Celiac Disease and Non-Celiac Gluten Sensitivity: Separating the Wheat from the Chaff
You’ve probably noticed – there’s an explosion of gluten-free foods in the grocery stores and health food markets! So, what exactly is gluten?
Gluten is a protein in wheat, rye and barley. If you’ve been diagnosed with celiac disease, you probably know that there’s only one treatment: a strict gluten-free diet. When people with celiac disease eat foods or use products containing gluten, even in very small amounts, their immune system responds by damaging or destroying villi, the tiny projections lining the small intestine that do most of our nutrient absorption. Left untreated, celiac disease can lead to malnutrition, osteoporosis and certain cancers.
If a person tests negative for CD and wheat allergy, but has CD-like symptoms such as abdominal pain, bloating, or diarrhea that go away on a gluten-free diet, then he or she is said to have Non-Celiac Gluten Sensitivity (NCGS).
It is thought that NCGS is also an immune response to gluten, but less severe than Celiac Disease. Because NCGS doesn’t cause tissue damage, the long-term complications that untreated CD can cause don’t happen. But it certainly can cause discomfort, which a gluten-free diet can cure.
A gluten-free diet doesn’t mean you’ll never enjoy food again – many healthy and delicious foods are naturally gluten-free: all fruits and veggies, all unprocessed meats, fish, and dairy, starches like potato and sweet potato, and many grains, like rice and quinoa. The “silver lining” to CD and NCGS is that those diagnosed with these conditions often end up eating healthier because they no longer eat as many processed foods.
Why are we seeing so much more CD and NCGS in recent years? Part of the reason is that health care providers are looking for it. Some also believe that, with the availability of many more processed foods starting after World War 2, exposure to gluten has increased astronomically. Eating a variety of unprocessed grains, and limiting processed gluten containing products (most junk food, white bread, etc.), is just plain good nutritional sense, and may ultimately help limit immune responses to gluten.
Maryann Ludlow, RD, CD, CDE is a registered dietitian at Fletcher Allen.