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Non-Celiac Gluten Sensitivity

Non-Celiac Gluten Sensitivity (NCGS) occurs when a person experiences symptoms similar to celiac disease, but doesn’t actually have celiac disease. NCGS is often defined by what it’s not: It is not an allergic reaction like a wheat allergy and it’s not an autoimmune reaction like celiac disease, either.

Even though people with NCGS don’t have an autoimmune or allergic reaction, they still start to experience symptoms after eating anything with gluten or other wheat proteins in it. Symptoms usually appear soon after eating gluten and disappear when gluten has been removed from the diet.    

Common gluten sensitivity symptoms

The symptoms of NCGS are similar to the digestive issues found with celiac disease or wheat allergy: diarrhea, abdominal pain and bloating. But people with NCGS also tend to have non-digestive symptoms, like:

  • Headache
  • "Mental confusion or a “foggy mind”
  • Fatigue
  • Joint Pain
  • Numbness in the arms or legs1,2

Children with NCGS have typical digestive symptoms, like abdominal pain and chronic diarrhea, but tiredness is also a frequent complaint.3


Common triggers

Gluten isn't found in just wheat - it's in barley, bulgur, rye and seitan, too. And products that are labeled wheat-free aren't necessarily gluten-free: They may contain spelt (a form of wheat), rye or barley-based ingrediants that although wheat-free, are not gluten-free. And although oats don't contain gluten, it is often processed in facilities that also produce gluten-containing grains and can be contaminated, so many people with NGCS avoid oats, too.


Some common foods, drinks, and sauces that could contain gluten and can cause a response include:

  • Pastas
  • Noodles
  • Bread and pastries
  • Baked goods
  • Cereal & granola
  • Breakfast foods like pancakes, waffles, French toast and biscuits
  • Breading & coating mixes
  • Crackers
  • Croutons
  • Soy sauce4,5
  • Sauces & gravies, since many use wheat flour as a thickener
  • Beer and malt beverages
     


Gluten can be hidden in many foods—that’s why it’s important to read the label or ask before buying or eating a food. Some more surprising examples of where you might find gluten include:

  • Energy bars and granola bars 
  • French fries and potato chips
  • Processed lunch meats
  • Candy and candy bars
  • Soups
  • Salad dressings and marinades4,5



     

Gluten can also be found in non-food items like lipstick, lip-gloss and lip balm, herbal or nutritional supplements, drugs and over-the-counter medications, vitamins and supplements, and play-dough.

 

I think I might have non-celiac gluten sensitivity

How do I find out?

If you’ve noticed that eating foods containing gluten causes problems, talk to your healthcare professional about getting tested. Many people are so used to living with—being and embarrassed by—their uncomfortable gastrointestinal issues that they never consider asking for help. But learning what causes your symptoms now may also help you avoid more serious issues in the future.

 

 

A missed or incorrect diagnosis can delay treatment and lead to an increased risk of other serious health complications including:

  • Bone disease, like osteoporosis
  • Reproductive problems, including infertility
  • Some intestinal cancers
  • Inadequate nutrient absorption
  • Delayed growth in children
  • Development of additional autoimmune diseases6

 

Be sure to talk your healthcare professional before trying a gluten-free diet: If you stop or even reduce the amount of gluten you eat before you're tested, it could change your test results and result in misdiagnosis or in a falsely negative test. And since there are no tests to specifically identify NCGS, you will first need to rule out celiac disease, wheat allergy, or any other possible causes of your symptoms.

Knowing can help you get relief

References
  1. Sapone A, Lammers KM, Mazzarella G, et al. Differential mucosal IL-17 expression in two gliadin-induced disorders: Gluten sensitivity and the autoimmune enteropathy celiac disease. Int Arch Allergy Immunol. 2010;152:75-80.
  2. Volta U, Tovoli F, Cicola R, et al. Serological tests in gluten sensitivity (non celiac gluten intolerance) J. Clin. Gastroenterol. 2012;46:680–685.
  3. Mastrototaro L, Castellaneta S, Gentile A, et al. Gluten sensitivity in children: Clinical, serological, genetic and histological description of the first paediatric series. Dig. Liver Dis. 2012;44:S254–S255.
  4. Celiac Disease Foundation. Gluten-free diet guide for celiac disease and non-celiac gluten sensitivity. https://celiac.org/wp/wp-content/uploads/2013/12/quick-start-guide.pdf. Accessed September 2017.
  5. Mulder CJ, van Wanrooij RL, Bakker SF, et al. Gluten-free diet in gluten-related disorders. Digest Dis. 2013;31:57.
  6. Elli L, Branchi F, Tomba C, et al. Diagnosis of Gluten Related Disorders: Celiac Disease, Wheat Allergy and Non-Celiac Gluten Sensitivity. World J Gastroenterol. 2015:7110–7119.