If you’ve ruled out celiac disease but eliminating gluten from your diet seems to alleviate your symptoms, you may have gluten sensitivity. Gluten sensitivity, also referred to as non-celiac gluten sensitivity (NCGS) or non-celiac wheat sensitivity (NCWS), is a condition when ingesting gluten leads to intestinal or other reactions.
If excluding gluten from your diet relieves symptoms, and eating gluten causes symptoms to return, you could be diagnosed with gluten sensitivity simply through a process of elimination.
What causes gluten sensitivity?
Little is still known about gluten sensitivity even though it was identified over 40 years ago. Experts are mixed in terms of their thoughts on the definition of the condition, its actual causes, and how to more definitively diagnose it.
Someone with NCGS is reactive to gluten from wheat, barley, and rye. Some experts don’t agree that gluten is the cause of the reactions, at least in some individuals. Some hypothesize that other components of wheat may be causing reactions, such as fructans, a type of carbohydrate and one type of “FODMAP” (Fermentable Oligo-, Di-, Monosaccharides and Polyols). FODMAPs are types of short chain carbohydrates found in a broad range of foods.
Wheat contains fructans, but so do some foods that do not contain gluten such as onion and watermelon. Going on a gluten-free diet that eliminates wheat could reduce fructan intake and, if fructans are the issue, relieve symptoms.
Is there a test for gluten sensitivity?
Gluten sensitivity is currently diagnosed by ruling out celiac disease and wheat allergy (as well as other conditions.) There are no tests or biomarkers to identify NCGS. A biomarker is something present in the body (blood or tissues) that is a sign of a status, condition, or disease in the body. Researchers have yet to identify a NCGS biomarker, but if they did, it would help physicians accurately diagnose the condition.
While genetic testing can be helpful to rule out celiac disease, a negative result for celiac disease does not rule out gluten sensitivity.
Note: If you think you may have gluten sensitivity, it is important to have testing done before giving up gluten. Ruling out celiac disease is a first step in testing for NCGS, and this testing may not be accurate if you are already on a gluten-free diet.
What we know about gluten sensitivity
- Gluten sensitivity is not an autoimmune disorder like celiac disease.
- Emerging research indicates possible immune system involvement (not autoimmune).
- Gluten sensitivity may manifest symptoms that are like those caused by celiac disease.
- Gluten sensitivity does not result in intestinal damage, characteristic of celiac disease, but may cause intestinal inflammation.
- A strict gluten-free diet alleviates the symptoms of true gluten sensitivity.
- There is currently no test for gluten sensitivity.
What we still don’t know
- How to clearly diagnose NCGS.
- Whether or not you need to remain on a gluten-free diet for life.
- Whether or not fructans – or other components of wheat, barley and rye along with, or other than, gluten – cause reactions, at least in some individuals.
