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Non-Coeliac Gluten Sensitivity

Gluten in the diet is often blamed for a range of symptoms including abdominal pain, bloating, loose stools, lethargy, behavioural changes, headaches, general muscle and joint aches. Symptoms improve in some patients when gluten is removed from their diet.

There is an increasing trend to put these symptoms down to gluten, but this may not necessarily be the case. It is important to be checked out by your GP to exclude other important conditions, rather than continuing on a permanent gluten free diet speculatively. This is particularly the case with children, where unnecessary food restrictions should be avoided as much as possible. Other conditions may be the cause of the symptoms, these include irritable bowel syndrome, wheat intolerance and malabsorption of fermentable sugars (FODMAPs). Sometimes, improvement in symptoms can be coincidental.

Non-coeliac gluten sensitivity (NCGS) describes a set of symptoms that people think is caused by gluten. Removing gluten seems to help these patients. The cause and treatment of this condition is not well understood. There are also no specific blood tests that help to diagnose this condition. This makes it frustrating for all concerned. Non-coeliac gluten sensitivity is different to coeliac disease which is associated with positive coeliac antibodies on blood testing. Coeliac disease also requires a positive small bowel biopsy. Patients with non-coeliac gluten sensitivity will have normal coeliac antibody tests. Also, if a small bowel biopsy is undertaken it will show normal results. It is also not associated with other diseases such as diabetes and thyroid disease which are known to be associated with coeliac disease.

More research is required into NGCS, to help those patients who seem to respond to gluten removal, but do not have coeliac disease.

Key points:

Seek proper medical advice beforehand. Screen for coeliac disease through your GP, before trialling a gluten free diet, as the correct result for coeliac disease will not be shown if you are already on a gluten free diet.

Improvement in symptoms by trialling a gluten free diet may not be due to the gluten. Other conditions also need to be considered such as irritable bowel syndrome (IBS), wheat intolerance, and malabsorption of fermentable sugars (FODMAPs). For more information on Irritable Bowel and FODMAPs see the Members Area of our site.