Non Celiac Gluten Sensitivity
A growing body of evidence suggests that up to eight times as many people suffer from non-celiac gluten sensitivity than classic celiac disease. Despite the apparently common nature of this form of gluten intolerance, it is diagnosed with far less frequency than actual celiac disease.
In a letter published within a 2004 issue of Practical Neurology, researchers Marios Hadjivassiliou and Richard Grünewald assert that the classic gastrointestinal symptoms of celiac disease, termed gluten sensitive enteropathy, are only one manifestation of gluten sensitivity. In line with this reasoning, the pair conclude that dermatologists, neurologists and family physicians should use anti-gliadin antibody screening as a first line of diagnostic testing for patients showing atypical signs of gluten intolerance.
Intestinal biopsy, considered the gold standard for celiac testing, will often be negative for these patients. However, with or without digestive symptoms, many patients with neurological, behavioral and dermatological symptoms show elevated levels of anti-gliadin antibodies and find symptom relief with a gluten-free diet.
Non-Celiac Digestive Symptoms
The symptoms most commonly associated with celiac disease, such as diarrhea, gas, bloating and other digestive upsets, can sometimes occur without causing intestinal damage. These patients will usually not show elevated anti-gliadin antibodies or characteristically damaged villi, and as a result may be advised that their symptoms are not related to gluten sensitivity. Despite a negative diagnosis, however, many patients with this form of sensitivity still find relief on a gluten-free elimination diet.
Dermatitis Herpetiformis
Dermatitis herpetiformis is a skin condition characterized by intensely itchy bumps and blisters, usually occurring at the scalp, knees, elbows, back and buttocks of affected individuals.
Also known as Duhring's disease, dermatitis herpetiformis was the first non-celiac form of gluten sensitivity commonly recognized by the medical community. In 1966, an article published in The Lancet (2:1280-1282) noted that a group of patients with this characteristic itchy, blistering rash exhibited small intestinal changes that mirrored the established signs of celiac disease, even though the patients had no gastrointestinal symptoms.
Remarkably, these dermatological symptoms cleared with adherence to a gluten-free diet, and doctors realized that symptoms of gluten intolerance were not necessarily restricted to the digestive system. In spite of this, other symptoms of non-celiac gluten sensitivity remain controversial.
Neurological Conditions
The effect of gluten on neurological function remains a controversial subject among doctors and scientists, but mounting evidence supports the notion that gluten sensitivity triggers a number of behavioral, emotional and motor conditions. Among them:
- Gluten Ataxia: A neurological condition characterized by involuntary jerky movements, ataxia can have a number of causes. Most of these causes currently have no identified treatment. Diagnosis of gluten ataxia offers hope of an effective, drug-free therapy for patients who formerly had no recourse for treatment.
- Migraine Headaches: It is commonly accepted that migraine headaches often have dietary triggers. Coffee, cheese and chocolate have long been identified as possible culprits, but gluten sensitivity is a relatively new association.
- Attention Deficit Hyperactivity Disorder (ADHD): Some evidence suggests that there may be a link between attention-related learning disorders and gluten sensitivity.
- Depression: Many autoimmune diseases are linked with emotional symptoms, and gluten intolerance is no exception. There is some evidence that patients experience improvement in the physiological markers of depression and related conditions when adhering to a gluten-free diet. When patients have both gluten intolerance and other autoimmune conditions, such as type I diabetes, the connection appears to be even more significant.
- Autism:The connection between autism and gluten intolerance is highly controversial, but both anecdotal and scientific evidence are growing in support of the link.
Each of these conditions is undoubtedly complex with varied etiologies, however a gluten-free diet represents a low-risk therapy patients can implement independently as one facet of a comprehensive treatment plan.
Other Non Celiac Gluten Sensitivity Symptoms
As time goes on, specialists are explaining a number of formerly mysterious conditions with gluten sensitivity. Patients diagnosed with such diverse conditions as lupus (Annals of the Rheumatic Diseases 63:11,) Lou Gehrig`s disease, and schizophrenia have shown remarkable recoveries when placed on gluten-free diets.
Does this mean adherence to a gluten free diet is a cure-all? Not necessarily. It does, however, indicate that the interactions between diet and health are far more complex and individual than previously recognized. If you are coping with a condition you feel might be related to gluten sensitivity, there is no harm in requesting an anti-gliadin antibody blood test, or following an elimination diet. Removing gluten from your menu is a natural, drug-free way to take charge of your health with very few risks and potentially significant benefits.
Related Topics
