Gluten Sensitivity Real but Rare

Is gluten sensitivity a real condition or a consumer-driven fad fueled by the food industry? Skeptics point to the fact that there is no test to diagnosis gluten sensitivity except for an elimination diet. They add that people are using gluten-free for weight loss and other vague reasons.

Although these statements are true, that does not mean the condition does not exist. It is interesting that an elimination diet has been called “the gold standard for diagnosing food allergies” yet its relevance is dismissed by some when used to identify gluten sensitivity.

Experts such as Dr. Alessio Fasano, Director of the Mass General Center for Celiac Research and Treatment, estimate an incidence of gluten sensitivity of up to 7 percent of the population. The causes are under study, but hypotheses include intestinal inflammation, changes in the gut microbiota, and high-gluten wheat.

A panel of celiac disease experts published consensus opinions last year in BMC Medicine. They proposed a diagnosis of gluten sensitivity in cases of gluten reaction where allergic and autoimmune causes have been ruled out.

Symptoms of gluten sensitivity may include abdominal pain, rashes, headache, foggy brain, fatigue, diarrhea, depression, anemia and joint pain. As in celiac disease, the treatment is elimination of gluten. Gluten is found in wheat, rye, barley and foods containing these grains.

Two small but scientifically rigorous studies have been published supporting the diagnosis of gluten sensitivity. The gluten-free diet is difficult, so the reward, feeling good, would have to be significant for someone to pass on bread.

For anyone suffering a combination of vague and bothersome gluten-related symptoms, the first stop is the doctor. Starting a gluten-free diet before being tested for celiac disease could prevent a correct diagnosis. If celiac and allergy are ruled out, discuss gluten sensitivity with your physician and ask for a referral to a registered dietitian for guidance. For more, visit celiactcentral.org.

Sheah Rarback is a registered dietitian on the faculty of the University of Miami Leonard M. Miller School of Medicine.

Celiac Disease/Gluten Intolerance, Food Allergies Intolerances/Sensitivities