Summarised by Centrist
A new review of decades of research suggests most people who believe they are sensitive to gluten may be reacting to irritable bowel syndrome rather than gluten itself.
The analysis found that people reporting non-celiac gluten sensitivity reacted no differently to gluten, wheat, or a placebo. As co-author Jessica Biesiekierski put it, “That told us something else, not gluten, was driving symptoms.”
Unlike celiac disease, non-celiac gluten sensitivity has no biomarker and is often self-diagnosed. Fewer than 3 percent of self-reported cases are confirmed by objective testing. When proper testing is done, only about 30 percent of people who think they have gluten sensitivity actually fit the definition.
And most of them, up to 80 percent, also have IBS, which shows the two conditions overlap a lot.
Researchers noted that many patients reacted even when gluten was not given, and that nervous system sensitivity and psychological factors may influence symptoms. The authors wrote, “Whether non-celiac gluten sensitivity represents a discrete condition or a subset of patients with IBS and specific dietary triggers remains unclear.”
Gluten-free diets carry risks of their own. Dr Biesiekierski said gluten-free products are “lower in fibre, folate and minerals” and can lead to nutritional deficiencies. Long-term restriction can also disrupt gut bacteria and increase anxiety around eating.
The review comes as gluten-free products grow rapidly despite celiac disease affecting only 2 percent of the population. Researchers said the first step for anyone concerned is testing for celiac disease and wheat allergy. After that, a supervised diet may help identify specific triggers.
