Gluten intolerance is one of the wheat-related disorders. These are symptoms that some people have after they eat foods that contain gluten. Wheat has high gluten content. Barley and rye also contain it.
Researchers often give gluten intolerance the name non-celiac gluten sensitivity. The reaction to eating gluten is not the same as that for people who have celiac disease, even though the symptoms are similar.
Celiac disease happens to people who are genetically at risk, whereas gluten intolerance is not so well understood.
In celiac disease, the body’s immune system attacks its own tissues, triggered by gluten in the diet. It only happens in people who have a genetic vulnerability. Scientists have even identified certain genes that may be behind celiac disease.
The third wheat-related disorder is wheat allergy. This disorder can produce very serious signs and symptoms.
Symptoms of gluten intolerance
People with gluten intolerance should avoid eating wheat-based foods such as bread.
The most common symptoms of gluten intolerance are, when the diet contains wheat:
- Belly pain
- Feeling unwell, including tiredness
The following are further symptoms that people with gluten intolerance might also experience. They are less common than the symptoms above and include wider symptoms beyond the gut:
- Stomach pain (more specific than belly pain)
- Joint or muscle pain
It is important to get medical advice for these symptoms. If the signs and symptoms turn out to be because of some reason other than gluten intolerance, it may be important to get treatment.
Gut symptoms can be vague. Many conditions affecting the gut show some overlap that can be looked into with the help of doctors.
Diagnosing gluten problems requires the diet to carry on as normal. Diagnosis cannot be made if patients decide to stop eating gluten foods before seeing a doctor.
Severe belly pain is not a symptom of gluten intolerance. Severe pain needs immediate medical attention.
Difference between gluten intolerance and wheat allergy
Wheat allergy is the most serious of the wheat-related disorders. It is similar to other allergies, has serious symptoms, and can be a severe threat.
Gluten intolerance symptoms are not dangerous, whereas wheat allergy symptoms and signs can even be life-threatening.
The symptoms of wheat allergy include:
- Nausea and vomiting
- Mouth or throat irritation
- Rash, hives
- Blocked nose
- Irritated eyes
- Difficulty breathing – people experiencing this should call an ambulance straight away
It is important to get medical advice urgently for suspected wheat allergy. Severe allergic reactions can quickly threaten life.
Vomiting, diarrhea, and swelling that restricts breathing are all very serious symptoms when caused by allergy. Go to a nearby emergency room or call an ambulance.
What triggers gluten intolerance symptoms?
The main gluten food is wheat, though many other foods such as grains, barley, and rye also contain gluten.
Scientists have a good understanding of why signs and symptoms happen to people who have celiac disease or wheat allergy. Why people with gluten intolerance have their gut symptoms is not clear, however.
What is gluten?
Gluten is the name for the proteins that give wheat its unique baking qualities. It determines the ability of wheat dough to absorb water, stick together, and remain viscous and elastic.
Wheat is the main gluten food but many others also contain these proteins. Gluten foods include other grass-related grains, barley, and rye.
Gluten is found in baked foods such as breads and cracker-type biscuits, and in pastas, seasonings, and spices.
While gluten is known to be behind celiac disease, there is debate about whether it is the cause of gluten intolerance. Scientists question whether it is something else about wheat that causes it.
There is even debate about whether “non-celiac gluten sensitivity” should be renamed “non-celiac wheat sensitivity.” Wheat intolerance may perhaps be a better name than gluten intolerance.
Diagnosis of gluten intolerance
Doctors diagnose gluten intolerance by first excluding more serious diseases. Diagnosis begins with an investigation of the symptoms and signs. Doctors take a history of the gut symptoms that could be signaling gluten intolerance.
Doctors will also ask about any wider signs and symptoms. This is in part to help with ruling out other potential problems. Part of the diagnosis is to rule out celiac disease. Doctors seeing gluten intolerance symptoms should always check for celiac disease.
The best advice for people with gluten intolerance is to avoid wheat-based food, though this can be difficult.
Doctors test for celiac disease by:
- Testing the blood for certain antibodies
- Taking a biopsy to confirm celiac disease and tell it apart from gluten intolerance
Diagnostic tests are always done while the person has been eating a gluten-rich diet. Otherwise, no reaction can be found.
If there are no antibodies, the problem is unlikely to be celiac disease. But people with gluten intolerance can sometimes show this test result.
The biopsy gives a clearer answer. A biopsy involves taking a small sample of the lining of the intestine. The lab analysis of the biopsy sample looks for damage to the lining of the intestine. In gluten intolerance, no damage to the lining of the intestine will be found.
When the symptoms match and other problems have been ruled out, gluten intolerance is diagnosed.
Living with gluten intolerance
Living with gluten intolerance means a life similar to that of a person with celiac disease. A gluten-free diet is the treatment.
For celiac disease, the gluten-free diet is more important and is followed strictly.
For gluten intolerance, the best advice is to avoid foods that contain wheat and gluten. This can be difficult because a lot of foods are based on wheat.
There is much help for people who need to avoid gluten. This includes food products in grocery stores being clearly labeled for wheat and gluten content. Nutritionists and dieticians are further sources of help on food planning.
Common foods to avoid because they contain wheat and gluten include:
- Wheat-based biscuits like crackers
It may also help people to manage the condition by keeping a diary that lists foods eaten and symptoms experienced. This can include amounts and times.
Written by Markus MacGill