Understanding The Gluten Intolerance Spectrum

    Published: 06-16-2009
    Views: 9,482
    Living Without Magazine editor Alicia Woodward describes the “gluten spectrum”, from celiac disease to non-celiac gluten sensitivity.

    Alicia Woodward: Hi! I am Alicia Woodward, editor of 'Living Without,' the world's leading magazine for people with food allergies and sensitivities.

    Today I would like to talk with you about the gluten spectrum and non-celiac gluten sensitivity. A recent study lead by the University of Maryland, Center for Celiac Disease Research suggests that genetically susceptible people react to gluten with a spectrum of responses that range from celiac disease, to gluten sensitivity, to wheat allergy.

    The gluten sensitivity was once synonymous for celiac disease, a condition originally known as gluten-sensitive enteropathy, but now celiac disease is seen as separate from non-celiac gluten sensitivity. Gluten sensitivity has been most recently defined as intolerance to gluten that doesn't need the diagnostic criteria of celiac disease, that is symptoms developed upon exposure to gluten, but there is no intestinal damage and celiac screening tests may come up negative.

    Two gluten associated disorders, dermatitis herpetiformis and itchy skin rash, and gluten ataxia, a neurologic disorder that impairs balance and gait are associated with celiac disease. Although many with these conditions show no celiac like intestinal damage, both conditions are result of the same autoimmune mechanism seen in celiac disease.

    Approximately three million people in the US or 1% of the population have celiac disease. About 400,000-600,000 people are allergic to gluten. Although no absolute numbers for non-celiac gluten sensitivity are yet available, one celiac disease expert estimates that up to 20 million Americans may have the disorder.

    The symptoms of celiac disease and non-celiac gluten sensitivity overlap. Like celiac disease, gluten sensitivity is associated with intestinal discomfort, like stomachaches, gas and bloating, diarrhea, in constipation and reflux. In addition, it's related to neurologic symptoms such as headache, mood swings, numbness and tingling in the fingers or toes, muscle cramps, chronic fatigue and weight loss.

    Gluten sensitivity has also been linked to behaviors seen in those with schizophrenia and autism. There are no tests available yet to diagnose gluten sensitivity. Diagnosis is made by conclusively ruling out celiac disease and wheat allergy.

    If symptoms improve on the gluten free diet and return when gluten is reintroduced, the person maybe diagnosed with gluten sensitivity. If you suspect that you or a family member is on the gluten spectrum, talk to your doctor, and remember, you are not alone.