Gluten Intolerance Disorders Overview
Gluten intolerance refers to a range of conditions affecting people who have an adverse response to dietary gluten. These four health issues are: celiac disease, non-celiac gluten sensitivity (NCGS), gluten ataxia, and wheat allergy.
Celiac disease is an autoimmune condition that attacks the body’s own healthy tissue in the intestines and throughout the body. This abnormal immune response occurs whenever an individual with CD eats gluten. Over time, the lining of the small intestine becomes damaged and can no longer process nutrients properly.
Symptoms of gluten intolerance associated with CD include:
- Diarrhea, nausea, vomiting, heartburn, acid reflux, constipation, abnormal bowel movements, and stomach pain
- Mood problems such as anxiety, depression, and irritability
- Fatigue, headaches, and poor concentration
- Bone and joint pain, and arthritis from inflammation
- Blistering, itchy skin rash (dermatitis herpetiformis)
- Menstrual and reproductive issues
Vitamin and mineral deficiencies can lead to iron-deficiency anemia, numbness in the extremities, osteoporosis, and many other health problems associated with malnutrition. Genetic screening, antibody blood tests, and biopsy of the small intestine are used to diagnose celiac disease.
Non-Celiac Gluten Sensitivity
This is the most common form of gluten intolerance, and the most difficult to diagnose. It is a generalized immune response to gluten proteins. Gluten intolerance symptoms include all the gastrointestinal discomfort associated with celiac disease along with systemic symptoms such as headache, fatigue, and “foggy brain”. There is no long-term damage to the intestines with this condition. Gluten sensitivity is diagnosed by ruling out other diseases with similar symptoms and by eliminating and reintroducing gluten into the diet to monitor the body’s response.
This is a rare but very serious form of gluten intolerance. Like celiac disease that attacks the gut, gluten ataxia is also an autoimmune response. However, the tissue that is endangered is the cerebellum (the part of the brain that handles motor control). Inflammation and tissue damage from this disease cause symptoms such as loss of balance, poor coordination, and difficulty walking. The damage may be irreversible if the condition is left untreated.
People with wheat intolerance don’t necessarily have true gluten intolerance because there are other proteins in wheat that could potentially cause an adverse reaction. There is no “gluten allergy test” as such. However, traditional allergy testing (skin tests, blood tests, and food challenges) may be used to diagnose wheat allergy. People who are allergic to wheat may not have a bad reaction to other grains such as barley and rye that contain gluten. Wheat intolerance that is really gluten sensitivity will cause similar symptoms for any grain that contains gluten.
The onset of wheat allergy symptoms (nausea, vomiting, diarrhea, itching, watering eyes, etc.) usually occurs more rapidly than the onset of gluten sensitivity symptoms, and a life-threatening reaction is possible. Wheat allergies are most common in children (who usually outgrow this problem by about age three). Gluten sensitivity tends to be a lifelong condition.
Avoiding products that contain gluten is currently the only effective treatment for each form of gluten intolerance.