Symptoms
Gluten sensitivity can cause the following intestinal and extraintestinal symptoms: Intestinal symptoms:
- Abdominal pain
- Diarrhea
- Nausea
- Flatulence, bloating
- Weight loss
Extraintestinal symptoms:
- Fatigue, weakness
- Headache
- Muscle and joint pain
- Insensibility in the extremities, muscle contractions.
- Skin rashes: Eczema, redness of the skin
- Neuropsychiatric disorders such as depression, anxiety.
- Anemia
The symptoms occur hours to days after ingestion of gluten-containing foods such as bread. Unlike celiac disease, gluten sensitivity does not cause damage to the intestine.
Causes
The cause of gluten sensitivity is an intolerance to foods containing gluten. The “gluten protein” gluten is a protein mixture found in many grains such as wheat, rye, barley, and spelt. Gluten is an essential component of bread, to which it gives its flavor and texture. However, gluten sensitivity is not celiac disease, in which the immune system triggers an inflammatory reaction in the intestines after ingesting gluten. Gluten sensitivity is also not an IgE-mediated wheat allergy. It is therefore referred to as “non-coeliac gluten sensitivity” (NCGS) or non-celiac gluten sensitivity (Vavricka, 2013). The pathophysiology has not been fully elucidated.
Diagnosis
Diagnosis is made on the basis of patient history, clinical symptoms, physical examination, and with a provocation test. First, laboratory methods are used to rule out celiac disease and wheat allergy. Subsequently, it is tested whether an improvement occurs with a gluten-free diet. The diagnosis can be confirmed with a re-exposure. Irritable bowel syndrome causes very similar symptoms and can occur simultaneously.
Treatment
For treatment, it is recommended to strictly avoid foods containing gluten. Gluten is found in wheat flour, rye flour, barley flour, and hidden in many processed foods. Gluten-free foods are available in grocery and specialty stores.
Criticism
The condition is not yet fully recognized and is the subject of controversy. There is also criticism that many individuals self-diagnose.
