley. They undoubtedly feel better off gluten, sometimes right away. Most celiac sufferers also begin to feel better soon after quitting gluten but it can take many years for the intestinal damage to heal, and often it never heals completely. Undiagnosed, celiac disease can cause serious long-term problems like osteoporosis, infertility and cancer.

So, is Gluten Sensitivity a fad? Sometimes. But sometimes it is a very real syndrome with very real symptoms. And if gluten causes distresses, by all means, stop ingesting gluten! But remember, it's always better to err on the side of caution and seek out educated medical help.