Non-coeliac gluten sensitivity

Non-coeliac gluten sensitivity (NCGS) is the most recent term for a person who experiences adverse reactions when consuming gluten but who do not have coeliac disease. Unlike coeliac disease, which is fairly well understood now, NCGS is only just beginning to be recognized by the wider medical community. As it stands, there is still little scientific research to support the diagnosis.

The symptoms of non-coeliac gluten sensitivity

The symptoms of non-coeliac gluten sensitivity are recognized as being similar to those of coeliac disease. These include;

  • Abdominal pain
  • Diarrhea
  • Bloating
  • Wind

The difference between coeliac disease and NCGS is in the bodies immune response. The symptoms of non-coeliac gluten sensitivity are evident only as a response to the ingestion of gluten, for example, wind or bloating. Whereas, a person with coeliac disease will experience symptoms as well as having an autoimmune response. In a person with the coeliac disease, the autoimmune system will recognize gluten as a foreign, dangerous body. The problem is that while trying to destroy gluten the body is actually producing antibodies that destroy the villi that line the small intestine.

The latest research for NCGS

In Australia, the medical and scientific community is still researching NCGS. The most current study drew the conclusion that a low FODMAP diet actually reduced the symptoms of NCGS. The low FODMAP diet was developed as a treatment for irritable bowel syndrome (IBS).

In saying this the low FODMAP diet is also largely wheat, rye, and barley free diet, but the study was also giving the participant’s gluten tablets (low, high or placebo). The study had a low FODMAP run-in the period before the tablets were introduced and symptoms remained improved even after the gluten tablet trial. These results were in contrast to a study done in 2011 that was only measuring the effects of gluten tablets on those who had self-diagnosed NGCS, on a normal gluten-free diet. Therefore the conclusion was drawn that a low FODMAP diet can substantially reduce and perhaps alleviate the symptoms of NCGS. More definitive research is still required to further understand NCGS.

Treating NCGS

If you are experiencing symptoms that you think might be NCGS here is a course of action for you to take.

  • Visit your GP and have a blood test (coeliac serology) to ensure you don’t have the elevated antibodies that are suggestive of the coeliac disease. If you do, you will have to follow the proper diagnosis for coeliac disease.
  • If your blood test is negative and your doctor cannot find any other health-related issues that might cause your gluten sensitivity to ask to be referred to a dietitian.
  • Work with a dietitian to start a low FODMAP diet, reassess the results after time. If you are still not feeling better the dietitian will work with you further to try and deduce what is causing you discomfort. This might involve an elimination diet, just warning you, it isn’t fun…

Key points

There are some key reasons why the gluten-free diet isn’t always the right answer to dietary symptoms;

  • Self-prescribed gluten-free diets can mean the coeliac disease is never detected, leading to health implications in the future. If you must change your diet do so with the guidance of a dietitian.
  • The improvements seen on a gluten-free diet might not be representative of the actual issue.
  • low FODMAP diet is the first step in dealing with gastrointestinal issues.
  • A gluten-free diet over time can be lacking in some of the major nutrients the body needs, so it isn’t prescribed unless it is medically required.
  • NCGS isn’t fully understood yet. More research and studies are required to learn more.