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Broad and learned
clinical background

Gut Reactions #6 – How sensitive are you about gluten?

In recent months there has been increasing media coverage concerning gluten-free diets and gluten sensitivity.

For patients with coeliac disease (CD), a gluten-free diet is essential: their symptoms (and small intestinal abnormalities) improve on a gluten-free diet. CD is diagnosed with a simple test.

Conversely, patients with gluten sensitivity, also known as non-coeliac gluten sensitivity (NCGS), do not have coeliac disease, but their symptoms (including malaise, fatigue, headache, numbness, “brain fog”, anxiety, fibromyalgia-like symptoms and rash) improve on a gluten-free diet. The reasons for this are unclear; this is a new area and there is a need for more research to understand this condition.

Furthermore, some patients with IBS (who have not been diagnosed with coeliac disease) have also experienced relief from their symptoms on gluten-free diet. This has led to speculation that they may have NCGS. However, it is unclear whether the improvement in IBS symptoms in patients with suspected NCGS is related to the specific effects of gluten or the reduction in FODMAPs (associated with a gluten-free diet).

Interestingly, a recent controlled trial of a low FODMAP diet in patients with IBS (without CD) did not show any difference in symptoms when exposed afterwards to low or high gluten containing diets; the patients responded to the low FODMAP diet but did not respond further depending upon the gluten content of that diet.

While it is clear that much is still up for debate, what is agreed upon by researchers and practitioners alike is that if you experience any symptoms of CD, NCGS or IBS, it is important to get tested for CD first so you can exclude this from the equation. If you have any doubt about your diagnosis of CD or IBS then WKG is happy to meet with you to discuss.

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