Gluten Intolerance

Gluten intolerance is a term commonly used to describe symptoms that occur after eating gluten-containing foods.

The medical term non-celiac gluten sensitivity is often used for people who develop symptoms related to eating gluten but do not have celiac disease or a wheat allergy. Researchers are still learning about the causes of non-celiac gluten sensitivity, and there is no single test that can confirm the condition.

Gluten is a protein found naturally in wheat, barley and rye.

Gluten intolerance is different from celiac disease. Celiac disease is an immune condition in which eating gluten damages the lining of the small intestine. Gluten sensitivity does not cause the same intestinal damage.

Gluten intolerance is also different from a wheat allergy, which is an allergic reaction to proteins found in wheat and can cause symptoms such as hives, swelling or difficulty breathing.

Symptoms associated with gluten sensitivity can vary from person to person. They may occur after eating foods containing gluten and may improve when gluten-containing foods are removed from the diet.

Common symptoms include:

• Abdominal pain or discomfort

• Bloating 

• Gas

• Diarrhea

• Constipation

• Nausea 

• Fatigue

• Headaches

• Joint or muscle pain

• Difficulty concentrating, sometimes described as “brain fog” 

• Skin rashes

These symptoms can also occur with many other digestive conditions. Symptoms alone cannot determine whether someone has gluten sensitivity or celiac disease.

There is no single test that can diagnose gluten intolerance or non-celiac gluten sensitivity. Diagnosis typically begins with a gastroenterologist, who reviews your symptoms, medical history, diet and response to different foods.

Because gluten sensitivity and celiac disease can cause similar symptoms, your care team will first determine whether you should be tested for celiac disease.

Your care team may use:

• Blood tests for celiac disease 

• Upper gastrointestinal endoscopy

• Biopsies of the small intestine

• Genetic testing in certain situations

• Tests for other digestive conditions 

• A detailed review of your symptoms and diet

Celiac disease testing is most accurate when you are still eating gluten. Starting a gluten-free diet before testing can affect results and make celiac disease more difficult to diagnose.

Once celiac disease and wheat allergy have been appropriately excluded, your gastroenterologist may consider whether your symptoms are consistent with non-celiac gluten sensitivity.

There is no medication specifically approved to treat non-celiac gluten sensitivity. Treatment focuses on identifying foods that trigger symptoms and developing a diet that helps manage those symptoms while maintaining good nutrition.

Gluten-free diet

Some people with gluten sensitivity feel better when they reduce or avoid foods containing gluten.

A registered dietitian can help you determine whether a gluten-free diet is appropriate and make sure you continue to get enough fiber, vitamins, minerals and other nutrients. 

A gluten-free diet can be restrictive, so it is important to identify whether gluten itself is causing symptoms before making long-term dietary changes.

Other causes of symptoms

Gluten-containing foods also contain other ingredients that may cause digestive symptoms. For some people, symptoms may be related to carbohydrates called FODMAPs rather than gluten itself.

Other conditions, including irritable bowel syndrome, lactose intolerance and other digestive disorders, can cause symptoms similar to gluten sensitivity. 

Your gastroenterologist can help determine whether another condition may be contributing to your symptoms and recommend appropriate testing or treatment.

UC Health offers specialized digestive disease care through a team of gastroenterologists and other specialists who work together to diagnose and manage complex digestive conditions.

Our approach recognizes that symptoms associated with gluten can have many possible causes. By evaluating for celiac disease, wheat allergy and other digestive conditions, our specialists can help determine the most appropriate approach for your symptoms.

If you experience digestive problems or other symptoms after eating foods containing gluten, UC Health's digestive disease specialists can help determine what may be causing your symptoms.

If you have not been tested for celiac disease, talk with your health care provider before starting a gluten-free diet, as avoiding gluten can affect diagnostic testing.

Schedule an appointment to receive an evaluation and learn more about your treatment options.

Call 513-475-7505.