‘Non-Celiac Gluten Intolerance’: Does it Exist?

When we first added our Gluten Allergies and Celiac Disease section to our site, a Celiac patient we know objected to the heading we use in the Special Diet Information section that appears on every recipe on the site. The label she objected to was "Gluten Sensitivity," under which label we specify whether or not the recipe is gluten-free and if there are any adjustments that should be made to the recipe to make it gluten-free.

She felt that "gluten sensitivity" implied that Celiac is not a serious disorder. While we understood her reasoning (and still do), at the time the jury was still out as to whether there were those whose symptoms, including fatigue and Irritable Bowel Syndrome, were improved on a gluten-free diet. We chose to have the label we used be as inclusive as possible.

Recently a group of researchers in Australia designed a study to test whether those who did not have Celiac Disease - but felt better on a gluten-free diet - would experience symptoms if they consumed gluten without their knowledge (Am J Gastroenterol 2011;106:508-514).

For their study they recruited 34 men and women who definitely did not have Celiac Disease but whose abdominal symptoms had been controlled by following a gluten-free diet for at least the previous six weeks. For the six weeks of the study, half of the participants were given two slices of gluten-free bread and one gluten-free muffin to eat each day. The other half of the participants received the same two slices of gluten-free bread and one muffin, but the researchers had added specific amounts of gluten to their breads and muffins. Neither the researchers nor the participants knew who got the gluten-free breads until the end of the study.

Once per week, all of the participants responded to a survey that evaluated their abdominal symptoms. At the beginning and end of the study, their blood, urine and stools were collected for analysis as well.

So did those who ate gluten without knowing it have their abdominal symptoms return? Nine of the participants had to withdraw from the study early because their symptoms were so intolerable. Six of those were from the group receiving gluten in their breads. Over the course of the whole study, almost 70% of those receiving gluten answered "no" to the question, "Are your symptoms well controlled?"

Interestingly, the results of blood, urine and stool analyses remained the same for both groups at the beginning and end of the study.

What this means for you

This study, though small, is very well designed and certainly supports the idea that there are those who do not have Celiac Disease who react negatively to the presence of wheat gluten in their diet. Unfortunately, we still have no idea why that is.

First posted: March 9, 2011