Coeliac or Non-Coeliac Sensitivity: That is the question
Wheat or gluten in the diet is often blamed as a cause of a variety of unpleasant digestive symptoms including: abdominal pain, diarrhoea, bloating and excessive wind. Some may also experience other symptoms like lethargy and poor concentration. Feeling better when you remove wheat or gluten for your diet does not necessarily mean that you have coeliac disease.
It’s important to get properly assessed to help exclude any serious medical problems and establish the best course of treatment.
If you have been diagnosed positive for coeliac disease through antibody blood testing, genetic testing or the gold standard biopsy via colonoscopy then it is imperative that you never eat gluten, as you have the inability to process this protein. Many of you may have already discovered that diagnosing coeliac disease is often difficult and inconclusive. Testing for coeliac disease via a blood test or biopsy is only accurate when you are still consuming gluten. So if you’re already on a gluten free diet, returning to a diet containing gluten is necessary to make a diagnosis of coeliac disease. Genetic testing can also be a strong positive, however if you do have the gene, it is not a given that you will develop coeliac disease. The gene often needs to be triggered and this trigger could include: an infection or a eating a high gluten diet. There is a strong genetic predisposition for those with coeliac disease. It affects 1:100 people worldwide and if someone has an immediate relative with coeliac disease, there’s a 1:10 chance their children will have it too. If the gene test is negative, then you will not have coeliac disease, but you are still able to develop non-coeliac sensitivity.
Non-coeliac gluten sensitivity is when people experience digestive discomfort following the ingestion of gluten. However, these symptoms may not be as severe as what someone with coeliac disease may experience, but more importantly – they will not have the genes for coeliac disease.
The mechanisms behind this sensitivity are still not fully understood. Some people may be more prone to intestinal permeability, so their digestive tract is more easily irritated by larger protein molecules, like gluten. They may also find that following the FODMAPs diet unhelpful as they may still be experiencing digestive complaints. This is because the foods in the FODMAPs diet cause osmotic activity (where water crosses out of the cells) and rapid fermentation so you still experience symptoms of bloating and cramping due to the fermentation and diarrhoea, despite being off gluten and following the FODMAPs diet.
Some often find at times that they may be able to even tolerate small amounts of gluten, but having too much will cause digestive upset. It’s all about being aware of what your body can tolerate and this may vary depending on your stress levels and other foods you may also be consuming that can potentially irritate the intestinal tract, such as caffeine, alcohol, artificial sweeteners, etc.
If you feel that the above may be applicable to you, then seeking advice from our naturopaths in clinic may be beneficial.