What is Gluten Sensitivity, Is It Real?!

​Do you or have you ever suffered with gut pain, bloating and abdominal pain, nausea, gastroesophageal reflux disease? Even symptoms including joint/muscle involvement, headache, anxiety, foggy mind, skin rash, dermatitis, fatigue and weakness and even numbness --- These are the most frequently reported symptoms stemming from a possibly common issue. This is an important article that could make the world of difference to you if you do have these things!
 
Over the past two decades, the incidence of diseases believed to be induced by the ingestion of wheat and related gluten-containing cereals, including rye and barley, has increased (1). Non-coeliac gluten/wheat sensitivity (NCG/WS) is a syndrome characterized by intestinal and extra-intestinal symptoms occurring a few hours or days after the ingestion of gluten and wheat proteins in patients testing negative for coeliac disease and wheat allergy (2).
It has been established that other foods can cross-react with gluten. Antigens from other foods cross-react with various wheat antigens (3). If a subgroup of patients on a gluten-free diet does not show improvement in their GI or other symptoms, attention should be given to dairy and other cross-reactive foods, such as yeast, corn, oats, millet and rice, as shown in a recent study (3). The study also commented that some oat varieties contain avenin, which cross-reacts with wheat, barley, and rye. What this means in simple language is that foods can potentially act like other foods that you may not have suspected.
Patients who complain of symptoms following bread and pasta ingestion should not eliminate gluten and wheat, but they should correctly undergo the diagnostic work-up to rule out Coeliac Disease (CD) and Wheat allergy (WA) (2). A self-diagnosis of gluten / wheat intolerance must be avoided since, once the elimination diet is begun, it is very difficult to reintroduce wheat to study the patient. Treatment with gluten / wheat withdrawal should be started only when there is a clear evidence that the patient can be affected by NCG/WS (2).
The first step of the diagnostic work-up for NCWS is based on the symptom assessment (scored from 1 as very mild to 10 as very severe) at baseline (when patients are still on a gluten/wheat-containing diet) and weekly for 6 weeks on gluten-free diet (GFD) by using the modified GSRS questionnaire. This is a Gastrointestinal Symptom Rating Scale (GSRS) integrated with extraintestinal manifestations. A GFD-dependent symptom decrease of greater than 30% compared with baseline in at least three symptoms is regarded as a criterion to suspect NCWS (2).
Since NCGS at this time is a poorly defined condition with highly subjective symptoms, a common clinical approach of eliminating suspected symptom-inducing foods followed by clinician-supervised re-challenge with close symptom monitoring has been advocated. In the most up to date literature/evidence This may prove superior to other methods due to its ease of administration and being more informative (4).
 
If this resonated with you and you would like more information……
Come mon and see one of our Drs of Chiropractic and Kinesiology at Sprouting Health
 

1. Leonard MM, Sapone A, Catassi C, et al. Celiac disease and nonceliac glutensensitivity: a review. JAMA 2017;318:647–56.
2. Volta U, Caio G, Karunaratne TB, Alaedini A, De Giorgio R. Non-coeliac gluten/wheat sensitivity: advances in knowledge and relevant questions. Expert review of gastroenterology & hepatology. 2017 Jan 2;11(1):9-18.
3. Vojdani A, Tarash I. Cross-reaction between gliadin and different food and tissue antigens. Food and Nutrition Sciences. 2013 Jan 10;4(01):20.
4. Priyanka P, Gayam S, Kupec JT. The Role of a Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet in Nonceliac Gluten Sensitivity. Gastroenterology research and practice. 2018;2018.