People who are sensitive to gluten experience symptoms when they consume gluten. Gluten is a protein found in wheat, rye and barley. These symptoms may include:
- Digestive problems
- rashes or other skin problems
- brain fog
- joint pain
Getting a gluten sensitivity diagnosis isn’t always easy. There is evidence that non-celiac gluten sensitivity is a real condition, But many healthcare providers don’t believe it. Doctors also disagree on how to test for this condition or how to interpret the test.
Celiac disease testing recommended by most doctors first If you think you have a reaction to gluten. However, if your test results are negative, the next step may be to look for gluten sensitivity.
This article looks at gluten sensitivity and its diagnosis.
Test for gluten sensitivity at home
You can buy at-home kits that test for various food sensitivities, including gluten. These kits test fecal or finger prick blood samples.
Unfortunately, the testing methods used by these kits have not been proven effective. They may not be able to reliably identify food allergies, food intolerances, or gluten sensitivity.
Everlywell is a test kit that was cast in the TV series Shark Tank. The test looks for an antibody called IgG. However, IgG antibodies are not a good indicator of food intolerance. Many people without these conditions will test positive with these kits. This can lead people to limit healthy foods even when they are not really needed.
The EnteroLab Gluten Sensitivity Test is another kit you can use at home. This test looks for gluten antibodies in stool samples. However, its testing protocol has not been validated by external studies.
EnteroLab kits are produced by gastroenterologist Kenneth Fine. Fine has been criticized by the medical community for failing to publish his research and results. For this reason, few doctors accept EnteroLab test results as evidence of gluten sensitivity.
Be wary of home test kits for gluten sensitivity. They often give false positive results and do not use approved testing methods.
Gluten Sensitivity Labs and Testing
abdominal cavity Disease must be ruled out before gluten sensitivity can be diagnosed. Doctors usually start with a set of abdominal blood tests. These tests look for certain antibodies. There is some evidence that two of these tests can also detect non-celiac gluten sensitivity:
However, about half of those with gluten sensitivity test negative. This means that these two tests are not very useful for finding gluten sensitivity. There is currently no specific blood test for gluten sensitivity.
How to Diagnose Celiac Disease
Gluten Free Diet and Gluten Challenge
The best ways to diagnose gluten sensitivity are questionnaires and gluten challenges. This is usually used for research, but can also be used for diagnosis.
gluten free diet
Some people try a gluten-free diet first. This should be done under the supervision of a nutritionist.
First, eat a normal gluten diet for at least six weeks. Assess your symptoms weekly. Then follow a strict gluten-free diet for at least the next six weeks. Again, assess your symptoms weekly. You may be sensitive to gluten if your one to three major symptoms have decreased by more than 30% in at least three of the six weeks.
The next step is to see your healthcare provider for gluten challenges. This may be a single blind test. This means you won’t know if you’ve gotten gluten, but your healthcare provider will.
During the gluten challenge, you will take 8 grams of gluten or a placebo daily for one week. Placebo does not contain any gluten or other potential allergens. Gluten or placebo is usually ingested in food such as muffins, bars or bread. Other foods you eat during the week should be gluten-free. You will record your symptoms on a questionnaire.
The second part of the challenge begins after a one-week waiting period. This time you will get the opposite result from the first week. For example, if you are taking gluten for the first time, this time you will take a placebo.
If your symptoms change by at least 30% from one week to another, it may indicate gluten sensitivity. If not, you may want to look at other possible causes of your symptoms.
Since there are no blood tests for gluten sensitivity, doctors use dietary and gluten challenges to help diagnose the condition. In both cases, you will consume gluten under controlled conditions and record your symptoms.
exclude other conditions
You can only be diagnosed with a gluten allergy if other conditions are ruled out. These include:
- Celiac disease
- food allergies, especially wheat allergies
All three conditions are treated with a gluten-free or wheat-free diet. However, they have some important differences.
Celiac disease is an inherited autoimmune disease. This condition can cause your immune system to mistake normal parts of your body for invaders. Celiac disease damages the lining of the small intestine, which can lead to poor nutrient absorption.
Celiac disease has many symptoms. It can be diagnosed with blood tests and small bowel endoscopy/biopsy. A long tube with a camera on the end allows your healthcare provider to see the inside of your digestive system during an endoscopy. For a biopsy, a small amount of tissue is removed and sent to a laboratory for analysis. These tests can be done if your doctor suspects celiac disease. They cannot be used to detect gluten sensitivity.
A wheat allergy is an immune response to the proteins in wheat. When you have this disease, your body’s immune system sees these proteins as invaders. Symptoms may include:
- swollen lips and throat
- allergic reactions, in extreme cases
Allergic reactions to wheat occur very quickly. Symptoms usually appear within minutes to hours.
People with a wheat allergy can still eat non-wheat sources of gluten. An exception is whether they also have celiac disease or non-celiac gluten sensitivity. Children may no longer be allergic to wheat, but in adults, it usually persists for life.
non-celiac gluten sensitivity
This condition does not have the same characteristics as celiac disease or a wheat allergy. The patient’s small intestine was not damaged. Symptoms also develop slowly for two days or more after exposure to gluten. This contrasts with the rapidly developing symptoms of wheat allergy.
There are some links between gluten sensitivity and irritable bowel syndrome. That’s why it’s important to talk to your doctor if you think you’re having a reaction to gluten.
Do you have irritable bowel syndrome, celiac disease or gluten sensitivity?
Conditions like celiac disease and wheat allergy need to be ruled out before you can be diagnosed with gluten sensitivity.
People with gluten sensitivity can experience symptoms after consuming the protein found in wheat, rye, and barley. Unfortunately, there are no good tests available to diagnose this condition.
Consult your doctor if you suspect you have a gluten sensitivity. The best way to get a diagnosis is to try a gluten-free diet or take a gluten challenge. First, your doctor will want to rule out other causes, such as celiac disease and wheat allergy.
Gluten sensitivity testing is still in its infancy. Today, diagnosis is based on ruling out other conditions, gluten challenges, and response to a gluten-free diet. Without reliable home tests, blood tests can only rule out celiac disease and other conditions.
Hopefully better and more accurate tests will be developed in the future. First, researchers need to agree on criteria for the condition.
Non-celiac gluten sensitivity treatment options