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 identified certain genes that may be behind celiac disease. However, gluten intolerance is less well understood and scientists are unsure why it occurs.
Here are some key points about gluten intolerance. More detail and supporting information is in the main article.
- Gluten intolerance is a wheat-related disorder.
- Symptoms include bloating and belly pain.
- Diagnostic tests will rule out celiac disease, while treatments focus on dietary adjustments.
Symptoms of gluten intolerance
People with gluten intolerance should avoid eating wheat-based foods such as bread.
Symptoms of gluten intolerance occur after the individual has consumed wheat. The following checklist gives some signs to look out for:
The following are less common symptoms of gluten intolerance:
- stomach pain (more specific than belly pain)
- joint or muscle pain
It is important to get medical advice for these symptoms to rule out other causes. Gut symptoms can be vague and many conditions affecting the gut have overlapping symptoms.
Diagnosing gluten problems requires that the individual continues to eat gluten. Diagnosis cannot be made if the patient decides to stop eating gluten before seeing a doctor.
Severe belly pain is not a symptom of gluten intolerance. Severe pain requires immediate medical attention.
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, including:
- other grass-related grains
Gluten is found in baked foods such as:
- cracker-type biscuits
While gluten is known to be behind celiac disease, there is debate about whether it is the cause of gluten intolerance. Scientists question whether something else, other than gluten in the wheat causes the symptoms.
There is even debate about whether "non-celiac gluten sensitivity" should be renamed "non-celiac wheat sensitivity."
What triggers gluten intolerance symptoms?
Scientists have a good understanding of why symptoms appear in people who have celiac disease or wheat allergies. However, why people with gluten intolerance have symptoms is not yet clear.
Gluten intolerance versus wheat allergy
The main food that contains gluten is wheat, though many other foods such as grains, barley, and rye also contain the protein.
An important difference between gluten intolerance and wheat allergy is that the symptoms of gluten intolerance are not dangerous, whereas a wheat allergy can potentially 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 immediately
It is important to get medical advice urgently for a suspected wheat allergy as severe allergic reactions can quickly threaten life.
Diagnosis of gluten intolerance
The best advice for people with gluten intolerance is to avoid wheat-based food, though this can be difficult.
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 signal gluten intolerance.
Doctors will also ask about any wider signs and symptoms. This is to help rule out other potential problems, such as celiac disease.
Doctors test for celiac disease by:
- Testing the blood for certain antibodies - if there are no antibodies, the problem is unlikely to be celiac disease.
- Taking a biopsy - this 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. If there is damage, it is more likely to be celiac disease.
Diagnostic tests are always done while the person continues to eat gluten in their diet; otherwise, no reaction can 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 following a gluten-free diet. This can be difficult because many foods are based on wheat.
Today, food products in grocery stores are clearly labeled for wheat and gluten content, which makes avoiding gluten easier than it was a decade ago. Nutritionists and dieticians can also help plan diets.
Common foods that contain wheat and gluten include:
- wheat-based biscuits like crackers
- some seasonings and spices
It may also help people to manage the condition by keeping a diary that lists foods eaten and any symptoms that occur.