More people are adopting a gluten-free diet these days in hopes that it will make them look and feel better. Others eliminate gluten from their diet believing they’re gluten-sensitive after experiencing symptoms like bloating, fatigue, headaches or diarrhea when they eat products that contain gluten. Many of these people are self-diagnosed with gluten sensitivity based on the fact they feel better when they don’t eat foods with gluten and never really know whether they have it or not. Gluten-sensitivity is surprisingly common. Estimates are that 7% or more of the population is sensitive, compared to about 1% of people with diagnosed celiac disease. Unfortunately, a significant number of cases of celiac disease go undiagnosed. Is there a test you can take to tell you whether you’re sensitive to gluten?
Gluten-Sensitivity versus Celiac Disease
There is a test for celiac disease, an inflammatory disease where the body produces antibodies against gluten. This leads to intestinal inflammation and can cause a wide range of other symptoms outside the intestinal tract. In fact, almost every part of the body can be affected by celiac disease. In people with celiac disease, even tiny amounts of gluten can trigger intestinal inflammation. That’s why it’s important to avoid all gluten exposure if you have it. Long-term intestinal inflammation increases the risk for intestinal lymphoma, a type of malignancy that can be fatal.
Celiac disease can be diagnosed by blood tests that detect specific antibodies that are often elevated in people with celiac disease, although the test isn’t completely reliable. It can be falsely negative, especially for people in the early stages who don’t have significant intestinal damage. Some doctors order an intestinal biopsy to look for intestinal inflammation and damage.
There’s another group of people who have some of the symptoms of celiac disease like bloating, diarrhea or abdominal discomfort when they eat foods containing gluten, but they don’t have elevated antibody levels when tested. These people fall into the category of gluten-sensitivity, which is an underdiagnosed problem. Some people diagnosed with irritable bowel may actually have a sensitivity to gluten and could be helped by eliminating gluten from their diet. Unlike celiac disease that can damage the lining of the intestine, prevent absorption of nutrients and affect other tissues in the body, gluten-sensitivity doesn’t cause severe intestinal damage or nutritional deficiencies –and it doesn’t increase the risk of intestinal lymphoma.
Unfortunately, there is no blood test or other tests to confirm that you have gluten-sensitivity that isn’t celiac disease. The only way to know whether you’re sensitive to gluten is to try a gluten-free diet and see if the symptoms improve. This involves eliminating all sources of gluten from your diet for three or four weeks and recording your symptoms in a journal. If the symptoms are better on a gluten-free diet, it’s best to keep gluten out of your diet long-term.
Following a Gluten-Free Diet is Challenging
The reason why you should do a three or four-week test diet to see if you’re sensitive to gluten is that going completely gluten-free is challenging and not really necessary if you don’t need it. Gluten is found in a number of foods other than wheat, barley, and rye. Processed foods often have “hidden” gluten. Emulsifiers, modified food starch, malt, flavorings and food colorings in foods can be sources. It’s not uncommon to find gluten in soup mixes, soy sauce, condiments, salad dressings, beverage mixes, some dairy products, and candy. Going completely gluten-free requires lots of commitment and time spent scrutinizing labels – and it’s not cheap. If you buy gluten-free packaged foods, it could put a strain on your budget.
The Bottom Line?
Unlike celiac disease where there are blood tests available, there’s no diagnostic test for gluten sensitivity. The best way to know whether you’ll benefit from a gluten-free diet is to try it and see if your symptoms improve. If you don’t feel better, there is really no benefit to completely eliminating gluten from your diet.
Gluten-Free Society. “Neurological Disease Common in Patients with Celiac Disease”
Celiac Disease Foundation