Gluten is a big source of health problems for people who have celiac disease – a disease where the small intestine is very sensitive to gluten. It’s becoming common for people who haven’t been diagnosed with celiac disease to eliminate gluten from their diet because it makes them feel better.
Many people wonder if going gluten-free is just another diet trend. The answer is no. There are people who have celiac disease and can’t eat it; people who have no problem eating it; and people who fall in the middle and can eat it but are sensitive to it.
Gluten sensitivity is a reaction to gluten that doesn’t show up in celiac disease tests, even though it’s a real thing. Scientists from around the world are working on a new classification system for gluten related illnesses that’ll include celiac disease, wheat allergy, and non-celiac gluten sensitivity (NCGS).
Gluten is a protein found in wheat and a few other grains like rye and barley. People who have celiac disease, about 1 in 100 people in the U.S., have an immune reaction to gluten when they eat it.
The immune reaction triggers an attack on their small intestine. These attacks can damage the body’s villi, finger-like projections that line the intestine and help digest and absorb nutrients into the body.
Diagnosing celiac disease starts with taking a medical history and blood tests for antibodies to gluten. Sometimes a biopsy of tissue from the small intestine is done to confirm the diagnosis. But neither test will show NCGS, unfortunately.
Roughly 1 in 20 people have symptoms of gluten sensitivity. The symptoms can be similar to those of celiac disease, or can be vaguer and show up outside of the gut, like:
There’s also a special case for people with irritable bowel syndrome (IBS). They are four times as likely to have celiac disease, and about 40 percent of them have problems with gluten that improve when they go on a gluten-free diet.
The cause of gluten sensitivity isn’t well understood, but it’s something people often inherit. It may also be caused by environmental factors like physical trauma or emotional stress; viral, bacterial, or fungal infection; or surgery or pregnancy.
Scientists don’t know exactly why there’s a growing problem with gluten intolerance, but they have several theories:
Whether you need to limit gluten in your diet, or you want to, it’s a good idea to do some research to help you understand it. At the end of this article are several resources you can check out. You should also consider talking to your doctor or consulting a dietitian.
It’s best to do lab work to rule out celiac disease before eliminating gluten; once gluten has been eliminated, the celiac test won’t be reliable.
Here are good basic starters for limiting gluten:
It’s important you do something about celiac disease and gluten sensitivity because they can result in malnutrition. Over time there can be serious medical consequences, including anemia, infertility, bone loss, psychological or neurological conditions, and even cancer.
Currently the only treatment for celiac disease is life-long avoidance of gluten.
 Sapone et al.: Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine 2012 10:13